chapter 16

Angiotensin II

increases blood pressure by stimulating kidneys to reabsorb more water and by releasing aldosterone raise BP, from the adrenal cortex reaboptioin kidney increase blood volume and BP.

Thrombocytopenia

low platelet count

The release of ADH will cause what to happen to water?

normal serum osmolity, increases circulating blood volume, impoves cardiac output, maintains blood pressre (BP)

the client's PaCO2 has been between 56 and 64 mm Hg for several months. Why should the nurse be cautious administering oxygen?

respitory acidosis Using oxygen may result in the client developing carbon dioxide narcosis and hypoxemia.

osmoreceptors in hypothalamus

speciallized neurons that sense the concentration of substances in blood.

acids

substance that releases hydrogen ions when dissolved into water (fluid)

third spacing

the accumulation and sequestration of trapped extracellular fluid in an actual or potential body space as a result of disease or injury

passive diffusion

the movement an area of higher concentration to lower concentration

A nurse in the ICU is planning the care of a client who is being treated for shock. What statement best describes the pathophysiology of this client's health problem?

Cells lack an adequate blood supply and are deprived of oxygen and nutrients.

Baroreceptors

Cells that are sensitive to blood pressure changes.

Fluid Volume Excess (FVE)

Distended neck veins Crackles in the lung fields Shortness of breath

accompany respiratory acidosis.

Headache, blurry vision, abdominal pain, and diarrhea may

renin-angiotensin-aldosterone system

a hormone cascade pathway that helps regulate blood pressure and blood volume.

Hypercalcemia

are malignancies and hyperparathyroidism. Anorexia, nausea, vomiting, and constipation are common symptoms of hypercalcemia muscle weakness, lack of coordination, abdominal pain, confusion, absent tendon reflexes, shallow respirations, emergency!

metabolic alkalosis primary

increased paco2

Crystalloid fluids

- fluids clear as particles are dissolved in the solution, solutions can be electrolytes, glucose, or combinations of both, may be administered through peripheral vein or central vein (PICC; CVC, implantable port) - 3 types: isotonic, hypotonic, hypertonic

The intensive care nurse caring for a client in shock is planning assessments and interventions related to the client's nutritional needs. What physiologic process contributes to these increased nutritional needs?

The release of catecholamines that creates an increase in metabolic rate and caloric requirements

Dehydration

volume body fluid is significantly reduced in both extracellular and intracellular compartmentsA serious reduction in the body's water content

healthy infant should have what percentage of interstitial body fluid?

25%

Serum Osmolality

280-300 mOsm/kg cpmcemtration of substance in blood

Maintaining fluid balance, especially in older adults, can be a challenge. While hypovolemia is to be avoided, there is also an accompanying danger for blood clots and urinary stones. What condition contributes to the possible development of these life-threatening events?

Hemoconcentration, a high ratio of blood components in relation to watery plasma, increases the potential for blood clots and urinary stones and compromises the kidney's ability to excrete nitrogen wastes.

A nurse is caring for a client in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat:

Hyperkalemia is a common complication of acute renal failure. It's life-threatening if immediate action isn't taken to reverse it. Administering glucose and regular insulin, with sodium bicarbonate if necessary, can temporarily prevent cardiac arrest by moving potassium into the cells and temporarily reducing serum potassium levels

risk factors for fluid and electrolyte imbalances, which assessment finding is the highest priority for the nurse to follow up?

Irregular heart rate

treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis?

Light-headedness or paresthesia may complain of light-headedness or paresthesia (numbness and tingling in the arms and legs).

Cancer is the second leading cause of death in the United States, second only to heart disease. Half of all men and one third of all women will develop cancer during their lifetimes. Which types of cancer have the highest prevalence among both men and women?

Lung and colon

A significant side effect of this medication is thrombocytopenia. What symptom would the nurse assess for in a patient at risk for thrombocytopenia?

Nose bleed

1,600 mg of sodium daily?

One beef cube and 8 oz of tomato juice

Osmosis and osmolality

Osmosis is the movement of fluid from a region of low solute concentration to a region of high solute concentration across a semipermeable membrane.

A client with a diagnosis of gastric cancer has been unable to tolerate oral food and fluid intake and her tumor location rules out the use of enteral feeding. What intervention will best meet this client's nutritional needs?

Parenteral nutrition given via a peripherally inserted central catheter

Which electrolyte is a major cations?

Potassium, sodium, and calcium.

The Risks and What You Can Do About Them. Participants will receive information, but the major focus will be screening for relevant cancers. This program is an example of what type of health promotion activity?

Secondary prevention involves screening and early detection activities that seek to identify early stage cancer in individuals who lack signs and symptoms suggestive of cancer.

A medical nurse educator is reviewing a client's recent episode of metabolic acidosis with members of the nursing staff. What should the educator describe about the role of the kidneys in metabolic acidosis?

The kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance.

electolytes

are substance that carry an electrical charge when dissolved in fluid

base

are substances that relase hydrogen into fluids

facilitated diffusion

assisted transport of particles across membrane to the other (no energy input)

Hypovolemia

decreased blood volume low volume extracellular fluid lethargic, depressed , dementia difficulty swallowing

Osmosis

diffusion of water (movement of water though a semipermeable membrane- one that allows some but not all substances in a slolution to pass though from diluted area to a more concentrated area)

active transport(ATP)

drives molecules across a membrane from a region of lower concentration to a region of higher concentration

Hemoconcentation

high ratio of blood components in relation to watery plasma

Natriutetic peptides

hormone like substance acts in opposition to renin angiotensin aldosterone system.

A nurse is caring for a client in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat:

hyperkalemia.

receiving large volumes of crystalloid fluid to treat hypovolemic shock. In light of this intervention, for what sign or symptom should the nurse monitor?

hypothermia

Filtration

A process that separates materials based on the size of their particles. (promotes the movemtn of fluid and some dissoled substance though a semipermeable membreane accofring to pressure diffrences)

The measurable chemical levels disclose how well the body is (or is not) functioning. Which of these chemical substances release hydrogen into fluid?

Acids are substances that release hydrogen into fluid.

renal function

BUN because it does not vary with protein intake and metabolic state.

What is the consequence of the release of catecholamines in the skeletal muscles during the compensation stage of shock?

Blood supply to the skeletal muscles increases.

The nurse should assess for the onset of acute kidney injury by referring to what laboratory findings? Select all that apply.

Blood urea nitrogen (BUN) level Urine specific gravity Creatinine level

The nurse is caring for a client being treated with isotonic IV fluid for hypernatremia. What complication of hypernatremia should the nurse continuously monitor for?

Cerebral edema

Which electrolyte is a major anion in body fluid?

Chloride

hydrochlorothiazide. What nursing action will best reduce the client's risk for electrolyte disturbances?

Ensure the client has sufficient potassium intake.

The ICU nurse is caring for a client with sepsis whose tissue perfusion is declining. What sign would indicate to the nurse that end-organ damage may be occurring?

Heart and respiratory rates are elevated

Hypokalemia causes what?

fatigue, weakness, anorexia, nausea, vomiting, cardiac dysrhythmias, leg cramps, muscle weakness, and paresthesias