Fundamentals...Nursing Sciences

Diuretics, excessive vomiting, gastrointestinal suctioning, hyperaldosteronism, ingestion/or infusion of excess sodium bicarb, massive transfusion of whole blood are all causes of

Metabolic alkalosis

Hypercalemia signs and symptoms

Muscle weakness, diminished or absent deep tendon reflexes, disorientation, lethargy, coma

In calculation intake....1 oz =_______mL

30

Triamterene is a ____________-retaining diuretic.

potassium

A client with heart failure has been started on intravenous medication therapy with inamrinone. The nurse determines which finding, if noted in the client, is an adverse effect of the medication?

Hypotension

The IV catheter used for a blood transfusion should be at least ______ or ______ gauge.

18 or 20

Packed red blood cells are a blood product used to replace erythrocytes; infusion time for 1 unit is usually between

2 and 4 hours

_______________ solutions such as 0.45% normal saline are inappropriate for the client with cerebral edema because they have the potential to cause cellular swelling and cerebral edema.

Hypotonic solutions

A continuous infusion should not infuse for more than _____ hours.

24

During an allen test, if pinknesss fails to return within ______ seconds, the ulnar artery is insufficient, indicating that the radial arter should not be used for obtaining a blood specimen; another site needs to be selected

6 to 7 seconds

The nurse has a new prescription to administer verapamil (Calan) by the intravenous (IV) route. In administering this medication, the most important nursing action should be to use what item to monitor the client's response to the medication?

A Cardiac Monitor

Hypokalemia Symptoms

A SIC WALT Alkalosis Shallow Respirations Irritability Confusion and Drowsiness Weakness and Fatigue Arrithymias Lethargy Thready Pulse

A client with a calcium imbalance is at risk for this...

A pathological fracture; so move he client carefully and slowly; assist the client with ambulation.

A client with heart failure usually is not given this type of solution

A solution containing saline

Measures to relieve thirst include:

Chewing gum or sucking hard candy, freezing fluids, adding lemon juice to water, gargling with refrigerated mouth wash

The nurse in the hospital emergency department is caring for a client with suspected opioid overdose and is preparing to administer naloxone hydrochloride (Narcan) via the intravenous route. Which indicates that the nurse has accurate knowledge of the administration of this medication?

After the initial dose, prepares to administer additional intravenous doses of naloxone hydrochloride in increments at 2- to 5-minute intervals

The nurse is told by a health care provider that a client in hypovolemic shock will require plasma expansion. The nurse anticipates receiving a prescription to transfuse which product?

Albumin

You should add extension tubing to the IV tubing set for...

Children, clients who are restless or clients who have special mobility needs

ST Depression Shallow, flat, or inverted T wave Prominent U wave

Hypokalemia

When inserting an intravenous line into a clients vein, the nurse would continue to advance the catheter when

Blood return shows in the backflash chamber of the catheter

The nurse is administering lidocaine hydrochloride by the intravenous route. Which finding would indicate to the nurse that the client is experiencing toxicity?

Blurred vision and nausea

A client has a closed head injury with increased intracranial pressure (ICP). The increased ICP is being managed by mannitol (Osmitrol) 25 g by the intravenous (IV) route every 2 hours. The nurse is planning to administer this medication via IV pump and plans to administer this medication in what manner?

By giving it slowly over 30 to 90 minutes

Phosphorus has an inverse relationship with

Calcium

Tall T waves Depressed ST segment

Hypomagnesium

The nurse has a prescription to give amiodarone (Cordarone) intravenously to a client. During administration of this medication, the nurse should monitor which option as the priority?

Cardiac Rhythm

Lactated Ringer's solutions contain potassium and should not be administered to these types of clients

Clients with acute kidney injury or chronic kidney disease

IV calcium is administered slowly and diluted with this; NEVER NS

D5W

A client with diabetes mellitus usually does not receive this type of solution

Dextrose

Postassium is never administered by IV push, intramuscular or subcutaneous route; it is always...

Diluted and administered using an infusion device

Peripheral Intravenous Sites to Avoid

Edematous extremity, an arm that is weak, traumatized or paralyzed, the arm on the same side as a mastectomy, an arm that has an arteriovenous fistula or shunt for dialysis, a skin area that is infected

Before a patient is given fat emulsions (lipids) this allergy should be assessed

Egg Allergy

When receiving TPN blood glucose should be checked

Every 4 to 6 hours

Shortened ST segment Widened T wave

Hypercalcemia

Tall peaked T waves Flat P waves Widened QRS complex Prolonged PR interval

Hyperkalemia

Prolonged PR interval Widened QRS complexes

Hypermagnesium

A positive Trousseau's and Chvostek's sign indicates...

Hypocalcemia

Proloned ST segment Prolonged QT interval

Hypocalcemia

_____________ solutions include 5% dextrose in water (D5W), 0.9% saline (NS), and 5% dextrose in 0.225% saline

Isotonic

What should be done if a PN solution is found and it is cloudy or darkened?

It should be returned to the pharmacy

NO P Equals NO

K; if the client is not urinating; do not administer potassium

Hyperkalemia will ...

MURDER!!!! Muscle twitching, Cramping Urine (Oliguria/Anuria) Respiratory Depression Decreased Cardiac Contractility ECG Changes Reflexes

Diabetes mellitus, DKA, excessive ingestion of aspirin, high fat diet, insufficient metabolism of carbs, malnutrition, renal insufficency and severe diarrhea, the use of an ileostomy are all causes of

Metabolic Acidoisis

The nurse is caring for a client with acute pulmonary edema. The health care provider (HCP) tells the nurse that medication will be prescribed to help reduce preload and afterload. The nurse anticipates that the HCP will prescribe which medication?

Nitroprusside sodium

A client in shock is receiving dopamine hydrochloride by intravenous (IV) infusion. The nurse should have which medication available for local injection if IV infiltration and medication extravasation occur?

Phentolamine

A client receiving total parenteral nutrition (TPN) is demonstrating signs and symptoms of an air embolism. What is the first action by the nurse?

Place the client on the left side in Trendelenburg's position.

A client admitted with hypertensive crisis has an intravenous (IV) infusion of 1000 mL of normal saline with 20 mEq of potassium chloride added. A prescription is written to administer sodium nitroprusside by continuous IV infusion. The nurse should plan to do which to administer this medication?

Protect the sodium nitroprusside from light with an opaque material.

Hypocalcemia signs and symptoms

Remeber!!! Low Milk!!! Cats will be mad! Cramps Anxiety and irritability Tetany and twitches Seizures

Magnesium should not be administered to clients in

Renal failure

If the client has a condition that causes an obstruction of the airway or depresses the respiratory system, monitor the client for this..... Causes include: Asthma, atelectstatis, brain trauma, bronchitis, central nervous system depressants, hypoventilation, pneumonia, pulmonary edema

Respiratory acidosis

If the client has a condition that causes over-stimulation of the respiratory system; monitor the client for this.... Causes include: fever, hyperventilation, hypoxia, hysteria, overventilation by mechanical vents, pain

Respiratory alkalosis

The emergency department nurse is preparing to administer fomepizole (Antizol) to a client suspected of having ethylene glycol (antifreeze) intoxication. The nurse obtains the vial of medication and notes that the medication has solidified. Which action should the nurse take?

Run the vial under warm water

During a circulatory overload during the infusion, always do this first

Slow the infusion

Sodium Food

THink of the perfect sandwhich.... One with white or whole bread with butter, canned meat (processed) and frankfurters, bacon, cheese and spread with mustard, ketchup, soy suace and salt.

Potassium Food

Think PORTS ABC Potatoes,Pork, Oranges, Raisons, Tomatoes, Strawberries, Spinach, Apricots, Bananas, Beans, Cantelope, Carrots, Fish, Mushrooms

Foods with Calcium

Think!!! Collard With Milk? Really? So Slack! Collards, Milk, Yogurt, Tofu, Cheese Sardine, Spinach

Hyponatremia Symptoms

Think.......I Can't Increased ICP Convulsions, Confusion, Cramping A Headache Nausea and Diarrhea (Hyperactive Bowel Sounds) Tired

Hypernatremia Symptoms

Think...Fried Salt Fever Restlessness Increased BP Edema Decreased Urine=Dry Mouth Skin Flushed Agitated Low Fever Thirsty; twitching

For central line insertion, tubing change, and line removal, the client should be placed in this position and instructed to do this

Trendelenburg, Valsalva

A client being admitted to the coronary care unit from the emergency department has a stat prescription to receive a dose of procainamide. The nurse interprets that the client has which condition if this medication is needed?

Ventricular ectopy

The fluid of choice for a client with excess fluid volume is

a hypertonic solution of 5% dextrose in 0.9% normal saline.

The universal red blood cell donor and recipient

donor=o negative/ recipient=AB positive

A solution of 0.45% sodium chloride is ______________

hypotonic

When drawing blood from a double-lumen central venous catheter, the ________ port is used because it is usually the port with the largest lumen. For blood cultures, the _______ specimen is used for the sample, and the line is not ________ beforehand. Turning off the infusion for _____ minute prevents contaminating the sample with IV solution.

proximal, initial, flushed, one

Fomepizole (Antizol) is a medication that is used to treat known or suspected ethylene glycol (antifreeze) intoxication. It is administered via

the IV route.Diluting the medication in 100 mL of 0.9% normal saline and administering over 30 minutes