Dr. Coleman Whiteboard Notes Week 1

An increased Hct level is most often associated with _______

dehydration

A patients labs show BUN 32 and Hct 49%. Which condition does the nurse suspect ?

dehydration

Which electrolyte is most at risk for depletion when takin furosemide?

Potassium (K+)

Thiazide diuretics primarily promote the excretion of ________

sodium and water

increase CVP indicates _______

overload

decreased CVP indicates _______

deficit

which system provides respiratory compensation for acid-base imbalances

lungs

diarrhea causes loss of ________

bicarbonate

SIADH involves _______ ADH

too much

Excess ADH leads to __________

fluid overload

diabetes inspidus = too little ______ = fluid ________ = increased thirst.

DI= too little ADH = fluid loss

no shift

0.9% NS, LR

isotonic

goes INTO cells

0.45 NaCl 0.225 NaCl

Hypotonic

goes OUT of cells

D5NS, D5LR, 3%, 5% NaCl

Hypertonic

Labs:

Na

Ca

K+

Mg

Cl

PO4

BUN

Cr

Hct

WBC

Labs:

Na 136-145

Ca 9-10.5

K+ 3.5-5

Mg 1.3-2.1

Cl 98-106

PO4 3-4.5

BUN 10-20

Cr 0.6-1.2

Hct 38-45

WBC 5000-10000

water goes to ______

salt

Which 2 lab results point to issues of the heart

Magnesium and potassium

An elevated BUN level most commonly indicates _____

Dehydration and impaired kidney fx

Creatinine is primarily used to assess _______

kidney fx

concentration of particles

osmolality

A serum osmolality less <275 indicates ________

water excess (over hydration )

A serum osmolality of >295 indicates _______

water deficit (dehydration )

define specific gravity

compares urine density to water

an increased urine specific gravity most commonly indicates _________

dehydration

an decreased urine specific gravity most commonly indicates _________

fluid overload

A patients urine specific gracity is 1.030. How would you interpret this finding?

patient is dehydrated

Generic name for Lasix

Furosemide

Lasix is classified as what type of diuretic?

loop diuretic

Avoid giving furosemide (lasix) to patients with ________ becasuse

altered kidney fx because it depletes potassium

Hydrochlorothiazide is classified as a _______

thiazide diuretic

Hydrochlorothiazide brand name is _________

hydrodiuril

which type of diuretic prevent potassium loss?

potassium sparing diuretics (Aldactone)

A pH > 7.45 indicates

Alkalosis

PaCo2 above 45 causes the blood to become _______

acidic

HCO3 below 22 causes ______

acidosis

Which ABG value controls acidity directly?

pH

Which ABG value reflect respiratory ?

PaCO2

Which ABG value reflect metabolic fx ?

HCO3

A bicarbonate level of 30 mEq/L indicates ______

metabolic alkalosis

Emergent circumstances require: IV or PO

IV

Based on these S&S, what is this patient experiencing?

Weight loss

Thirst

concenrated urine

low urine volume

dry skin

sunken eyeballs

sunken or depressed fontanels

hypotension

decreased cardiac output

tachypnea

low grade fever

mental status change

acute weight loss

Fluid volume deficit

Name the condition:

Dry mucous membranes, hypotension, tachycardia, poor skin turgor

FVD

Based on these S&S, what is this patient experiencing?

Peripheral edema

high CVP

pulmonary edema

acute rapid wight gain

altered urine output/concentration

distended neck veins (JVD)

crackles

tachycardia

shortness of breath

wheezign

Fluid volume Excess

Name the condition:

Edema, crackles, bounding pulse, hypertension

FVE

The body maintains fluid balance through the kidneys, hormones and _________

thirst mechanism

Which organ plays the largest role in fluid regulations ?

Kidneys

Which hormone increases water reabsorption by the kidneys?

ADH

Bounding pulse is most associated with _______

FVE

thready pulses are most often associated with _________

FVD

When fluid volume decreases, the body compensates by increasing HR and _______

vasoconstriction.

which system provides metabolic compensation for acid-base imbalances

GI

slow breathing =

Retain CO2

Rapid breathing =

blow off CO2

retaining CO2 makes the blood more ______

acidic

blowing off CO2 makes the blood more _______

alkaline

vomiting causes loss of ________ from the body

Acids, hydrogen, potassium, NaCl

What hormone directly controls water reabsorption in the kidneys

ADH

too much ADH = fluid overload = ___________

hyponatremia

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