NRS233 EXAM 3

What electroyltes impact cardiac function?

K+ and Mg+

What is TBW?

Total Body Weight is the percentage of body weight that consists of water

Where is the majority of body fluid in?

intracellular (within cell)

What is extracellualr fluid?

fluid outside the cell (interstital, intravasular, or tanscellular)

what is interstital fluid?

fluid btw cells and blood vessels

What is intravascular fluid?

blood plasma

transcellular fluid examples

cerebrospinal fluid

plueral fluid

synovial fluid

what electrolyes are in high concentration of the ICF?

Na, Cl, HCO3-

what electrolyes are in high concentration of the ECF?

K, Mg, phospahte

what is a solvent?

liquid

what are solutes?

are substances dissolved in a solvent

Which solute (Crystalloidal or Colloidal) dissolves easily?

crystaolloids dissolve easily and colloids do not

What is osmosis?

is the movement of water across cell membrane

what is osmotic pressure?

is the force created when two solutions of different concentration are sparated by a selectively permeable membrane

what excerts osmotic pressure? what direction does it pull?

fluid in the compartments excert the pressure

it is an inward pulling pressure

what controlls osmotic pressure in the intravascular space?

the presne of plasma proteints (albumin)

what is the tonicity of a isotonic solution? what movment occurs?

has the same tonicity as blood

there is no movment so cell does not change shape

what is the tonicity of a hypotonic solution? what movment occurs?

fluid is more dilute than blood

fluid moves into the cell causing the cell the swell

what is the tonicity of a hypertonic solution? what movment occurs?

fluid is more concentrated than the blood

fluid moves out of the cell causing the cell to shrivel

What is filtration?

the process by which fluid and solutes move togather from an area of higher pressure to one of lower pressure

what is hydrostatic pressure?

is the force of the fluid pressing against the blood vessel

what is capillary hydrostatic pressure?

pressure pushing out of the caplilares into interstitialfluid

what is interstitial hydrostatic pressure?

pressure pushing into the capilliares excreted from the intersitial fluid

What is oncotic pressure?

is the inward pulling force caused by blood proteins that move fluid from interstitial area into capillairy

is capillarly hydrostatic pressure higher at arterial or venous end?

arterial

which is stronger capillary hydrostatic pressure or tissue hydrostatic pressure?

capillary

what is normal fluid intake in a healthy adult?

2200-2700 ml

what is normal fluid output in a healthy adult?

2200-2700 mL

where is angiotensinogen secreated from?

liver

where is renin secreated from?

kidney

what does aldosterone do?

increases Na+ and H2O retention which increaces BP

where is ADH secreated?

hypothalamus signal posterior pitutiary gland to secrete it

what will ADH do?

reabospr H20 which will increased fluid volume and decrease plasma osmolarity

What does angiotensin II do?

vasoconstriction

where is aldosterone secreated from?

adrenal cortex

whre is ANP secreated from and what does it do?

secreated from atria b/c increase BP

ANP cuases increase in GFR which increases excreation of water in urine

normal potassium levels

3.5-5.0 mEq/L

what is fxn of potassium?

maintans resting membrane potential for skeletal, smooth, and cardiac muscle

normal Ca+ levels

8.5-10.5 mg/dL

what is Ca+ function

influence excitaility of msucle cells and needed for muscle contraction

what will Ca+ imbalances cause?

tingling and numbness

normal levels for Mg

1.3-2.1

what is Mg function

influnece function of neromuscular junctions

normal phosphate levels

1.7-2.6

analgesic

reducing pain

generic term for medication to lessen pain

pain threshold

the point at which the brain recognizes the stimulus as pain

pain tolerance

the intensity or duration of pain that a patient is able or willing to endure

describe acute pain

has a rapid onsent and short duration

subsides when injury is healed

describe caner/malginat pain

pain that stems from cancer or caner treatment (ex tumor pressing on bone, toxicity from chemothreapy)

describe noncancer pain

acute pain that proceeds to chronic pain. May be prolonged and potentially life threating (ex. whiplash, low back pain, sicke cell diease)

describe chronic pain

persisten pain that lasts longer than 6 months

may be episodic or continous

may lead to a disability

describe neropathic pain

episodic or continous pain that results from a nerve injury and persist even without painful stimulus

describe nociceptive pain

physiological pain that results from noicpetor stimulation in repsonse to an injury or tissue damage (ex. surgery, inflammation, trauma)

Describe visceral pain

when a person has pain of an organ that normally is not felt (ex liver)

describe referred pain

pain in an ear other than area causing the pain

see in MI, appedixitis, gallbadder probs

describe radiating pain

pain that extends to other areas

what is multimodal analagesia?

is a therapeutci straegies to treatpain

it is the use of more than one means for controlling pain

what is preemptive analgesia?

therapeutic strategie to manage pain

is the administration of medications prior to a painful even in order to minizme pain

what are examples of noopiod analgesics?

IV profin, Alieve, asprin

aceatminophin

what are examples of nonsteroidal antiinflmmatory drugs?

ibprofen and asprin

used to treat mild to moderate pain

what atre opiod analgesics and what do they treat?

treat moderate to severe pain

what is stereognosis?

is a sense that allows a person to recognize the size, shape, and texture of an object.

what are tactile receptors?

nerve fibers that detect by touch and pressure

what is olfaction?

sense of smell

What are chemoreceptors?

sensory nerve endings that react to chemicals

what is gustation?

the sense of taste

what is the normal sensory process?

reception (stimulus of recptor)

perception (interpretation)

reaction

what is a sensory deficity?

deficit in the normal function of sensory recption and perception

what is sensory deprivation?

inadequate quality or quantity of stimulation

what is sensory overload

reception of multiple sensory stimuli

Risk factors for sensory deprivation

Nonstimulating or monotonous environment

Impaired vision or hearing

Mobility restrictions

Inability to process stimuli

Emotional disorders

Limited social contact

risk facors for sensory overload

pain or discomfort

admission to acute care or change to new unit

monitiring and alamrs in ICU

invasive tubes

decreased cognitive ability

what is peripehral neuropathy?

nerve damage away from the center of the body

caused by damage to sensory nerve fibers in arms and legs

what is anosmia?

is the complete loss of sense of smell

what is xerostomia?

is a taste deficit related to decreased salivary production

what is presbycusis?

age-realted hearing loss

what is vertigo?

the sensation that objects are moving around the person

what is tinnitus

a ringing sound in the ear

what is myopia?

nearsightedness

person able to see clearly only in short distances

what is presbyopia?

farsightedness

decreased in the ability to focus on near objects

what is cataracts?

the clouding of lens of the eye

causes blurring of vision

what is glaucoma?

serious eye condition

cuased by increased intraocular pressure, putting pressure on the optic nerve which leads to loss of peripheral visual fields and possibly blindness

what is diabetic retinopathy?

a complication of diabetes mellitus in which the blood vessel of the retina become damaged

what is macular degneration?

the leading cause of visual defects in the US

is the loss of vision in the central visual feild

what is a metabolic concern for diabetic patients? explain

diabetic ketoacidosis

there is too many ketones in blood stream makes ABG acidic

what can respiratory do to help diabetic keotacidosis?

increase respiration rate

this can only be maintined for short tim

which takes longer to cause change renal compensation or respiratory compensation?

renal

what is SIDH?

sydrome inappropite diertic hormone?

what does SIDH effects? How to treat?

will effect Na+ levels (hyponatremia)

give hypertonic solution (CAREFULLY)

what is the first two things a nurse should do if pain on IV site?

look at site yourself

stop IV if problem

what will you give heart failure patients to remove fluid?

diuretic (ex lasix)

if you are worried about the mirtral valve function what should you order?

echocardiogram

if EKG show ST elevation, what test should you run next to see if coronary arteries are okay?

cardiac catherization

3 things to prevent atelectasis?

incentive spirometer, cough/deep breaht, ambulate

what is it called if fluid in plueral space?

pleural efficusion

if a patient cannot see up close what do they have?

presbyopia

what are the labs to look at to see if patient has MI

CPK and troponin

if pateint has trouble hearing they have?

presbycusis