Remediation 1 exam

Cells and Water

Cells require water for proper functioning, and the body is made up of 60% water. Cells transfer water into the vascular system to maintain hydration.

Kidneys' Role in Hydration

Kidneys retain urine to conserve water when the body is dehydrated, potentially leading to hypernatremia if hydration is not restored.

Hypernatremia Effects

Insufficient water intake can elevate sodium levels, necessitating nurse intervention with IV fluids to prevent seizures caused by cerebral edema from hypernatremia.

Seizure Mechanism in Hypernatremia

Hypernatremia causes brain cells to shrink due to fluid loss, potentially triggering seizures if sodium levels remain high.

Fluid Balance Management

Excess water may require diuretics or fluid restriction, with kidneys increasing urine output and cells releasing water to maintain balance, preventing brain swelling and seizures.

Intake and Output Monitoring

I&O monitoring focuses on liquid intake and output, excluding solid intake. NG tube irrigation counts as intake, while bladder irrigation is subtracted from total output.

Dehydration and Hyponatremia

Severe dehydration can lead to hyponatremia, necessitating fluid replacement with water to prevent seizures due to cerebral edema from low sodium levels.

Liver Functions

The liver produces bile, filters toxins, and acts as the final filtration point for blood returning to the heart. It also synthesizes clotting factors crucial for preventing excessive bleeding.

Coagulation Factors and Medication

Liver dysfunction can lead to abnormal clotting factor production, potentially causing blood clots. Heparin drip is used to manage clotting disorders, with PTT monitoring to adjust dosages.

Anticoagulant Therapy

Warfarin therapy requires monitoring PT and INR levels to prevent clotting. PT range is 16-22, INR range is 2-3, and adjustments are made based on results.

Hepatitis C and Liver Damage

Hepatitis C infection can lead to liver damage, causing cirrhosis. Liver biopsy assesses the extent of cirrhosis, but it's contraindicated in patients on blood thinners.

Hepatic Encephalopathy

Liver damage impairs ammonia breakdown, leading to elevated ammonia levels and hepatic encephalopathy. Lactulose enema is administered to reduce ammonia levels and manage symptoms.