ANRS 216 Med-Surg Exam 1 In-Depth Study Guide

Vocabulary flashcards covering core topics from the ANRS 216 Med-Surg Exam 1 Study Guide, including fluid and electrolyte imbalances, acid-base disorders, endocrine emergencies, respiratory disorders, and safety pearls.

Fluid Volume Deficit (FVD / Hypovolemia)

Inadequate circulating fluid volume caused by GI losses, bleeding, poor intake, fever/diaphoresis, burns, diuresis, or third spacing.

Fluid Volume Excess (FVE / Hypervolemia)

Excessive fluid in the intravascular and interstitial spaces, commonly associated with impaired renal excretion, heart failure, or excessive fluid administration.

Hypernatremia

Electrolyte imbalance representing a water deficit or sodium excess, characterized by thirst and potential neurologic changes.

Hyponatremia

Low serum sodium level that causes potential neurologic symptoms and requires seizure precautions when severe.

Hypokalemia

Serum potassium deficit leading to weakness, cramps, dysrhythmias, and ECG changes; IV potassium replacement must be diluted and administered via a pump, never IV push.

Hyperkalemia

Elevated serum potassium level causing weakness, paresthesias, and potentially lethal cardiac dysrhythmias, requiring continuous ECG monitoring.

Hypomagnesemia

Low serum magnesium leading to neuromuscular irritability, tremor, weakness, and dysrhythmias; associated with alcohol-use-related malnutrition.

Hypermagnesemia

Elevated serum magnesium resulting in depressed neuromuscular and cardiac function; commonly caused by impaired magnesium excretion in renal failure.

Hypocalcemia

Low calcium level manifesting as perioral/finger tingling, cramps, tetany, Chvostek/Trousseau signs, and potential dysrhythmias.

Hypercalcemia

Elevated serum calcium causing weakness, fatigue, constipation, polyuria, thirst, confusion, and potential dysrhythmias.

Isotonic Crystalloids

IV fluids, such as 0.9\text{ }\normalfont{\%} normal saline and lactated Ringer's, that expand intravascular volume and are commonly used for hypovolemia.

Hypotonic Fluids

IV fluids that move water into cells for selected hyperosmolar or dehydration states; avoided in patients with increased intracranial pressure or severe cellular edema risk.

Hypertonic Fluids

IV fluids that pull water into the intravascular space, requiring careful monitoring and used in select severe hyponatremia situations under close supervision.

Normal ABG Reference Values

Standard arterial blood gas parameters: pH $7.35\text{--}7.45$, \text{PaCO}_2 $35\text{--}45\,\text{mmHg}$, \text{HCO}_3^- $22\text{--}26\,\text{mEq/L}$, \text{PaO}_2 $80\text{--}100\,\text{mmHg}$, and \text{SaO}_2 $95\text{--}100\,\%$.

Respiratory Acidosis

Acid-base disorder defined by pH $< 7.35$ and \text{PaCO}_2 $> 45\,\text{mmHg}$, caused by hypoventilation or \text{CO}_2 retention (e.g., COPD exacerbation, severe asthma fatigue, CNS depression, airway obstruction).

Respiratory Alkalosis

Acid-base disorder defined by pH $> 7.45$ and \text{PaCO}_2 $< 35\,\text{mmHg}$, caused by hyperventilation (e.g., anxiety/pain, hypoxemia, fever, early salicylate toxicity).

Metabolic Acidosis

Acid-base disorder defined by pH $< 7.35$ and \text{HCO}_3^- $< 22\,\text{mEq/L}$, caused by conditions such as DKA, lactic acidosis/shock, severe diarrhea, or renal failure.

Metabolic Alkalosis

Acid-base disorder defined by pH $> 7.45$ and \text{HCO}_3^- $> 26\,\text{mEq/L}$, caused by vomiting, NG suction, diuretic use, excess bicarbonate, or volume depletion with acid loss.

Rapid-acting Insulin

Insulins (lispro, aspart, glulisine) with a quick onset used as meal-time coverage and administered close to meals according to specific product/orders.

Short-acting Insulin (Regular)

Insulin with a slower onset than rapid-acting insulin; notably the classic insulin type administered IV in DKA emergencies.

Intermediate Insulin (NPH)

A cloudy suspension insulin providing intermediate duration of action; must be gently rolled to mix prior to administration.

Long-acting Insulin

Basal insulins (glargine, detemir, degludec); glargine must never be mixed with other insulins in the same syringe.

A1C

Laboratory measure reflecting average blood glucose over roughly the prior $2\text{--}3\,\text{months}$, with many adult patients having a target goal around $< 7\,\%$.

Metformin

An oral antidiabetic medication that decreases hepatic glucose production and improves insulin sensitivity.

Metabolic Syndrome

A cluster of cardiometabolic risk factors consisting of central adiposity, elevated blood pressure, elevated glucose/insulin resistance, high triglycerides, and low HDL.

Diabetic Ketoacidosis (DKA)

A metabolic emergency characterized by significant hyperglycemia, ketone production, and metabolic acidosis; managed with fluid resuscitation, IV regular insulin, and strict potassium monitoring.

Hyperosmolar Hyperglycemic Syndrome (HHS)

A metabolic emergency characterized by extremely high blood glucose, severe dehydration, and high serum osmolality with little or no significant ketoacidosis.

Peak Flow Green Zone

Asthma peak flow measurement generally between $80\,\%$ and $100\,\%$ of personal best, indicating good control.

Peak Flow Yellow Zone

Asthma peak flow measurement between $50\,\%$ and $79\,\%$ of personal best, indicating caution or a flare-up.

Peak Flow Red Zone

Asthma peak flow measurement $< 50\,\%$ of personal best, signaling a medical alert requiring immediate rescue actions.

Albuterol

A short-acting \beta_2 agonist bronchodilator used for rapid relief of acute bronchospasm.

Montelukast (Singulair)

A leukotriene receptor antagonist used for long-term control and prevention of asthma symptoms, not for acute bronchospasm.

Status Asthmaticus

Severe, persistent asthma unresponsive to usual rescue therapy; red flags include silent chest, severe dyspnea, exhaustion, and impending respiratory failure.

Pursed-Lip Breathing

A technique involving gentle nasal inhalation and slow exhalation through pursed lips, helping keep airways open longer and reducing air trapping in COPD.

Atelectasis

Partial or complete collapse of alveoli that promotes retained secretions and impairs ventilation; managed with incentive spirometry, coughing, deep breathing, and mobility.

Heparin-Induced Thrombocytopenia (HIT)

A prothrombotic emergency indicated by a new fall in platelet count following heparin exposure, requiring immediate cessation of heparin and provider notification.

Petechiae

Tiny pinpoint bleeding spots on the skin that may signal a bleeding tendency.

V/Q Scanning

A diagnostic imaging test evaluating ventilation versus perfusion in the lungs, particularly useful for pulmonary embolism evaluation when CT contrast is contraindicated.