60 questions

Dosage clac

7 questions over nursing process/care plan

Assess
Diagnose
Planning
Implementation
Evaluation

Hypernatremia – Isotonic saline (09%), 5% dextrose in 0.45% NaCl, isotonic nonsaline IV fluids (5%
dextrose in H2O), encourage H2O intake, loop diuretics

Hyponatremia – hypertonic fluids (3% NaCl)

the osmolarity of the ECF is lower than that of the ICF; water moves into the cell – swelling.

Hyperkalemia – butter, margarine, cranberry juice, ginger ale, hard candy, root beer, sugar, and honey
Loop diuretics if kidney function is adequate, maintain IV access

Hypokalemia – avocado, broccoli, dairy products, dried fruit, cantaloupe, bananas, juices, melon, lean
meats, milk, whole grains, citrus fruits, legumes, coffee, eggs, tea, cocoa, and some colas

Hypocalcemia – administer PO or IV calcium (IV diluted in dextrose 5% and water and given as a bolus
infusion), vitamin D enhances the absorption, Sz precautions, avoid over stimulation***dairy, canned
salmon, sardines, fresh oysters, dark leafy green veggies, yogurt

Hypercalcemia – hyperthyroidism, hyperparathyroidism

Hypomagnesemia – discontinue loop diuretics, osmotic diuretics, and phosphorus containing medications,
IV magnesium sulfate given via pump not to exceed 150mg/min or 67 mEq over an 8-hour period, dark
green veggies, nuts, whole grains, seafood, peanut butter and coca

Hypermagnesemia – kidneys disease, hypothyroidism, adrenal insufficiency

Fluid Volume Overload – Hypervolemia

S/S – Tachycardia, bounding pulse, HTN, tachypnea, weakness, decreased energy, headache, altered
LOC, Ascites (accumulation of fluid in peritoneal cavity – abd swelling), CRACKLES, cough,
increased respiratory rate, edema, weight gain, increased urine output
Labs – Hct and Hgb: decreased, Serum and urine osmolality: decreased, BUN: decreased
Nursing Action: sodium restricted diet, place pt in high-Folwer's position, administer oxygen, low
sodium diet, Sz precautions
Hypervolemia - result from excessive fluid in the extracellular fluid space

Fluid Volume Deficit – Hypovolemia

S/S – hyperthermia, tachycardia, thread pulse, hypotension, tachypnea, hypoxia, thirst, dry tongue,
nausea, vomiting, anorexia, weight loss, oliguria, cool clammy skin, diaphoresis
Labs – Hct: increased, BUN: >25, Specific Gravity: >1.030, Sodium >145, Osmolality >295
Nursing actions: Normal Saline, high sodium diet

Alkalosis – pH >7.45
Respiratory alkalosis - Decreased CO2, decreased or normal H+ concentration
Metabolic alkalosis – increased HCO3-, decreased H+ concentration;
 Respiratory acidosis – Increased CO2 and increased or normal H+
Metabolic acidosis – Decreased HCO3-, increased H+ concentration, pH<7.35
Respiratory – PaCO2 <35 or >45
Metabolic – HCO3- <22 or >26
Uncompensated pH is outside the expected range and either the HCO2- or paCO2 is outside range
Partially compensated – pH, HCO3-, and PaCO2 are outside the expected range
pH is within the expected range, but the PaCO2 and HCO3- are both outside the range

ABGs
Metabolic Acidosis with kidney failure (pH <7.35)

POTASSIUM – never give IV push (high risk of cardiac arrest), max rate is 10 mEq/hr,

Assess before Address

Insensible fluid loss – what will you see with dehydration?

skin, lungs, and stool
increased with thyroid crisis, trauma, burns, extreme stress, and fever

Dehydration –

Interventions for nursing diagnoses