The document discusses homeostasis and fluid, electrolyte, and acid-base balance. It covers the key electrolytes sodium, potassium, calcium, and their roles in the body. For each electrolyte, it discusses normal values, functions, causes and signs of imbalance, diagnostic tests, and nursing management for hypo- and hyper- conditions. It provides examples of nursing questions related to fluid and electrolyte imbalances.
This lecture is based on National guidelines(Sri Lanka) and guidelines by NHS UK. all the materials used to prepare the lecture are trusted and high in quality. also the books referred are internationally recognized. both hyper and hypokalemia management included in the lecture. lecture is free and you can even download. i kept no copy rights. i appreciate your support, comments and suggestions. also i would be grateful if you can make these lectures popular. wishing your success.
This PPT gives an idea to MBBS students about the Type of fluids, Calculating the daily requirements as well as the drop rate to be used in day today clinical practice.
This lecture is based on National guidelines(Sri Lanka) and guidelines by NHS UK. all the materials used to prepare the lecture are trusted and high in quality. also the books referred are internationally recognized. both hyper and hypokalemia management included in the lecture. lecture is free and you can even download. i kept no copy rights. i appreciate your support, comments and suggestions. also i would be grateful if you can make these lectures popular. wishing your success.
This PPT gives an idea to MBBS students about the Type of fluids, Calculating the daily requirements as well as the drop rate to be used in day today clinical practice.
I bought this file from (FB name: Dee Dee). The files are extremely helpful, visit his Facebook account or Facebook page.
https://web.facebook.com/groups/670462807397676/
What is an electrolyte imbalance?
An electrolyte imbalance means that the level of one or more electrolytes in your body is too low or too high. It can happen when the amount of water in your body changes. The amount of water that you take in should equal the amount you lose. If something upsets this balance, you may have too little water (dehydration) or too much water (overhydration). Some of the more common reasons why you might have an imbalance of the water in your body include:
1. Certain medicines
2. Severe vomiting and/or diarrhea
3. Heavy sweating
4. Heart, liver or kidney problems
5. Not drinking enough fluids, especially when doing intense exercise or when the weather is very hot
6. Drinking too much water
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. Homeostasis
• Walter Bradford Cannon
•maintenance of a relatively constant environment within a body.
• state of balance.
•body’s ability to regulate physiologically its inner environment to ensure stability in response to fluctuations in the outside environment & the weather.
Fluids, Electrolytes & Acid-Base
2
3. Fluids, Electrolytes & Acid-Base
3
•process that stimulate or amplify similar changes that causes movement away from normal state.
Homeostasis
•regulating mechanism in which an increase/decrease in the level of substance decreases/increases the function of the organ producing the substance.
10. Fluids, Electrolytes & Acid-Base
10
Functions of water
1. Move electrolyte and O2 into and out of cells.
2. Aid in digestion
3. Cleanse the body of waste.
4. Regulate body temperature
5. Lubricates joints and mucous membranes.
12. Fluids, Electrolytes & Acid-Base
12
I wonder how much water do they have in their bodies?hmm
Total Body Water
13. Fluids, Electrolytes & Acid-Base
13
Fluid Intake & Fluid Loss
Ingested fluids
Water in foods
Oxidation
Skin
Lungs
Feces
Kidneys
14. Fluids, Electrolytes & Acid-Base
14
• Passive Transport
•a process that transport ions across the cell membrane against a concentration gradient.
•does not require use of energy.
• Active Transport
•use of energy to move ions across a semipermeable membrane against a concentration, chemical or electrical gradient.
Fluid Balance Mechanisms
15. Fluids, Electrolytes & Acid-Base
15
Passive Transport
• Osmosis
•movement of fluids from lower solute to higher solute concentration.
D2.5W
0.45% NSS
0.3% NSS
0.2% NSS
D50W
D5W
D10W
D5NSS
D5LR
3%NSS
0.9% NSS
LRS
16. Fluids, Electrolytes & Acid-Base
16
Passive Transport
• Diffusion
•movement of solutes from an area of higher to lower concentration gradient.
• Filtration
•removal of particles from a solution through a movement of fluid across the membrane.
19. Fluids, Electrolytes & Acid-Base
19
Predict:
Drowning in freshwater is different from drowning in saltwater. In fact, more people drown in freshwater than salt water. Why?
28. Fluids, Electrolytes & Acid-Base
28
Hypervolemia: Nursing Management
1.Monitor I & O, v/s, weight, edema and breath sounds.
2. Diet:
3. Position:
4.Adm. diuretics a.p
5.Skin care daily
29. Fluids, Electrolytes & Acid-Base
29
1
The client at the highest risk for fluid volume deficit is a: a. 36-year-old client with diarrhea. b. 4-month-old client with fever. c. Healthy 80-year-old client with a fractured wrist. d. 26-year-old pregnant client with n/v.
FLUID IMBALANCE
30. Fluids, Electrolytes & Acid-Base
30
2
A 32-year-old client has a nursing Dx of FVE. A nurse examining the client would expect to find:
a. Postural HTN
b. Cool extremities
c. Moist mucous membranes
d. Weak, rapid pulse
FLUID IMBALANCE
32. •major cation in the ECF.
Fluids, Electrolytes & Acid-Base
32
Functions:
1. Assists with nerve generation & nerve transmission.
2. Partcipates in Na-K pump
3. Controls water distribution throughout the body.
4. Maintains body fluid volume.
Sodium
Normal Value:
Sources:
Inversely proportional to:
Table salt, processed foods, ham, bacon, pickles, preserved foods, baking products, ketchup
35. Fluids, Electrolytes & Acid-Base
35
Hyponatremia
Medical & Nursing Intervention/s:
1.Provide SAFETY!
2.MIO, daily weights, v/s
3.Provide Na replacement a.d.
4.Encourage food high in Na.
5.Monitor clients on lithium therapy.
6.Restrict water intake.
39. Fluids, Electrolytes & Acid-Base
39
3
Why does excessive administration of D5W cause hyponatremia? a. The kidneys excrete the excess potassium. b. The lungs exhales the excess vapor. c. Water in the solution dilutes the serum Na level. d. Dextrose in the sol/n concentrates the Na level.
ELECTROLYTE IMBALANCE
40. Fluids, Electrolytes & Acid-Base
40
4
The nurse evaluates which of the ff clients to be at risk for developing hypernatremia?
a. 50-year-old with Pn, diaphoresis and high fever.
b. 39-year-old with diarrhea and vomiting.
c. 62-year-old with CHF taking Lasix.
d. 60-year-old client with lung CA and SIADH.
ELECTROLYTE IMBALANCE
41. •most abundant cation in the ICF.
Fluids, Electrolytes & Acid-Base
41
Potassium
Normal Value:
Sources:
Inversely proportional to:
Fruits, vegatables, nuts, milk, coffee & cola, milk
Functions:
1. Skeletal and cardiac muscle contraction.
2. Maintains acid-base imbalance.
3. Part of Na-K pump
42. Fluids, Electrolytes & Acid-Base
42
Hypokalemia
Causes:
Medications
GI suction/vomiting
NPO, Diarrhea
Cushing’s Dse
Hyperventilation
IV Insulin
48. Fluids, Electrolytes & Acid-Base
48
5
The nurse knows that when caring for the client on a telemetry unit, she would expect to find which EKC changes in a hypokalemic patient?
a. Tall T-wave
b. shortened PR interval
c. Absent P waves
d. U wave
ELECTROLYTE IMBALANCE
49. Fluids, Electrolytes & Acid-Base
49
6
A client is being discharged from the hospital after being treated hypokalemia. In order for the client to maintain an appropriate K+ level, the nurse suggests which food when providing discharge teaching?
a. Baked potatoes
b. Peas
c. Fowl
d. Nuts
ELECTROLYTE IMBALANCE
50. •most abundant electrolyte in the entire body.
Fluids, Electrolytes & Acid-Base
50
Calcium
Normal Value:
Sources:
Inversely proportional to:
Milk and milk products, tofu, broccoli, sardines, green leafy vegetables
Functions:
1. Bones and teeth formation.
2. Muscular contraction and relaxation.
3. Needed for vit. B12 absorption.
4. Needed for normal blood clotting
5. Nerve transmission
57. Fluids, Electrolytes & Acid-Base
57
7
The client’s calcium level is 8.8 mg/dL. An appropriate nursing intervention at this time is:
a. Notify the physician stat!
b. Administer oral calcium supp.a.d.
c. Limit intake of foods rich in calcium.
d. No intervention required at this time.
ELECTROLYTE IMBALANCE
58. Fluids, Electrolytes & Acid-Base
58
8
A client with recent thyroidectomy complains of numbness and tingling around the mouth. Which of the following findings indicates the serum Ca is low? a. Bone pain b. Depressed DTRs c. Carpopedal spasm d. Constipation
ELECTROLYTE IMBALANCE
59. •second most abundant intracellular cation.
Fluids, Electrolytes & Acid-Base
59
Magnesium
Normal Value:
Sources:
Green leafy vegetables, nuts, legumes, seafood, whole grains, bananas, oranges, cocoa, chocolate
Functions:
1. Muscle sedatives/ Cardiac output
2. Maintains intracellular activity.
3. Maintains normal heart rhythm.
4. Promotes vasodilation of peripheral arterioles.
65. Fluids, Electrolytes & Acid-Base
65
Medical & Nursing Intervention/s:
1. Adm. diuretics as prescribed.
2. Decrease Mg salt administration.
3. Respiratory support!
4. Dialysis
5. 0.45% saline and/or Ca gluconate
Hypermagnesemia
66. Fluids, Electrolytes & Acid-Base
66
9
A client presents to the ED with tachycardia, HPN, and SZ. Further assessment reveals a history of chronic pancreatitis, causing the nurse to expect: a. Magnesium deficit b. Sodium deficit c. Potassium excess d. Calcium excess
ELECTROLYTE IMBALANCE
67. Fluids, Electrolytes & Acid-Base
67
10
The nurse evaluates which of the ff clients to have hypermagnesemia?
a. A client with chronic alcoholism, Mg level: 1.3 mEq/L.
b. A client who has hyperthyroidism, Mg level: 1.6 mEq/L.
c. A client who has renal failure, takes antacids, Mg level: 2.9 mEq/L
d. A CHF client, takes diuretic, Mg level 2.3 mEq/L.
ELECTROLYTE IMBALANCE
68. •Primary intracellular anion.
Fluids, Electrolytes & Acid-Base
68
Phosphorous
Normal Value:
Sources:
Inversely proportional to:
Red & organ meats, poultry, fish, eggs, milk, legumes, whole grains, nuts, carbonated drinks
Functions:
1. Promotes muscles & nerve fxn
2. Assists with CHO, CHON HCHO metabolism.
3. Bone/teeth formation & strength
4. Part of ATP
5. Phospholipids
74. Fluids, Electrolytes & Acid-Base
74
Medical & Nursing Intervention/s:
1. Administer meds as prescribed:
• Al-containing antacids
• Ca carbonate
2. Avoid phosphate laxatives/ enemas
3. Increase OFI
4. Diet:
Hyperphosphatemia
75. Fluids, Electrolytes & Acid-Base
75
11
The nurse should monitor for clinical manifestations of hypophosphatemia in which of the ff client? a. A client with osteoporosis taking vit.D and Ca supplements. b. A client who is alcoholic and with renal failure. c. A client with CRF awaiting for the first dialysis run. d. A client with hypoparathyroidism secondary to thyroidectomy.
ELECTROLYTE IMBALANCE
76. Fluids, Electrolytes & Acid-Base
76
12
A nurse reviews a client lab result and note a serum P level: 2.0 mg/dL. Which condition most likely caused this serum P level? a. Alcoholism b. Renal failure c. Hyperparathyroidism d. Hyperthyroidism
ELECTROLYTE IMBALANCE
88. Fluids, Electrolytes & Acid-Base
88
pH: 7. 28
ABG Review: Interpretation
pCO2: 50mmHg
pCO2: 29 mEq/L
How am I going to interpret this ABG result?
Rule:
1. Look at the pH:
acidosis/alkalosis.
2. Determine the cause:
respiratory/metabolic.
3. Determine if un/-compensated.
4. Identify if it is fully/partially.
91. • a primary deficit in the concentration of base bicarbonate in the ECF.
Fluids, Electrolytes & Acid-Base
91
Metabolic Acidosis
pH
HCO3
pCO2
• common stimuli:
DKA & starvation
Tse hypoxia
A/C Renal failure
Excessive HCO3 loss
diarrhea
94. • a primary excess in the concentration of base bicarbonate in the ECF.
Fluids, Electrolytes & Acid-Base
94
Metabolic Alkalosis
pH
HCO3
pCO2
• common stimuli:
Vomiting, gastric suctioning
Hypokalemia
Cushing dse, hyperaldosteronism
Dialysis
Use of antacids
102. Fluids, Electrolytes & Acid-Base
102
Medical & Nursing Intervention/s:
1. Encourage to conserve CO2.
2. Provide emotional support and reassurance.
3. Adm. anti-anxiety meds, sedation.
4. Adjust ventilator settings
5. Provide adequate rest.
pH, PCO2
103. Fluids, Electrolytes & Acid-Base
103
A client with Pn presents with the ff ABG: pH: 7.28, pCO2: 74, HCO: 28, pO2: 45, which of the following is the most appropriate nursing intervention?
a. Administer sedative a.d
b. Place client in left lateral position.
c. Place client in High-Fowler’s position.
d. Assist the client to rebreath in a paper bag.
Acid-Base Balance
104. Fluids, Electrolytes & Acid-Base
104
A client with COPD feels SOB after walking in the bathroom on 2 liters of O2 via nasal cannula. The morning ABGs were: pH: 7.36, pCO2: 62, HCO3: 35, SaO2: 88%. Which of the following is your first intervention? a. Call the physician and report the client’s condition. b. Turn the O2 up to 4Lpm via nasal cannula. c. Encourage the client to sit down and take deep breaths d. Provide rest and teach pursed-lip breathing
Acid-Base Balance
105. Fluids, Electrolytes & Acid-Base
105
A client with renal failure enters the ER after skipping three dialysis treatment to visit family out of town. Which set of ABGs would indicate to the nurse that the client is in a state of metabolic acidosis?
a. pH: 7.43, pCO2: 36, HCO3:26
b. pH: 7.41, pCO2: 49, HCO3:30
c. pH: 7.33, pCO2: 35, HCO3:17
d. pH: 7.25, pCO2: 56, HCO3:28
Acid-Base Balance
106. Fluids, Electrolytes & Acid-Base
106
A client with small bowel obstruction has had an NG tube connected to low intermittent suction for 2 days. The nurse should monitor for s/sx of which acid-base d/o? a. Respiratory alkalosis b. Respiratory acidosis c. Metabolic alkalosis d. Metabolic acidosis
Acid-Base Balance
107. Fluids, Electrolytes & Acid-Base
107
A client suffers from an anxiety d/o and is very upset, RR: 32 and complaining of light-headedness and tingling in fingers. ABG values: pH: 7.48, pCO2: 29, HCO3: 24. The nurse performs which of the following as a priority nursing intervention?
a. MIO
b. Encourage client to increase activity.
c. Institute purse-lip breathing every hour.
d. Provide reassurance to the client and administer sedatives a.d
Acid-Base Balance
108. “A diffused light has little power or impact. A focused light can set grass or paper on fire. When focused even more, it can cut through steel.” - Rick Warren
Fluids, Electrolytes & Acid-Base
108