Podcast
Questions and Answers
What is the primary driving force for the movement of water and electrolytes from the arterial capillary bed to the interstitial fluid?
What is the primary driving force for the movement of water and electrolytes from the arterial capillary bed to the interstitial fluid?
- Hydrostatic pressure resulting from the pumping action of the heart (correct)
- Osmotic pressure from dissolved particles
- Active transport mechanisms in capillary walls
- Concentration gradient of solutes
Which process requires energy expenditure to move substances against a concentration gradient?
Which process requires energy expenditure to move substances against a concentration gradient?
- Osmosis
- Filtration
- Diffusion
- Active transport (correct)
What role do baroreceptors play in the regulation of blood volume?
What role do baroreceptors play in the regulation of blood volume?
- They respond to changes in volume and regulate neural and endocrine activities. (correct)
- They facilitate the active transport of ions in the heart.
- They cause the release of hormones that increase blood pressure.
- They regulate hydrostatic pressure in blood vessels.
Which statement best distinguishes between filtration and osmosis?
Which statement best distinguishes between filtration and osmosis?
What effect does sympathetic stimulation have on renal arterioles?
What effect does sympathetic stimulation have on renal arterioles?
What does a brief contraction of the upper lip indicate?
What does a brief contraction of the upper lip indicate?
What adverse effect should a nurse closely monitor in an elderly patient undergoing surgery?
What adverse effect should a nurse closely monitor in an elderly patient undergoing surgery?
Which task is the circulating nurse solely responsible for during a cesarean section?
Which task is the circulating nurse solely responsible for during a cesarean section?
What factor does NOT contribute to inadvertent hypothermia during surgery?
What factor does NOT contribute to inadvertent hypothermia during surgery?
What is a primary responsibility of the circulating nurse in the operating room?
What is a primary responsibility of the circulating nurse in the operating room?
Which of the following is NOT a recognized effect of general anesthesia?
Which of the following is NOT a recognized effect of general anesthesia?
What condition should a nurse suspect if a patient exhibits Chvostek's sign?
What condition should a nurse suspect if a patient exhibits Chvostek's sign?
Which statement about the responsibilities of a circulating nurse is correct?
Which statement about the responsibilities of a circulating nurse is correct?
What is the most common acid-base imbalance associated with hyperventilation?
What is the most common acid-base imbalance associated with hyperventilation?
How do you interpret arterial blood gas results indicating a pH of 7.26, PaCO2 of 28, and HCO3 of 11 mEq/L?
How do you interpret arterial blood gas results indicating a pH of 7.26, PaCO2 of 28, and HCO3 of 11 mEq/L?
What should be documented when edema is noted around a peripheral IV insertion site?
What should be documented when edema is noted around a peripheral IV insertion site?
Which acid-base imbalance is primarily associated with hypoventilation?
Which acid-base imbalance is primarily associated with hypoventilation?
What evidence suggests that a metabolic problem may be the primary issue in a patient with a below-normal pH?
What evidence suggests that a metabolic problem may be the primary issue in a patient with a below-normal pH?
What might be a significant complication to monitor for in a patient receiving IV therapy?
What might be a significant complication to monitor for in a patient receiving IV therapy?
What does a PaCO2 level below normal typically indicate in patients?
What does a PaCO2 level below normal typically indicate in patients?
In emergency settings, which situation is most likely to cause respiratory acidosis?
In emergency settings, which situation is most likely to cause respiratory acidosis?
What does a pH level of 7.21 indicate about a patient's acid-base status?
What does a pH level of 7.21 indicate about a patient's acid-base status?
What does a normal HCO3 level of 24 indicate in relation to metabolic acidosis?
What does a normal HCO3 level of 24 indicate in relation to metabolic acidosis?
What is the primary purpose of administering a fluid challenge in a patient exhibiting oliguria?
What is the primary purpose of administering a fluid challenge in a patient exhibiting oliguria?
What is a likely response of a patient with fluid volume deficit after a fluid challenge?
What is a likely response of a patient with fluid volume deficit after a fluid challenge?
What symptom might indicate that the elderly woman is experiencing dehydration?
What symptom might indicate that the elderly woman is experiencing dehydration?
What might be an appropriate nursing response regarding the patient's reluctance to drink water during the day?
What might be an appropriate nursing response regarding the patient's reluctance to drink water during the day?
What is the significance of recognizing oliguric symptoms in a post-surgical patient?
What is the significance of recognizing oliguric symptoms in a post-surgical patient?
In the context of urinary output, what does oliguria refer to?
In the context of urinary output, what does oliguria refer to?
What can limiting fluids in elderly patients lead to?
What can limiting fluids in elderly patients lead to?
What might cause confusion in elderly patients post-surgery?
What might cause confusion in elderly patients post-surgery?
What is the most likely reason for low urine output in the 73-year-old man admitted to the ED?
What is the most likely reason for low urine output in the 73-year-old man admitted to the ED?
How does a sympathetic response affect urine output?
How does a sympathetic response affect urine output?
Which condition is NOT typically associated with confusion in elderly patients?
Which condition is NOT typically associated with confusion in elderly patients?
What hormone's lack might suggest a possible traumatic brain injury in the patient?
What hormone's lack might suggest a possible traumatic brain injury in the patient?
What characterizes the clinical manifestations of fluid and electrolyte disturbances in elderly patients?
What characterizes the clinical manifestations of fluid and electrolyte disturbances in elderly patients?
Which of the following statements regarding urinary output and fluid management is accurate?
Which of the following statements regarding urinary output and fluid management is accurate?
What is the primary use of Maalox in the gastrointestinal system?
What is the primary use of Maalox in the gastrointestinal system?
Why should TPN be initiated slowly in malnourished patients?
Why should TPN be initiated slowly in malnourished patients?
In which condition would KCl be indicated for a patient?
In which condition would KCl be indicated for a patient?
What is a key consideration when managing patients on TPN?
What is a key consideration when managing patients on TPN?
For a patient with hypophosphatemia, what dietary recommendation is appropriate?
For a patient with hypophosphatemia, what dietary recommendation is appropriate?
Which complication is NOT associated with rapid initiation of TPN in malnourished patients?
Which complication is NOT associated with rapid initiation of TPN in malnourished patients?
What is a significant risk for patients receiving parenteral nutrition too aggressively?
What is a significant risk for patients receiving parenteral nutrition too aggressively?
What physiological issue might arise from the administration of fluids too rapidly to malnourished patients?
What physiological issue might arise from the administration of fluids too rapidly to malnourished patients?
Flashcards
Respiratory Acidosis
Respiratory Acidosis
A condition where the body's pH is too low, often caused by an accumulation of carbon dioxide in the blood.
Respiratory Alkalosis
Respiratory Alkalosis
A condition where the body's pH is too high, often caused by excessive breathing (hyperventilation) which leads to a loss of carbon dioxide.
Metabolic Acidosis
Metabolic Acidosis
This indicates a problem with how the body regulates its acid-base balance, resulting in an overly acidic state.
Metabolic Alkalosis
Metabolic Alkalosis
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Acute Respiratory Acidosis
Acute Respiratory Acidosis
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Acute Respiratory Alkalosis
Acute Respiratory Alkalosis
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Phlebitis
Phlebitis
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Infiltration
Infiltration
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Fluid Challenge
Fluid Challenge
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Purpose of Fluid Challenge
Purpose of Fluid Challenge
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Reduced Renal Blood Flow
Reduced Renal Blood Flow
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Decreased Renal Function
Decreased Renal Function
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Fluid Challenge Procedure
Fluid Challenge Procedure
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Positive Fluid Challenge
Positive Fluid Challenge
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Negative Fluid Challenge
Negative Fluid Challenge
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Fluid Challenge and Hypertension
Fluid Challenge and Hypertension
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Confusion in Elderly Patients
Confusion in Elderly Patients
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Low Urine Output After a Fall
Low Urine Output After a Fall
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Oriented
Oriented
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Alert
Alert
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Pupils Reactive to Light
Pupils Reactive to Light
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Reninangiotensinaldosterone System (RAAS)
Reninangiotensinaldosterone System (RAAS)
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RAAS Trigger
RAAS Trigger
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Renin's Role
Renin's Role
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Active Transport
Active Transport
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Osmosis
Osmosis
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Hydrostatic Pressure
Hydrostatic Pressure
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Baroreceptors
Baroreceptors
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What is simethicone?
What is simethicone?
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What is Metabolic Alkalosis?
What is Metabolic Alkalosis?
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What is Total Parenteral Nutrition (TPN)?
What is Total Parenteral Nutrition (TPN)?
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What is Hypophosphatemia?
What is Hypophosphatemia?
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Why is slow TPN initiation crucial for malnourished patients?
Why is slow TPN initiation crucial for malnourished patients?
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Which foods are high in Phosphate?
Which foods are high in Phosphate?
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What is Phlebitis?
What is Phlebitis?
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What is Infiltration?
What is Infiltration?
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Chvostek's Sign
Chvostek's Sign
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Hypocalcemia
Hypocalcemia
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Hypomagnesemia
Hypomagnesemia
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Orthopedic Hardware Removal
Orthopedic Hardware Removal
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Hypothermia During Anesthesia
Hypothermia During Anesthesia
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Circulating Nurse
Circulating Nurse
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Cesarean Section
Cesarean Section
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Documentation by a Circulating Nurse
Documentation by a Circulating Nurse
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Study Notes
Fluid and Electrolyte Balance and Disturbance
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Specific Gravity Testing: Detects fluid volume deficits or excesses in patients with SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion). It does not directly assess nutritional status, potassium, or calcium levels.
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High Magnesium Levels: Prioritize assessment for diminished deep tendon reflexes in patients with acute kidney injury and elevated magnesium levels. Tachycardia, cool clammy skin, and acute flank pain are not the priority in this case.
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Third Spacing: Third spacing, a shift of fluid, leads to hypovolemia. Increased calcium and magnesium levels are not indicators of third-spacing shifts.
Respiratory Acidosis/Alkalosis
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Hyperventilation and Respiratory Alkalosis: Hyperventilation, often caused by anxiety, is a primary cause of respiratory alkalosis.
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Blood Gas Results: A patient with blood gas results of pH 7.26, PaCO2 28, HCO3 11 mEq/L has metabolic acidosis with a compensatory respiratory alkalosis.
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Third-Spacing Fluid Shift: Third-spacing fluid shift, which occurs when fluid moves out of the intravascular space but not into the intracellular space, can cause hypovolemia.
Complications of IV Therapy
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Peripheral IV Infiltration: Infiltration is the administration of a nonvesicant solution or medication into the surrounding tissue. Common findings include edema around the insertion site, leakage of IV fluid from the insertion site, discomfort, and coolness in the area of infiltration.
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Infiltration Assessment: The nurse should check for diminished deep tendon reflexes, which are an indicator of high magnesium levels. Tachycardia, flank pain, and cool, clammy skin are not usually associated with hypermagnesemia.
Peripheral IV Insertion
- Selection of Site: Select a hairless site if available, but also consider the potential impact on the patient's mobility when selecting a site.
- Tourniquet Time: Never leave a tourniquet in place for longer than 2 minutes.
Electrolyte Imbalances
- Hypocalcemia: Tetany (muscle spasms) is a critical manifestation of hypocalcemia.
- Hypokalemia: Patients with hypokalemia are likely to exhibit signs of dilute urine.
- Hypomagnesemia: Tingling, especially in the hands and feet is a key observation to be aware of in hypomagnesemic patients.
- Hypermagnesemia: Absent deep tendon reflexes may indicate hypermagnesemia.
- Hypernatremia: In the elderly, this condition can manifest as confusion, but it is not a normal condition associated with aging.
- Hypophosphatemia: This condition creates central nervous system dysfunction, resulting in seizures and coma.
- Hyperkalemia: Paresthesias and anxiety are common findings when assessing patients' risk for hyperkalemia.
Fluid Imbalance
- Fluid Challenge: A fluid challenge of 100 to 200 mL of normal saline over 15 minutes is used to evaluate renal blood flow.
- Fluid Deficit: In the elderly, dehydration may cause confusion, but this should not be considered normal, and interventions should be made.
Acid-Base Imbalance
- Acute Respiratory Alkalosis: A common occurrence in emergency situations such as pulmonary edema. Characteristics of hyperventilation include increased respiratory rate, decreased PaCO2, and low serum pH levels.
- Acute Respiratory Acidosis: Is a rare occurrence. It may be associated with acute respiratory distress syndrome.
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