NUR 280 Comp Review-, comp 2, {UPDATED DOCX}/ Download To Score An A

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NUR280 COMP 2 REVIEW • Prioritization- acute has a higher priority than chronic o Suddenly, new onset, just developed • Lab values!!! – don’t just know the ranges, but know how your patient ... is going to present if they are high/low o Hypocalcemia-Decreased HR, hypotension, decreased peripheral pulses, hyperactive bowels, cramping causes by diet, parathyroid disease, anticonvulsants, renal failure. o Hypercalcemia- Increased HR, bounding pulses, muscle cramps, N&V, caused by TB or other respiratory issues, dehydration, diuretics and parathyroid disease. o Hypomagnesemia- Tetany and positive chop stickssigns, caused by chronic alcohol abuse and GI losses. o Hypermagnesemia decreased deep tendon reflexes(OB/GYN), hypotension, bradycardia, bradypnea, and asystole, caused by excessive intake of Mg but most commonly causes by renal failure. o Hypokalemia-Psychosis,muscle cramps, palpitations and uncontrolled diabetes, caused by diarrhea, vomiting, alcohol abuse, excessive laxative use, Cushing’s Disease diuretics and anything that relates to metabolic alkalosis. o Hyperkalemia- Arrhythmias, fatigue caused by DKA, metabolic acidosis, Addison’s disease, severe burns, ACE inhibitors. o Hyponatremia- headache, neuro changes,seizures caused by excess water; DI, or renal failure or drinking too much water. o Hypernatremia- Excessive thirst, dry mouth, neuro changes caused by loss of water through skin, heatstroke. • Also know dig toxicity s/s and lithium toxicity s/s o Digoxin toxicity- 0.5-2.0 istherapeutic level. Anything greater is toxicity! ▪ Things to remember about dig: take apical pulse for 1 full minute before administering. Eat foods high in potassium. Digibind is antidote. Monitor renal efficiency and electrolytes ▪ Digoxin is to increase contractility of the heart ▪ Dig toxicity- tachycardia, anorexia, n/v, visual disturbances (halos), dysrhythmias! o Lithium toxicity- 1.0-1.5 istherapeutic level. Anything greater istoxicity! ▪ Things to remember about lithium: blood levels must be monitored frequently, take with mealsto reduced GI distress, takes 1-2 weeks to get in therapeutic level. Should have consistent fluid and sodium intake (2500-3000 mL/day) ▪ Lithium is a mood stabilizer- used for bipolar ▪ Toxicity- vomiting, diarrhea, drowsiness,muscular weakness, ataxia. • Newborn care prioritization o Heat loss is critical! o Respiratory distress- airway!!!! ▪ Bulb suctioning- mouth first and then nose! o Apgarscore ▪ Heartrate, respiratory effort, muscle tone,reflexes, color. ▪ 0-3 poor, 4-6 fair, 7-10 excellent. o Bonding- how is mom reacting to baby? Watch for postpartum depression!!! o Shots and drops- vitamin K drops in eyes, and hep B shot o Umbilicus care- 2 arteries and 1 vein ▪ Keep it dry, open to air, don’t submerge it. ▪ Dab it dry- no alcohol or other substance use • IV solution is running late- don’t increase the rate! - fluid overload • Besides checking iV site, priority patient assessment is respiratory o Crackles!!!! • How are Thyroid storm, organ rejections, and infection alike- increase in temperature! o Tachycardia, o Hyperpyrexia (high fever) • Thyroidectomy- have emergency trach kit and ambu bag at bedside o Low orsemi-fowler’s o Support head, neck, and shoulders to prevent flexion or hyperextension ofsuture line; elevate head of bed to 30 degrees o Trach set and suction supplies at bedside o Give fluids as tolerated. o Complications: ▪ Laryngeal nerve injury- detected by hoarseness ▪ Thyoidtoxicosis- increased temperature, increased pulse, hypertension, abdominal pain, diarrhea, confusion, agitation, seizures • Treatment- hypothermia blanket, oxygen, potassium iodine, PTU, propranolol, hydrocortisone, acetaminophen; also caused by trauma, infection, palpation, RAI therapy ▪ Hemorrhage- check back of neck and upper chest for bleeding ▪ Respiratory obstruction ▪ Tetany (from decreased calcium from parathyroid involvement- Chvostek’s and Trousseau’s sign ▪ Have IV calcium gluconate or IV calcium chloride available • Parathyroid gland removal along with thyroid- hypocalcemia- chovasetk and trousseau’s sign o CATS!!! - hypocalcemia • What do ACE inhibitors, Addison’s disease, and potassium sparing diureticshyperkalemia o ACE inhibitors- causes decreased BP, decreased aldosterone secretions-sodium and fluid loss this causes high levels of potassium (end in –pril) [Show More]

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