260 test 2
what is Na+ expected range ?
136 to 145 mEq/L
what is Ca expected range ?
9 to 10.5 mEq/L
What is K expected range?
3.5 to 5 mEq/L
what is Mg expected range ?
1.3 to 2.1 mEq/L
what is Cl expected range ?
98 to 106 mEq/L
what is Phosphorus expected range ?
3 to 4.5 mEq/L
what is hyponatremia ?
Na+ levels are less then 136 mEq/L
What are sign of FVE?
Ascities, crackles in lungs, dyspnea, edema, weight gain
What are signs of FVD?
Dark urine,high specific gravity,dry MM, low urine output ,Thirst, weight loss, poor skin turgor
What is hypernatremia?
Sodiun levels are over 145 mEq/L
What population is at high risk for Hypernatremia?
Breastfed infants and the elderly
What is hyperkalemia?
Potassium levels greater then 5.2 mEq/L
What is Hypokalemia?
Potassium levels less then 3.5 mEq/
What is Sinus bradycardia?
is a dysrhythmia that proceeds normally through the conduction pathway but at a slower than usual (less than60 beats/minute) rate.
When is immediate defibrillation used ?
used during pulseless ventricular tachycardia and ventricular fibrillation.
What is a Elective electrical cardioversion?
a nonemergency procedure done by a physician to stop rapid, but not necessarily life-threatening, atrial dysrhythmias.
What is a cardiac rhythm?
refers to the pattern (or pace) of the heartbeat
What is arterial flutter?
occurs because of a conduction defect in the atrium and causes a rapid, regular atrial rate, usually between 250 and 400 bpm and results in P waves that are saw-toothed.
What is syncope?
temporary loss of consciousness caused by a fall in blood pressure.
what the P-R interval represents?
It shows the time needed for the SA node impulse to depolarize the atria and travel through the AV node."
What is a transvenous pacemaker?
is a temporary pulse-generating device that sometimes is necessary to manage transient bradydysrhythmias such as those that occur during acute MIs or after coronary artery bypass graft surgery, or to override tachydysrhythmias.
What is a electrocardiogram?
is used to identify normal and abnormal cardiac rhythms.
What is the P wave?
depicts atrial depolarization, or spread of the electrical impulse from the sinoatrial node through the atria.
What is the PR interval?
epresents spread of the impulse through the interatrial and internodal fibers, atrioventricular node, bundle of His, and Purkinje fibers. The QRS complex represents ventricular depolarization
What is the T wave?
depicts the relative refractory period, representing ventricular repolarization.
Clients with persistent______________ are prescribed anticoagulation therapy to reduce the risk of emboli formation associated with ineffective circulation.
what is hemodynamics?
is the flow of blood through the body
about ___% of the adult body is fluid
amount of fluid in the body varies with these 3 things:
intracellular fluid makes up ___% of the human body, which is skeletal muscle mass
extracellular fluid makes up ___% of body fluid
name 4 intravascular flui types:
plasma, erythrocytes, leukocytes, thrombocytes
name 1 interstitial fluid type
name 3 transcellular fluid types:
cerebrospinal, pericardial, synovial
what are electrolytes?
active chemicals that carry positive [cation] and negative [anion] electrical charges
name 5 cations in electrolytes:
sodium, potassium, calcium, magnesium, hydrogen
name 5 anions in electrolytes:
chloride, bicarbonate, phosphate, sulfate, proteinate ions
what is the measurement for electrolytes?
how to gain fluids:
eating and drinking
daily I&O of water are equal to___?
loss of fluids happens by these 4 means:
kidneys, lungs, skin, GI tract
what is the urine output of a normal kidney?
1ml/ kg/ hr
how much water/ fluid does your lungs use everyday [ greater with increased RR]?
clinical manifestations of fluid imbalance may be ____
symptoms of fluid loss include:
delirium, cardiac reserve, reduced renal function, dehydration, thinning of skin/elasticity
is dehydration the same as FVD [fluid volume deficit]?
name the Abnormal fluid loss causes in fluid volume deficit:
vomiting, diarrhea, sweating, GI suctioning
name the decrease intake reasons of fluids in FVD:
nausea, lack of access to fluids
name a third- space fluid shift:
can diabetes insipidus, adrenal insufficiency, or hemorrhage also cause fluid volume deficit?
isotonic expansion of the extracellular fluid is caused by:
abnormal retention of water and sodium
fluid overload or diminished homeostatic mechanisms can lead to:
heart failure, kidney injury, and cirrhosis of the liver can also cause:
FVE [ fluid volume excess]
will consumption if excessive amounts of table salt or other sodiums lead to FVE?
when long stays in nursing care getting regular fluid treatments, it is important to keep in mind this:
possibility of administering excessive amounts of sodium- containing fluids
name a few things to nursing management of FVE:
I&O daily weights, lung sounds, edema, monitor other symptoms, monitor meds like diuretics, promote fluid restrictions related to sodium
fluid volume excess FVE is AKA:
serum sodium less than ____________ can cause hyponatremia:
fluid overload of a surgical patient can acutely cause this:
causes of sodium loss are:
h2o imbalance, vomiting, diarrhea, sweating, diuretics, adrenal insufficiency, SIADH
manifestations of low sodium are:
poor skin turgor, dry MM, headache, decrease salivation, decrease BP, nausea, abd. cramping, neurologic changes
name 4 tx or management of hyponatremia [low sodium]
treat underlying issue, sodium replacement, water restriction, medication
What is hypernatremia?
high/ excessive sodium
a person has hypernatremia is serum sodium is greater than__________:
145 mEq/ L
the 3 people likely to get hypernatremia are:
very old, very young, cognitively impaired
causes of hypernatremia [ incr sodium]:
fluid deprivation, excess sodium admin., diabetes insipidus, heat stroke, hypertonic iv solutions
thirst and elevated temperatures are manifestations of__:
gradually lowering serum sodium levels via infusion of hypotonic electrolyte solution is a treatment for this:
when treating hypernatremia, it is important to talk to the patient about this:
over- the- counter sources of sodium
Hypokalemia is this:
serum potassium level is considered hypokalemic at this level:
under 3.5 mEq/L
can hypokalemia occur even with normal potassium levels?
yes, when alkalosis is present, a temp shift or potassium into cells occurs
some causes of hypokalemia include:
GI losses, meds, prolonged GI suctioning, recent ileostomy, intestinal tumor, poor diet, hyperaldosteronism
ECG changes, dysrhythmias, dilute urine, excessive thirst, fatigue, anorexia,muscle weakness, decrease bowel motility and paresthesias are all manifestations of this:
hypokalemia [low potassium]
it is important to monitor for this in patients with hypokalemia:
in hypokalemic patients, it is important to watch for toxicity if they are taking ____:
IV potassium can only be administered after adequate ____ has been established:
**IV potassium is NEVER administered THIS WAY :
too much potassium in the body
hyperkalemia happens when potassium serum levels are greater than:
Hyperkalemia seldomly occurs in patients with:
normal renal function
hyperkalemia risk is greater in these patients:
cardiac arrest is frequently associated with this:
Signs of hyperkalemia are this:
Muscle cramps, Urine abnormalities, Respiratory distress, Decrease cardiac contractility, EKG changes, Reflexes
1 in 4 people die from this type of disease:
this is the most common type of heart disease accounting for 370k deaths annually
this percent of sudden cardiac deaths occur outside of the hospital:
what was the objective of the framingham heart study?
identify common risk factors that contribute to the development of cardiovascular disease
name the 3 layers of the heart:
endocardium, myocardium, epicardium
name the 4 heart chambers
right atrium, right ventricle, left atrium, left ventricle
and the 2 atrioventricular valves:
tricuspid & mitral
name the semilunar valves
aortic and pulmonic
what is depolarization?
electrical activation of a cell caused by influx of sodium into cells while potassium exits the cells
the return of cells to resting state caused by re-entry of potassium into cells while sodium exits is called:
there are 2 refractory periods, name them:
effective and relative
this refractory period is a phase in which cells are incapable of depolarizing:
this refractory period is a phase in which cells require stronger than normal stimulus to depolarize:
each cardiac cycle has 3 major sequential events..:
diastole, atrial systole, ventricular systole
this is the amount of blood ejected with each heartbeat:
SV [stroke volume]
this is the degree of stretch of cardiac muscle fibers at end of diastole:
resistance to ejection of blood from a ventricle is called:
ability of cardiac muscle to shorten in response to electrical impulse is called:
percent of end diastolic volume ejected with each heartbeat [left ventricle] with normal being between 55-70%
what is cardiac output definition:
amount of blood pumped by ventricle in liters per minute
what is the formula for cardiac output:
CO= SV x HR
contractility can be increased by 3 things:
catecholamines, sympathetic nervous system, certain medications
increased contractility results in increased ___:
contractility is decreased by these 3:
hypoxemia, acidosis, certain medications
can demographics or family genetics affect cardiovascular system?
can cultural or social factors play a role in cardiovascular disease?
name some lab tests assessing cardi system:
hematology/ coagulation/ blood chem, lipid profiles, brain natriuretic peptide, c-reactive protein, homocysteine
PT walking on treadmill with intensity progressing according to protocols is called this test:
cardiac stress testing
what is pharmacologic stress testing?
when medications like vasodilating agents are given to mimic exercise
this noninvasive ultrasound test is used to measure the ejection fraction of the heart, examine size, shape, and motion of cardiac structures
which of the following is the primary pacemaker for the myocardium?
which of the best defines stroke volume?
the amount of blood ejected with each heartbeat
Digoxin toxicity is
visual disturbances (e.g., flickering flashes of light, colored or halo vision, photophobia, blurring, diplopia, and scotomata), central nervous system abnormalities (e.g., headache, fatigue, lethargy, depression, irritability and, if profound, seizures, delusions, hallucinations, and memory loss), and cardiovascular abnormalities (e.g., abnormal heart rate, arrhythmias).
what is classic sign of cardiogenic shock?
is manifested as cerebral hypoxia (restlessness, confusion, agitation). Low blood pressure is a classic sign of cardiogenic shock.
Frequently, what is the earliest symptom of left-sided heart failure?
Dyspnea on exertion