[fgoff]

I've used these sites before
http://www.edgehill.ac.uk/Faculties/Health/mltr/presentations/Fliud-&-Electrolyes-HEA-101.html

http://www.elmhurst.edu/~chm/vchembook/250fluidbal.html

[VickyRN]

Have attached some of my lecture notes from F & E. Hope this helps

[VickyRN]

Have also attached some of my lecture notes/ study guides from my "Fluids" lecture

[VickyRN]

One more...

[Daytonite]

Originally Posted by kristen3g3tp8

What is the effect of Digitalis on ca++???

It causes the amount of calcium in the cells of the heart to be increased. Calcium excites the cells of the heart causing it to beat. The more calcium that builds up in the heart cells, the more stronger and forceful the heartbeats are. You can read about the effect of digitalis on the heart here:

http://texasheart.org/HIC/Topics/Meds/digimeds.cfm

[aka_selina]

• A nurse is caring for a client who has tissue ischemia. Which of the following nursing goals is a priority?
  • Obtaining accurate medical history
  • Reestablish oxygenation to the area
  • Immobilization of the affected area
  • Assessing for circulatory changes

I was thinking its assessing for circulatory changes cause ischemia has to do with blood clots but some ppl say its reestablishing oxygenation.

• The nurse is administering skin testing with intradermal injections of allergens on a patient’s forearm. Immediately after the nurse administers one of the injections, the patient complains of itching at the site and of weakness and dizziness. The nurse should first:
  • elevate the arm above the shoulder
  • administer subcutaneous epinephrine
  • apply a tourniquet above the injection site
  • apply a local anti-inflammatory cream to the site

• A patient is treated at a clinic with an injection of long-acting penicillin for a streptococcal throat infection. Her history reveals that she has received penicillin before with no allergic responses. When the penicillin injection is administered, the nurse should inform the patient that:
  • she must wait in the clinic area for 20 minutes before she is discharged
  • since she has taken penicillin before without problems, she can safely take it now
  • She would have immediate symptoms if she had developed an allergy to penicillin
  • She should monitor fever and skin rash typical of type III immune – complex reactions.

[CritterLover]

1. I would agree with reestablishing oxygenation to the area, if it could be done with nursing interventions. I can't think of one, though. That would probably require Interventional Radiology or Surgery. So then it would be assessing for other circulatory changes.

2. agree -- subq epi. Weakness and dizziness indcates a systemic reaction, requiring a more aggressive intervention.

3. agree -- wait 20 min (even if you've had a med before, you can still react. I'd had PCN type drugs many, many times before I ever reacted).

[Daytonite]

I saw that you also posted these questions in the general nursing discussion forum. I just wanted to give you the reasoning behind why the answer to the first question is the second answer choice: reestablish oxygenation to the area. It has to do with the nursing process. The word "goals" in the question was the clue to the answer. During the nursing process you are first assessing the patient and then determining goals, outcomes and nursing diagnoses. This all occurs before the planning stage which is where you actually start introducing your nursing interventions. One of the appropriate nursing diagnoses for a patient with tissue ischemia is Ineffective Tissue Perfusion. One of the major causes of a patient having this problem is that their body is unable to successfully transport oxygen into the capillary membranes. Formulating nursing goals for a patient are directly related to the causes of their problem. So, a goal would be to do something to help get oxygen to the oxygen-deprived tissues. None of the other choices: obtaining an accurate medical history, immobilizing the affected area and assessing for circulatory changes isn't going to accomplish that. So, clearly, there is only one answer choice. If the question had been worded differently and said "what is your first priority in taking care of this patient?" then your choice, assess for circulatory changes, would be correct. The reason. . .because the first step in the nursing process is to assess and collect data. I would sequence my own assessment in priority above getting a medical history from the patient, although it, too, is also part of the data collecting process. Immobilization of the affected area is a nursing interaction which would be undertaken after assessment and goals were determined.

Most everyone has given the correct answers and reasoning for the other two questions. They are pretty much grounded in knowledge of medication and reactions to them.

[aka_selina]

I got the answers from the Professor yesterday!

A nurse is caring for a client who has tissue ischemia. Which of the following nursing goals is a priority?
Reestablish oxygenation to the area

The nurse is administering skin testing with intradermal injections of allergens on a patient’s forearm. Immediately after the nurse administers one of the injections, the patient complains of itching at the site and of weakness and dizziness. The nurse should first:
apply a tourniquet above the injection site, because this will help the itching from spreading. A nurse can not administer subcutaneous epinephrine unless ordered. So that was such a tricky question.

A patient is treated at a clinic with an injection of long-acting penicillin for a streptococcal throat infection. Her history reveals that she has received penicillin before with no allergic responses. When the penicillin injection is administered, the nurse should inform the patient that:
she must wait in the clinic area for 20 minutes before she is discharged

[VickyRN]

Originally Posted by nrstob08

Dehydration -

why does the ECF increase and the ICF decrease in a hypertonic solution

why does the ECF decrease and the ICF increase in a hypotonic solution

Overhydration-

in a isotonic solution why does the ECF increase and why doesnt anything happen in the ICF?

in a hypotonic solution why do both the ECF and the ICF increase?

in a hypertonic solution why does the ECF increase and the ICF d

Tonicity refers to the solute concentration of a solution outside a cell and its effect on cellular fluid volume. The osmolarity of the solution determines the direction of water flow into or out of the cell. In normal body situations, solute concentration within and outside of the cell is usually nearly the same.

Hypertonic: higher osmolarity than cells (> 300 mmol/L). Higher solute concentration surrounding cells pulls water out of the cells. Greater solute, less water—water moves out of cells. The cell will shrink (crenation).

Hypotonic: lower osmolarity than cells (< 270 mmol/L). Lower solute concentration surrounding cells causes water to move into the cells. Less solute, more water—water moves into cells. The cell will swell and eventually burst.

Isotonic: same osmolarity as the cells (270 – 300 mmol/L). Equal solute and water—exact same number of particles in both solutions—no net movement of water. Does not change cell volume.

Both hypertonicity and hypotonicity in the extracellular fluids will destroy cells. Need isotonicity for cell homeostasis, for balance.