Med_Surg

semester1kid · Mar 11, 2011

That's a pretty broad topic - do you have a specific question or questions? The one thing I will say right up front is that when you learn arterial gas values along with pH, trends are as important (and probably more so) than whether the values are within normal limits. The pH level and HCO3 levels could still be within normal limits...but if they're trending down, a diagnosis of metabolic acidosis could be appropriate. Compensation of CO2 reduction could start taking place and thus, a drop in CO2 levels may further support the metabolic acidosis finding.

So in other words, on a test, they may either give you values that are within normal limits but getting close to borderline....or they may give you a series of values taken over the course of time that's trending in a given direction (but still within normal limits) and you'll have to determine a diagnosis. So I'd start with that....

I'm sure you already studied the Na+ (135-145), K(3.5-5) and so forth. Just one word of wisdom for that too - trending could be a factor with these too. For example, if someone has a history of having a K value averaging around 4.5 and is put on a diuretic for hypertension and a subsequent blood test shows the pt now has a value of 3.6, are you just going to sit on your hands because it's still within normal limits?

A big thing that relates more directly to nursing is learning the various tonicity of IV fluids and what would be appropriate for various conditions. For example, what happens with a burn victim and how is it treated (from a fluid point of view...leave the potential for infection part of it for another discussion:))?

Lastly, BUN and creatinine are standard values you should be looking at when you're first reviewing a pt's chart. What would happen with these values if the pt was dehydrated or has impaired kidney function?

I hope this helps...it certainly helps me as well because although we still have one more 'regular' exam, our final exam is only two weeks after that exam and it's going to include fluid, electrolytes and acid base questions:D

cschoppe · Mar 11, 2011

I bought a book called "Fluid and Electrolytes Made Easy" for my first med-surg semester a while ago and that seemed to help clear things up.

anonymousstudent · Mar 11, 2011

This is one of those things you have to understand. You cannot just memorize material, at least not in my opinion. Take a look at your physiology and match it up to the nursing implications. This concept is IMPORTANT. You cannot miss this, you have to learn it. Do what it takes, get it down.

Have you met with your teacher? If not you should, maybe they can explain it in person in a way that would help you.

Emilynn09 · Mar 12, 2011

Fluid & Electrolytes DeMystified is pretty good, and so is Med/Surg DeMystified, and the Made Incredibly easy series. There are also self teaching books for nursing labs and stuff out there. Hit up Amazon or your local book store and see what they have to help you out. I'd have never made it through that unit without my DeMysitfied books. It's a tough subject, I passed... but it took an incredible amount of effort.

turnforthenurse, MSN, NP · Mar 12, 2011

Fluids & Electrolytes Made Incredibly Easy! and also Reviews & Rationales: Fluids & Electrolytes and Acid-Base Balance by Pearson Prentice Hall are good books.

~Mi Vida Loca~RN, ASN, RN · Mar 13, 2011

Fluids & Electrolytes Made Incredibly Easy! and also Reviews & Rationales: Fluids & Electrolytes and Acid-Base Balance by Pearson Prentice Hall are good books.

The Fluids and Electrolytes Made Incredibly Easy really made everything click for me. I had owned the book for 3 years and just finally read it 3 weeks ago, Really wish I would have read it sooner but I think it did really well for explaining things and pulling it all together.