Anyone Up For Random FACT THROWING?? - page 72

OK I know this sounds stupid but I have a friend that gets really freaked out before big tests like finals, HESI, NCLEX, and usually we get together and a few days before I start throwing out random... Read More

  1. by   Melinurse
    DIABETES:
    Insulin pumps infuse a continuous basal rate & on the basis of activity, food intake, and /or the blood glucose level the patient can give themselves a bolus dose as well. Most commonly it infuses Regular Insulin.

    Glucocorticoids, thyroid meds, oral contraceptives, thiazides ( diuretics ), and estrogen increase blood glucose levels.
    Anticoagulants, ASA, alcohol, beta-blockers, tetracycline, and MAOIs, oh... and hypoglycemics decrease blood glucose levels.

    DKA= the main signs/symptoms of diabetic ketoacidosis are hyperglycemia, dehydration, electrolyte losses, and acidosis. Tx with rehydration ( start IV infusion with 0.9% NS or LR till blood glucose drops down some then add dextrose as prescribed ), IV regular insulin, K+ may be elevated from the acidosis & dehydration, watch for fluid overload, monitor blood glucose closely, do not let blood glucose fall too fast as it can cause edema ( cerebral )or IICP.

    NPH is an intermediate acting insulin with an onset of 3-4 hours, a peak of 4-12 hrs, and a duration of 16-20 hrs.


    Piscesmama, earlier I forgot to say I use Lippincott NCLEX reveiw book. But not for posting.
  2. by   JoanieDee, LPN
    Quote from RNRabbit2be75
    Okay help!
    This might sound stupid but to assess for a thrombis, the nurse would elict a homan's sign to see if there is pain on dorsiflexion...well in Saunder's 4th edition it says to "grasp the foot and dorsiflex it forward"....I thought you would grasp it and move it backwards, as in flexion, not plantar extension. Maybe I'm reading too much into it.
    The following is a link to allnurses.com, regarding homans' sign and PE's.......what we learned in school was never to use it because it is both usless and may cause an existing clot to break off, possibly causing a PE (although it had to be taught)

    https://allnurses.com/forums/f118/ho...-139050-2.html

    I suppose like alot of things, this is one that may be one way "by the book" and another in the real world.
  3. by   Melinurse
    Swan-Ganz Catheter for hemodynamic monitoring:
    Is a pulmonary artery catheter advanced thru the superior vena cava into the R atrium and venticle, and pulmonary artery. A sterile dry dressing should be changed every 24 hours; be sure to check site every shift for s/s of infection.

    A delay between the P wave and QRS = heart block

    Treatment of atrial flutter: correction of underlying disorder, beta-blockers, calcium channel blockers, digitalis, and amniodarone.
  4. by   JoanieDee, LPN
    This has always been so confusing to me, but after having read and reread, and so on, and so on...in Saunders, I think i may finally kind of understand it....so i will attempt to explain what i (may) have learned:

    ACID-BASE BALANCE
    We begin with Hydrogen Ions (H+), which are vital to life, and expressed as pH. The pH of body fluid is normally alkaline (7.35-7.45). The number of hydrogen ions in body fluid determines whether acid, alkaline, or neutral.

    Now, that having been said, we can move on to ACIDS, which:
    ---are produced as end-products of metabolism, and
    ---contain hydrogen ions
    Acids give up H+ ions to neutralize or decrease the strength of an acid, or to form a weaker base (therefore, acids are hydrogen ion DONORS)

    BASES:
    ---contain NO H+ ions
    ---are hydrogen ion ACCEPTORS
    Bases accept H+ ions from acids to neutralize or decrease the strength of a base, or to form a weaker acid.

    And I believe the purpose of all of this is to remain in a state of homeostasis, with the acids and bases doing their thing (give and take) to stay in balance, to keep bodily fluid pH in the range of 7.35-7.45

    Please feel free to correct any and all that is wrong with this....it can only help me and others who are using this fine fine sticky to have accurate facts. Thank you.
  5. by   lswoods83
    OMG! This thread is absolutely fantastic! I wish I would have discovered it sooner. I take the NCLEX on Wednesday and I'm the most petrified I've been in my entire life!!! I've read through the entire thread and loved it.....it's reinforced so many things I've been studying. We'll see how it goes....

    Thanks to all those that took the time to post facts Good luck to all!
  6. by   Melinurse
    [FONT=Lucida Console]Hydrogen ions are vital to life and expressed as pH. Body fluid is slightly alkaline. Norm is 7.35 to 7.45.
    [FONT=Lucida Console]Acids are end products of our metabolism which give up hydrogen ions to neutralize or decrease the acid into a weaker base.
    [FONT=Lucida Console]Bases have NO hydrogen ions but will accept H+ ions.

    [FONT=Lucida Console]Respiratory Acidosis: pH is less than 7.35 and PCO2 is greater than 45 mmHg. The pH may be 7.35-7.40 if compensated.

    [FONT=Lucida Console]Respiratory Alkalosis: pH is over 7.45 and PCO2 is less than 35 mmHg. pH may be 7.40 if compensated.

    [FONT=Lucida Console]Metabolic Acidosis: pH is less than 7.35 and HCO3 is less than 22 mEq/L

    [FONT=Lucida Console]Normal Blood Gas Values:
    [FONT=Lucida Console]pH = 7.35 to 7.45
    [FONT=Lucida Console]PCO2 = 35 to 45 mm Hg
    [FONT=Lucida Console]HCO3 = 22 to 27 mEq/L
    [FONT=Lucida Console]PO2 = 80 to 100 mm Hg

    [FONT=Lucida Console]And JoanieDee, I think you did ok with your description. Just wanted to offer it another way too. Repeating and rereading in a different way helps me so I thought it might help someone else too?:typing
  7. by   amdale
    Thanks for the mag sulfate antidote, That may be on this weeks exam. Great reminder.
  8. by   JoanieDee, LPN
    Quote from Melinurse
    [FONT=Lucida Console]Hydrogen ions are vital to life and expressed as pH. Body fluid is slightly alkaline. Norm is 7.35 to 7.45.
    [FONT=Lucida Console]Acids are end products of our metabolism which give up hydrogen ions to neutralize or decrease the acid into a weaker base.
    [FONT=Lucida Console]Bases have NO hydrogen ions but will accept H+ ions.

    [FONT=Lucida Console]Respiratory Acidosis: pH is less than 7.35 and PCO2 is greater than 45 mmHg. The pH may be 7.35-7.40 if compensated.

    [FONT=Lucida Console]Respiratory Alkalosis: pH is over 7.45 and PCO2 is less than 35 mmHg. pH may be 7.40 if compensated.

    [FONT=Lucida Console]Metabolic Acidosis: pH is less than 7.35 and HCO3 is less than 22 mEq/L

    [FONT=Lucida Console]Normal Blood Gas Values:
    [FONT=Lucida Console]pH = 7.35 to 7.45
    [FONT=Lucida Console]PCO2 = 35 to 45 mm Hg
    [FONT=Lucida Console]HCO3 = 22 to 27 mEq/L
    [FONT=Lucida Console]PO2 = 80 to 100 mm Hg

    [FONT=Lucida Console]And JoanieDee, I think you did ok with your description. Just wanted to offer it another way too. Repeating and rereading in a different way helps me so I thought it might help someone else too?:typing
    thank you for that, Mellinurse!! I need to see things in various ways before i "get it" most times, too, and appreciate the great help you are giving!!! Too funny also that I was trying to figure out a way to describe acidosis/alkalosis at the same time you typed that post...so i am just going to go ahead and post mine also, although yours seems accurate and is simpler than mine.....keep posting, please!!!!
  9. by   JoanieDee, LPN
    ACIDOSIS/ALKALOSIS

    With all ACIDOSIS, pH is down
    With all ALKALOSIS, pH is up

    Respiratory:
    Acidosis...... PCO2; pH (causes: asthma, atelectasis, brain trauma, bronchiactasis, bronchitis, hypoventilation, medications, emphysema)
    Alkalosis..... PCO2; pH (causes: fever, hyperventilation, hypoxia, hysteria, pain, overventilation by mechanical ventilators)

    Metabolic:
    Acidosis......HCO3 (bicarb ion); pH (or EVERYTHING DOWN) (causes: diabetis mellitus, ketoacidosis, excessive ingestion of ASA, high-fat diet, insufficient metabolism of CHO's, malnutrition, renal insufficiency or failure, severe diarrhea)
    Alkalosis..... HCO3; pH or (EVERYTHING UP) (causes: diuretics, excessive vomiting, excessive gastro. sunctioning, hyperaldosteromism, ingestion of excessive bicarbonates, massive transfusion of whole blood)

    ***Remember with gastro. irrigation of 2+ hours to use NS, not sterile water, to prevent alkalosis***
  10. by   JoanieDee, LPN
    Quote from lswoods83
    OMG! This thread is absolutely fantastic! I wish I would have discovered it sooner. I take the NCLEX on Wednesday and I'm the most petrified I've been in my entire life!!! I've read through the entire thread and loved it.....it's reinforced so many things I've been studying. We'll see how it goes....

    Thanks to all those that took the time to post facts Good luck to all!
    gl to you on Wednesday, not that you need it since you will do just fine with all you have learned (and will still learn on this great site.....i know I am re-learning just about everything on here!! I absolutely love it!!)
  11. by   Jack_ICU
    Quote from jadu1106
    fftopic:
    i know this is so off topic, but for those of you that have been following this thread since almost the beginning...

    [color=#2f4f4f]does anyone know where buttercup7507 is? she was a constant on here as i am...but of late i have not seen her on here. hmmmm...i am not even sure when she was supposed to test. i just don't know what has come of her....

    [color=#2f4f4f]i know this is off topic, but maybe someone can shed some light on this. i can't help but wonder how she is and what she is up to, especially since she is also in the same boat as me in preparing to study for this exam.

    [color=#2f4f4f]thanks for reading!!

    you are right jadu! buttercup has been missing in action! lol hope she is doing well. she was about to take her boards in august.
  12. by   grouchybuthappy
    plus.......more hemodynamics......
    swan ganz provides a measurement of left ventricular function
    cvp measures right heart filling. increased cvp means increasd blood volume which translates to right heart failure.
    both of these measure pressure in the ventricles.

    iabp: assists to augment cardiac ouput and helps with tissue perfusion, at the same time letting the heart muscle rest and recover. this is used for cardiogenic shock,hf, and unstable angina.
    keep hob elevated 30 degrees tp prevent migration,keep leg straight always. monitor ptt,pt since pt in on heparin.
  13. by   Melinurse
    Has anyone tried to send Buttercup7507 a PM? Hoping all is ok.

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