Nursing > Study Guide > NR 328 Exam 2 Study Guide | Pediatric Nursing : GI GU Cardiac Burns (All)
Fluid & Electrolytes Chapter 29: • Signs and symptoms of fluid overload pg. 1056 pg. 949 & 956-957 Generalized edema, pulmonary edema (moist rales & crackles), Hepatomegaly, slow bounding pulse,... weight gain, lethargy, elevated venous pressure, seizures, coma. Lab findings: Decreased serum electrolytes, low urine specific gravity, decreased hematocrit, variable urine volume. • Signs and symptoms of fluid deficit pg. 1056 pg. 949 & 951-955 Top 3: #1 Poor skin turgor #2 abnormal respirations= Tachypnea #3 Prolonged capillary refill >2 secs Tachycardia, dry skin & mucous membranes, sunken eyes & fontanels, irritability, lethargy, thirst, weight loss, diminished urine output, and altered level of consciousness, disorientation. Lab findings: High urine specific gravity, increased hematocrit, increased BUN, increased serum osmolality • Hypo and hyperkalemia & Foods that contain potassium Pg. 1359 pg. 1271 Hypokalemia: o < 3.5 mEq/L o Abnormal EKG; notched or flattened T waves, decreased ST segment, premature ventricular contractions o Muscle weakness, cramping, stiffness, paralysis, hyporeflexia, hypotension, cardiac arrhythmias, gallop rhythm, tachycardia or bradycardia, ileus, apathy, drowsiness, irritability, fatigue Hyperkalemia: o > 5.5 mEq/L o Variable urine volume o Flat P wave on ECG, peaked T waves, widened QRS complex, increased PR interval o Muscle weakness, flaccid paralysis, twitching, hyperreflexia, bradycardia, ventricular fibrillation and cardiac arrest, oliguria, apnea—respiratory arrest Foods that contain potassium: Foods with thick skin: Oranges, banana, nuts, squash, carrots, broccoli, kale, tomatoes, beans, avocado, fish, mushrooms • Signs and symptoms of hypo & hypernatremia pg. 1056 pg. 949-950 Hyponatremia (less than 135 mEq): anorexia, nausea, vomiting, weakness, lethargy, confusion, muscle cramps, twitching, & seizures. Hypernatremia (more than 145 mEq): Thirst, hyperpyrexia (Extremely high fever), sticky mucous membranes, dry mouth, oliguria (diminished urine output) hallucinations, lethargy, irritability, & seizures. • Types of dehydration: Isotonic, hypotonic, hypertonic (see Ecollege:DocSharing: Powerpoints: GI dysfunction) Babies= ECF > ICF (75% water) leads to more rapid loss Isotonic Dehydration: This is the primary form of dehydration occurring in children (Na remains normal since H2O loss and electrolyte loss are equal. Leads to shock) H2O loss = electrolyte loss hypovolemic shock. The major loss is from the ECF. Symptoms are related to hypovolemic shock [Show More]
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