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Urinary Function/Fluid and Electrolytes, banana, kidney, water, IV, Group…
Urinary Function/Fluid and Electrolytes
Fluid volume deficit (hypovolemia)
Signs and symptoms
change in mental state, weakness, weak pulse, thirst, weight loss, dark urine, oliguria, low BP, dry mucus membranes, reduced skin elasticity, tachypnea
diagnostics
lab values
subjective/objective assessment
Interventions
treat underlying cause
IV fluid replacement
monitor electrolyte values
Assessments
monitor weight
accurate intake and output
vital signs/peripheral pulse pressure
monitor effects of IV therapy
Complications
hypovolemic shock
heart failure
coma
alkalosis
death
causes
vomiting/diarrhea
fever/infection
excessive sweating
heat related illness
excessive urination
decreased fluid intake
kidney failure
Chronic Kidney Disease
risk factors
smoking
hypertension
diabetes
cardiovascular disease
family history/genetics
signs and symptoms
anemia
hematuria
oliguria
edema
fatigue
decreased LOC
hypertension
renal replacement therapy
hemodialysis
peritoneal dialysis
nursing management of dialysis
treatments
ACE inhibitors
treat the cause
vitamins/supplements
adjust doses of medications
adequate fluid intake
complications
fluid retention
hyperkalemia
cardiac dysrhythmias
hypercalcemia
anemia
bone disease
kidney function lab values
GFR
BUN
creatinine
Kidney transplant
post op considerations
lifestyle changes
eligibility
anti-rejection medication side effects
risks
rehabilitation
diet and lifestyle
consult dietitian
exercise
healthy food choices
low salt, low fat
good hydration
Renal failure
acute
chronic
End stage
Hyper/hypokalemia
Hypokalemia
causes
vomiting/diarrhea
NG suction
perfuse diaphoresis
potassium wasting diuretics
K+ less than 3.5 mmol/L
manifestations
muscle weakness/cramping
fatigue
n/v
cardiac dysrhythmia
Interventions
potassium supplement
cardiac assessment (ECG)
monitor K+ lab values
Hyperkalemia
K+ greater than 5.0 mmol/L
causes
kidney disease
potassium sparing diuretics
potassium drugs
ACE inhibitors
uncontrolled diabetes
dehydration
interventions
hold potassium meds, supplements, dietary intake
cardiac assessment (ECG)
monitor K+ lab values
administer diuretics if appropriate
calcium gluconate
Infections
signs and symptoms
fever
nausea and vomiting
pain: localized or radiating
abnormal GI or GU symptoms
chills
abdominal pain
treatments
antibiotics
cholecystectomy (for cholecystitis)
pain management
labratory tests/value
culture and senstivity
blood tests
ultrasound
endoscopic ultrasound
urine or stool sample
renal infections, pancreatitis, cholecystitis, UTI
IV therapy
Solution types
hypertonic: more water leaves the cell than enters; concentration greater outside the cell
D10W
D5NS
Isotonic: solution same concentration as cell
NS
RL
hypotonic: more water enters cell than leave it; concentration greater inside cell
1/2 NS
IV fluid assessments
s/s hyper/hypovolemia
cardiac and respiratory assessment
Intake and output
neurological assessment
assess effects and need for IV fluids
compatibility with medications
checking monograph for compatibility
some medications interact with IV fluids
complications
phlebitis
Infiltration
fluid volume overload
nursing interventions
perform assessments
follow orders for fluids (right solution, right rate)
monitor electrolyte values
changing IV bags and tubing when appropriate
understand types of solutions
health teaching
Group roles
: Jecyl-- concept map, Jazz and Katelyn-- researchers, Hannah-- facilitator, Paige-- presenter
