NUR 242 Med/Surg Exam 2 Questions and Correct
Answers, With Complete Solution. 2024/2025.
Hypocalcemia s/s
- serum level below 9
- painful muscle spasms in calf/foot during rest or sleep
- positive Chvostek's and Trousseau's signs
- parethesias, tingling, numbness
- WEAK THREADY HEART RATE that may be slower or faster than normal
Hypocalcemia causes
- inadequate oral intake of calcium and Vitamin D
- kidney failure
- malabsorption syndrome (Chrohn's disease)
- lactose intolerance
- ESKD
Hypocalcemia treatment
- oral or IV calcium supplements
- seizure precautions
- Vitamin D to help with the absorption of calcium from the GI tract
Hypercalcemia s/s
- serum level higher than 10.5
- severe muscle weakness and decreased deep tendon reflexes
- confusion
- lethargy
- INCREASED HR & BP
- severe prolonged - electrical conduction depression
- cyanosis, pallor
- blood clots
Hypercalcemia causes
- excessive oral intake of calcium and Vitamin D
- kidney failure
- use of thiazide diuretics
Hypercalcemia treatment
- D/C thiazide diuretics and replace with diuretics that enhance excretion of calcium
(lasix/furosemide)
- administer IV fluids (0.9% NS)
- sodium increases kidney excretion of calcium
Hypokalemia s/s
- serum level less than 3.5
- THREADY, WEAK, IRREGULAR PULSE
- orthostatic hypotension
- lethargy
- skeletal muscle weakness
- CARDIAC DYSRHYTHMIAS
Hypokalemia causes
, - Excessive use of diuretics, digitalis, corticosteroids
- diarrhea & vomiting
- kidney disease
- wound drainage
- prolonged gastric suctioning
Hypokalemia treatment
- increase serum potassium levels - oral of IV potassium
- NEVER GIVE VIA IV PUSH
- hold diuretics
- fall prevention
- use potassium-sparing diuretics if NEEDED
Hyperkalemia s/s
- serum level greater than 5.0
- SLOW, WEAK, IRREGULAR HEART RATE
- decreased BP
- profound skeletal muscle weakness
- CARDIAC DYSRHYTHMIA - TALL PEAKED T WAVES AND WIDE QRS
COMPLEXES
Hyperkalemia causes
- potassium-sparing diuretics
- salt substitutes
ACE inhibitors
- kidney failure
-rapid infusion of potassium containing IV solutions
Hyperkaelmia treatment
- assess cardiac complications
- fall prevention
- Kayexalate
- hold oral potassium supplements
- potassium restricted diet
- tele montior
Hypovolemia (dehydration) s/s
- INCREASED AND THREADY PULSE RATE
- dyspnea
- orthostatic hypotension
- flat neck veins and hand veins
- tenting of the skin
- diminished peripheral pulses
- decreased urine output
Hypovolemia causes
- occurs when fluid intake is not sufficient to meet the fluid needs of the body
- hemorrhage
- vomiting/diarrhea
- severe wounds
- diuretic therapy
- GI suctioning
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