SIMPLE NURSING

• ULCERATIVE COLITIS


  inflammation & ulcers in the colon (big long open sores that bleed) leading to decreased hemoglobin
• ULCERATIVE COLITIS SIGN & SYMPTOM

  • 15-20 bloody liquid stool per day
  • Anemia
  • Decreased H/H
  • Rebound tenderness (Report)
• CROHN'S DISEASE


  inflammation granulomas (bumps & lumps) from mouth to anus, but mainly in the small intestines that do not bleed. This deep inflammation can lead to fistulas, which are open tunnels of the GI tract that can contaminate the body.
• CROHN'S DISEASE TEST TIP

  Small Intestines

  • Skip Lesions
  • No blood (main difference from UC)
  • Inflamed tissue:
  • Fistulas, fissures, & abscesses
  • Granulomas (bumps & lumps)
• CROHN'S DISEASE SIGN & SYMPTOM

  • 5 loose stools/day (mucus/pus)
  • Steatorrhea (fatty stools)
• INFLAMMATORY BOWEL DISEASE CAUSES & TRIGGERS

  both conditions (UC & CROHN'S) are autoimmune diseases (the body is attacking itself), so naturally signs & symptoms come & go during times of stress, smoking, & sepsis (infection)
• ELECTROLYTE IMBALANCES

  The MOST deadly conditions are typically the MOST tested conditions, since the main goal of nursing school is to create safe nurses.
• POTASSIUM K+


  (3.5-5.0)

  PRIORITY

  Pumps the heart
• HYPERkalemia (over 5.0) Manisfestations


  Heart = HIGH pumps

  1. Peaked T Waves & ST elevations
  2. Severe V Fib & Cardiac Arrest
  3. Hypotension & Bradycardia

  Neuromuscular = HIGH

  1. Increased DTR
  2. Paralysis & paresthesia (tingling)
  3. Muscle Weakness (General Feeling of heaviness)

  GI = HIGH pumps

  1. Diarrhea
  2. Hyperactive bowel sounds
• HYPERkalemia (over 5.0) Causes


  • Renal Failure
  • Low Aldosterone
  • MEMORY TRICK for AL:
  • A: Adds Sodium
  • L: Loses Potassium
• HYPOkalemia (below 3.0) Manifestations


  Heart = Low & slow pump

  1. Flat T waves, ST depression & U wave

  Neuromuscular = Low & slow

  1. Shallow Respirations Most DEADLY
  2. Decreased DTR
  3. Muscle cramping & flaccid paralysis

  GI = Low & slow

  1. Constipation
  2. Hyp0active bowel sounds
  3. Paralytic ileus (paralyzed intestine)

  Priority risk for SBO
• HYPOkalemia (below 3.0) Causes


  Fluid Loss/Electrolyte Loss

  "Where fluid flow, Electrolytes Goooo"

  Diarrhea, Diuretics, Diet, DKA, AlDosterone
• SODIUM Na+


  (135-145)

  Maintains:

  • Blood pressure
  • Blood volume
  • pH balance

  (Swells the body with FLUID)
• HYPERnatremia (over 145) Manisfestations


  Body = Big & bloated

  1. Edema (swollen body)
  2. Flushed "red & rosey" skin
  3. Increased muscle tone
  4. Swollen dry tongue
  5. Nausea & Vomiting
• HYPERnatremia (over 145) Causes


  • Low ADH (antidiuretic hormone)

  DI: Diabetes Insipidus

  Think Dry Inside

  • Rapid respirations
  • Watery diarrhea
  • Loss of thirst
• HYPOnatremia (below 135) Manifestations


  Brain = Low & slow

  1. Headaches = Cerebral edema
  2. Mental status changes
  3. Seizures & Coma

  Muscular = Low & slow

  • Fatigue & muscle cramps

  Respiratory = Low & slow

  • Respiratory Arrest
• HYPOnatremia (below 135) Causes


  • Sweating
  • Excess water intake

  (running in the extreme heat) TEST TIP

  • SIADH (Excess ADH)
  • Vomiting & diarrhea
  • Diuretics & Diuresis
  • Diet low in salt
  • Low aldosterone
• CHLORIDE Cl-


  (97-107)

  Related to sodium

  Maintains:

  • Blood pressure
  • Blood volume
  • pH balance
• HYPERchloremia (over 107)


  NEARLY SAME AS HIGH SODIUM

  1. Swollen dry tongue
  2. Nausea & Vomiting

  ALKALOSIS - vomiting
• HYPOchloremia (below 97)


  NEARLY SAME AS low SODIUM

  1. Fatigue & muscle cramps
  2. Fever (only difference)
• MAGNESIUM Mg+


  (1.3-2.1)

  Mellows the muscles
• HYPERmagnesemia (over 2.1) manifestations


  Heart = High Mellow

  1. Heart block
  2. Hypotension, Bradycardia

  DTR = High Mellow

  1. Hyporeflexia (decreased DTR)

  Lungs & GI = High Mellow

  • Depressed respirations
  • Hypoactive bowel sounds
• HYPERmagnesemia (over 2.1) causes


  • Renal failure
  • Alcoholism
  • Malnourishment
• CALCIUM Ca 


  (9.0-10.5)

  Contracts the muscles

  Keeps the 3 B's Strong

  B - Bone

  B - Blood (clotting)

  B - Beats (heart)

  Inverse relationship with Calcium
• HYPERcalcemia (over 10.5) manifestations


  HIGH Calm

  1. Kidney stones, moans & groans (Renal Calculi)
  2. Constipation
  3. Bone Pain
  4. Severe muscle weakness & lethargy
• HYPERcalcemia (over 10.5) causes


  • Hyperparathyroidism

  High PTH = High Calcium

  • Cancer
  • Immobility
• HYPOcalcemia (below 9.0) manifestations


  Low Calm = Excited!

  1. T - Trousseau's Sign (Tweking arm when BP cuff on)
  2. C - Chvostek's Sign (Cheek smile when stroking face)
  3. Diarrhea
  4. Weak B's

  Weak Bones = Fractures

  Weak Blood clotting = r/f bleeding

  Weak Beats = Cardiac dysrhythmias
• Hypocalcemia (below 9.0) causes


  • Hypoparathyroidism

  Low PTH = Low Calcium

  • Renal failures TEST TIP

  Chronic kidney disease (CKD)
• PHOSPHATE


  (3.0-4.5)

  • Ca HIGH = Phosphate Low
  • Ca Low = Phosphate HIGH
• HYPERphosphatemia (over 4.5) manifestations


  Think Low Calcium signs

  1. Trousseau's & Tetany
  2. Chvostek's
  3. Weak B's (bones, blood, beats)
• HYPERphosphatemia (over 4.5) causes


  • Renal failure TEST TIP

  Chronic kidney disease (CKD)
• HYPOphosphatemia (below 3.0) manifestations


  Think High Calcium signs

  1. Kidney stones, moans & groans (Renal Calculi)
  2. Constipation
  3. Bone Pain
  4. Severe muscle weakness & lethargy
• HYPOphosphatemia (below 3.0) causes


  • Hyperparathyroidism

  High PTH = High Calcium

  • Genetics
  • Cancer
• URINARY


  The kidneys function like 2 washing machines helping to wash the blood from waste through Filtration, regulating fluid volume by Reabsorption, & also stimulates red blood cell production by producing Erythropoietin.

  Inside the nephron (the functional unit of the kidney) is the Glomeruli, a network of small blood vessels that help to filter the blood from waste.
• URINARY


  The time it takes for half of the medication to be eliminated from the body.
• URINARY

  "FRE the PEE"

  • F - Filtration of medications & waste
  • H - hydrogen ions (too much = High Acidity)
  • U - Urea (BUN - Blood Urea Nitrogen)
  • C - Creatinine (Over 1.3 = Bad Kidney)

  R - Reabsorption ADH - Anti-Diuretic Hormone

  ADH - Add Da H20 (memory trick)

  E - Erythropoietin (stimulates RBC production in bone)
• Anuria


  no urine output
• Oliguria


  Decreased urine output
• Pyuria


  WBC or pus in urine
• Polyuria


  Increased urine output