Medical-surgical Nursing Demystified

(Sean Pound) #1

(^426) Medical-Surgical Nursing Demystified



  • Weigh daily and compare.

  • Record fluid intake and output to check balance of fluid.

  • Monitor IV site for patency, signs of infiltration such as redness or induration.

  • Consult with dietician.

  • Explain to the patient:

    • Restrict salt in the diet.

    • Fluid intake restriction.

    • Proper oral hygiene to avoid irritation due to fluid restriction.




Hypocalcemia


WHAT WENT WRONG?


Hypocalcemia is an abnormally low level of calcium in the blood. Decreased
levels of calcium may be due to inadequate intake or absorption (vitamin D defi-
ciency, malabsorption), excess loss (associated with burns, renal disease, diuretics,
or alcoholism), endocrine disorders (such as hypoparathyroidism), decreased serum
albumin, hyperphosphatemia, or sepsis.

PROGNOSIS


Identification and correction of the cause is necessary to return the patient to a nor-
mal fluid and electrolyte balance. As the calcium level becomes more abnormal,
the risk to the patient is greater. Seizures and cardiac arrhythmias may develop,
which may become life-threatening.

HALLMARK SIGNS AND SYMPTOMS



  • Irritability

  • Paresthesia of lips (circumoral) and extremities

  • Muscle spasm and cramping

  • Tetany—intermittent painful tonic spasms, usually involving the arms and legs

  • Abdominal pain due to muscle cell cramping within the gastrointestinal tract

  • Laryngospasm and stridor (abnormal high-pitched breathing sound) as air-
    way becomes narrowed


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