Neuro Corticosteroids: Used mainly for brain

tumors, helps reduce inflammation and

Increased Intracranial Pressure (ICP) edema.
Types: Antihypertensives: To control blood
pressure, which can affect ICP.
Acute ICP: Sudden increase in pressure,
often due to trauma or a medical Nursing Management:
emergency, which requires immediate Head Positioning: Elevate the head of the
intervention. bed to 30 degrees to facilitate venous
Chronic ICP: Gradual increase in pressure, drainage.
often associated with conditions like Airway Management: Monitor oxygen
hydrocephalus, where the body has time to levels, avoid hypoxia or hypercapnia (high
adapt somewhat to the changes. CO2).
Reduce Environmental Stimulation:
Causes: Minimize noise, light, and activity around the
Traumatic Brain Injury (TBI): Damage to patient.
the brain tissue due to accidents or falls. Frequent Neurological Assessments:
Brain Tumors: Growths within the skull that Using tools like the Glasgow Coma Scale to
take up space, compressing the brain. monitor changes.
Infections: Meningitis or encephalitis can Family Education: Explain signs of
cause swelling of brain tissue. increased ICP and emphasize follow-up
Hydrocephalus: Accumulation of care.
cerebrospinal fluid (CSF) in the brain’s
ventricles. Cerebrovascular Accident (CVA)
Cerebral Edema: Swelling of brain tissue Types:
due to stroke, hypoxia, or toxins.
Signs and Symptoms: Ischemic Stroke: Caused by a blood clot
blocking an artery supplying the brain.
Early Signs: Headache, nausea, vomiting Hemorrhagic Stroke: Caused by bleeding
without nausea, and restlessness. in or around the brain due to a ruptured
Late Signs: Cushing’s triad (hypertension blood vessel.
with widened pulse pressure, bradycardia,
and irregular respirations), altered Causes:
consciousness, pupil changes, and Hypertension: The leading cause of
abnormal posturing. hemorrhagic stroke.
Atherosclerosis: Plaque buildup in arteries
Medications: can lead to clots, causing ischemic stroke.
Osmotic Diuretics (e.g., Mannitol): Helps Atrial Fibrillation: Increases the risk of
draw water out of brain cells to reduce clots in the heart, which can travel to the
pressure. brain.
Hypertonic Saline: Reduces brain swelling Other Risk Factors: Smoking, diabetes,
by drawing fluid out. high cholesterol, and sedentary lifestyle.
Sedatives or Barbiturates: Used to reduce
brain metabolism and oxygen demand. Signs and Symptoms:

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Ischemic Stroke: Sudden numbness or Miller Fisher Syndrome: A rare form that
weakness (often on one side), difficulty starts with eye muscle weakness and gait
speaking, vision problems, dizziness, and abnormalities.
confusion.
Hemorrhagic Stroke: Severe headache, Causes:
vomiting, loss of consciousness, and Often triggered by viral or bacterial
neurologic deficits. infections, surgery, or vaccinations.
It is an autoimmune disorder where the
Medications: body’s immune system attacks peripheral
Tissue Plasminogen Activator (tPA): For nerves.
ischemic strokes within 3-4.5 hours of
onset, helps dissolve clots. Signs and Symptoms:
Antiplatelet Agents (e.g., Aspirin): Weakness and tingling in the legs, which
Prevents further clotting in ischemic strokes. may progress to the upper body.
Anticoagulants (e.g., Warfarin): For Difficulty breathing if respiratory muscles
patients with high clot risk (e.g., with atrial are involved.
fibrillation). Loss of reflexes, and in severe cases,
Blood Pressure Control Medications: paralysis.
Crucial in hemorrhagic strokes to prevent
further bleeding. Medications:
Intravenous Immunoglobulin (IVIG):
Nursing Management: Modulates immune response.
Neuro Monitoring: Check consciousness, Plasmapheresis: Removes antibodies from
speech, motor skills, and response to the blood, reducing immune attack on
stimuli. nerves.
Vital Signs: Maintain stable blood pressure Pain Management: Analgesics for pain
and manage glucose levels. associated with nerve inflammation.
Positioning: Prevent aspiration by
positioning patients with head slightly Nursing Management:
elevated. Respiratory Monitoring: Check for
Rehabilitation Support: Physical, breathing difficulty, provide respiratory
occupational, and speech therapy are often support if needed.
needed. Prevent Complications: Address
Education on Risk Factor Management: immobility risks like pressure ulcers, DVT,
Lifestyle changes to prevent future strokes. and muscle atrophy.
ROM Exercises: Prevent contractures and
Guillain-Barré Syndrome (GBS) muscle wasting.
Types: Provide Psychological Support: Recovery
can take months, so emotional support is
Acute Inflammatory Demyelinating crucial.
Polyradiculoneuropathy (AIDP): Most Family Education: Inform about signs of
common, affects peripheral nerves. respiratory distress and relapse prevention.

Myasthenia Gravis (MG)

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Types: Medication Adherence: Stress the
importance of regular medication use to
Ocular Myasthenia Gravis: Limited to eye prevent worsening.
muscles, causing drooping eyelids and
double vision.
Generalized Myasthenia Gravis: Affects Multiple Sclerosis (MS)
multiple muscle groups, including those
involved in breathing. Types:
Relapsing-Remitting MS (RRMS):
Causes: Symptoms flare up (relapse) followed by
Autoimmune disorder where antibodies periods of partial or complete recovery.
attack acetylcholine receptors at the Primary-Progressive MS (PPMS):
neuromuscular junction, disrupting Symptoms worsen steadily without
nerve-muscle communication. remissions.
Secondary-Progressive MS (SPMS):
Signs and Symptoms: Initially relapsing-remitting, then progresses
Muscle weakness that worsens with activity steadily.
and improves with rest.
Ptosis (drooping eyelids), diplopia (double Causes:
vision), and dysphagia (difficulty Autoimmune disorder where the immune
swallowing). system attacks the myelin sheath in the
CNS. Exact cause is unknown, but involves
Medications: genetics and environmental factors.
Acetylcholinesterase Inhibitors (e.g.,
Pyridostigmine): Improve nerve-muscle Signs and Symptoms:
communication. Fatigue, muscle weakness, numbness or
Immunosuppressants and tingling, balance and coordination issues,
Corticosteroids: Suppress immune activity and vision disturbances.
against acetylcholine receptors.
IVIG or Plasmapheresis: Used for severe Medications:
exacerbations. Disease-Modifying Therapies (DMTs):
Such as interferons and glatiramer acetate,
Nursing Management: to slow progression.
Activity Management: Plan activities Corticosteroids: Used during relapses to
during times of peak strength. reduce inflammation.
Respiratory Monitoring: Monitor for Symptomatic Medications: Muscle
respiratory muscle weakness. relaxants, pain relievers, and medications
Energy Conservation Techniques: for bladder control.
Educate the patient on managing energy
and rest periods. Nursing Management:
Fall Prevention: Encourage the use of Mobility Support: Assist with walking aids,
mobility aids as needed. prevent falls, and encourage regular activity.
Manage Fatigue: Educate on balancing
activity with rest.

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Bladder and Bowel Training: Support Emotional and Cognitive Support:
bladder control and bowel regularity. Address depression, anxiety, and cognitive
Psychological Support: Provide mental changes.
health resources and counseling.
Medication Adherence: Emphasize Post-op
importance of DMT adherence and Nursing Care and Client’s Preparation
symptom management. During Preoperative, Intraoperative, and
Postoperative Phases
Parkinson’s Disease
Preoperative Phase:
Types: Assessment: Evaluate the patient's health
Primary Parkinson’s Disease: Idiopathic, status, medical history, allergies,
with no known cause. medications, and any surgical risk factors.
Secondary Parkinsonism: Due to drugs, Patient Education: Explain the procedure,
toxins, or other neurological disorders. potential outcomes, and recovery
expectations to reduce anxiety.
Causes: Preparation: Ensure the patient is fasting
Degeneration of dopamine-producing as required, perform necessary tests, mark
neurons in the substantia nigra, affecting the surgical site if needed, and start IV
motor function. access.

Signs and Symptoms: Intraoperative Phase:

Tremor, rigidity, slow movements, postural Patient Positioning: Position the patient to
instability, as well as mood and cognitive ensure comfort, safety, and access to the
changes. surgical site.
Asepsis and Sterility: Maintain a sterile
environment and adhere to infection control
Medications: protocols.
Levodopa/Carbidopa: Replenishes Monitoring: Observe vital signs and patient
dopamine in the brain. status; assist the surgical team as needed.
Dopamine Agonists: Stimulate dopamine
receptors. Postoperative Phase:
MAO-B Inhibitors: Slow dopamine Recovery Monitoring: Assess for
breakdown. complications such as bleeding, infection, or
anesthesia-related side effects.
Nursing Management: Pain Management: Administer pain
Fall Prevention: Encourage use of mobility medications as prescribed and monitor
aids. effectiveness.
Medication Management: Monitor for side Patient Education: Provide instructions on
effects like dyskinesia. wound care, activity limitations, and
Exercise Encouragement: Regular activity follow-up appointments.
to maintain muscle function.
Swallowing and Speech Support: Refer Operating Room Members and Their
for speech therapy if needed. Roles

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Surgeon: Performs the surgery; Hemostats: Clamps blood vessels to
responsible for preoperative planning and control bleeding.
intraoperative decision-making. Retractors: Hold back tissues to provide a
Anesthesiologist or Nurse Anesthetist: better view of the surgical site.
Administers anesthesia and monitors the Scissors: Used for cutting tissues; can be
patient's vital signs and sedation level. curved or straight, with different types for
Scrub Nurse or Surgical Technologist: tissue or suture cutting.
Prepares and manages surgical
instruments; maintains a sterile field during Types of Anesthesia
surgery. General Anesthesia: Patient is rendered
Circulating Nurse: Manages non-sterile unconscious; used for major surgeries.
activities, coordinates care, documents Administered via inhalation or IV drugs.
procedures, and assists with patient Regional Anesthesia: Numbs a specific
positioning. area of the body (e.g., spinal, epidural); the
Surgical Assistant: Helps the surgeon by patient remains awake but may receive
retracting tissues, suctioning fluids, and sedation.
suturing as required. Local Anesthesia: Numbs a small, specific
area (e.g., for minor procedures like
Principles of Asepsis and Sterility suturing).
Asepsis: The absence of pathogenic Monitored Anesthesia Care (MAC):
organisms. Aseptic techniques aim to Patient is sedated but not fully unconscious;
prevent contamination and infection. often used in conjunction with local
Sterility: Ensuring that equipment, anesthesia.
instruments, and the surgical field are free
from all microorganisms. Complications and Management of
Key Practices: Anesthesia
Hand Hygiene: Proper washing and
disinfecting of hands. Common Complications:
Sterile Field Maintenance: Only sterile Nausea and Vomiting: Often managed
objects should come into contact with the with antiemetics (e.g., ondansetron).
sterile field. Allergic Reactions: Immediate recognition
Use of Personal Protective Equipment and administration of antihistamines or
(PPE): Gloves, gowns, and masks help to epinephrine if severe.
prevent contamination. Hypotension: Managed with fluids and
Environmental Controls: Restricted traffic medications to stabilize blood pressure.
and airflow management in the OR to Respiratory Depression: Monitor
minimize contamination. breathing closely, especially after general
anesthesia; may require oxygen or
Medical and Surgical Instruments mechanical ventilation.
Scalpel: Used for incisions; available in Malignant Hyperthermia: A rare but
various blade sizes for different procedures. life-threatening reaction; treated with
Forceps: Grasp and hold tissues; can be dantrolene and rapid cooling.
toothed or non-toothed depending on tissue
type. Nursing Management:

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Preoperative Screening: Identify risk Treatment: Hormone replacement therapy
factors for anesthesia complications, such (e.g., cortisol, thyroid hormone, sex
as family history of malignant hyperthermia. hormones).
Intraoperative Monitoring: Continuous
monitoring of vital signs and Nursing Management: Monitor for vision
responsiveness. changes and signs of hormone imbalances,
administer hormone replacements, and
Postoperative Care: Close observation in educate patients on the importance of
the post-anesthesia care unit (PACU) to medication adherence and regular
manage any immediate complications and check-ups.
ensure a safe recovery.
Hyperthyroidism and Hypothyroidism
Endocrine
Hyperthyroidism:
Hyperpituitarism and Hypopituitarism Definition: Overproduction of thyroid
hormones, leading to an increased
Hyperpituitarism: metabolism. Graves' disease is a common
Definition: Excess production of one or cause.
more hormones by the pituitary gland, Causes: Often due to autoimmune disease
usually caused by a pituitary tumor. (Graves' disease), toxic multinodular goiter,
or thyroiditis.
Causes: Most commonly caused by a Signs and Symptoms: Weight loss, rapid
pituitary adenoma (a benign tumor). heartbeat, heat intolerance, nervousness,
Signs and Symptoms: Symptoms vary and bulging eyes (exophthalmos).
depending on the hormone overproduced Treatment: Antithyroid drugs (e.g.,
but can include enlarged hands and feet methimazole), beta-blockers to manage
(acromegaly), joint pain, vision changes, symptoms, radioactive iodine to reduce
and, in cases involving prolactin, menstrual thyroid activity, or surgery in severe cases.
irregularities or infertility.
Treatment: May involve medications like
dopamine agonists to shrink the tumor, or Hypothyroidism:
surgery to remove it. Definition: Insufficient production of thyroid
hormones, slowing down metabolism.
Hypopituitarism: Hashimoto’s thyroiditis is a common cause.
Definition: Insufficient production of Causes: Autoimmune disease (Hashimoto’s
pituitary hormones, affecting body growth, thyroiditis), iodine deficiency, or thyroid
thyroid function, and adrenal function. surgery.
Causes: Pituitary tumors, infections, Signs and Symptoms: Fatigue, weight
radiation, or head trauma. gain, cold intolerance, dry skin, hair loss,
Signs and Symptoms: Fatigue, weight and bradycardia.
loss, decreased libido, sensitivity to cold, Treatment: Levothyroxine, a synthetic
and possible vision changes. thyroid hormone to replace the deficiency.
Nursing Management: Monitor vital signs
and symptoms of thyroid imbalances,

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educate on medication adherence, manage Definition: Primary adrenal insufficiency,
diet and activity levels, and encourage where the adrenal glands do not produce
regular blood tests to monitor thyroid enough cortisol and aldosterone.
function.
Causes: Autoimmune destruction of the
Hyperparathyroidism and adrenal glands, infections like tuberculosis,
Hypoparathyroidism or metastatic cancer.

Hyperparathyroidism: Signs and Symptoms: Fatigue, muscle

Definition: Excessive secretion of weakness, weight loss, hyperpigmentation
parathyroid hormone (PTH), which raises (darkening of the skin), low blood pressure,
calcium levels in the blood. salt cravings, and hypoglycemia.
Causes: Parathyroid adenoma (tumor),
chronic kidney disease, or other conditions Treatment: Corticosteroid replacement
that alter calcium metabolism. (hydrocortisone or prednisone) and
Signs and Symptoms: Hypercalcemia, mineralocorticoid replacement
bone pain, kidney stones, fatigue, muscle (fludrocortisone) to maintain electrolyte
weakness, and abdominal pain. balance.
Treatment: May involve surgery to remove
overactive parathyroid glands, medications Nursing Management: Monitor for signs of
to lower calcium levels (e.g., calcimimetics), an Addisonian crisis (sudden drop in cortisol
or bisphosphonates to strengthen bones. leading to low blood pressure and shock),
educate on stress management, encourage
Hypoparathyroidism: adherence to medication, and advise a diet
Definition: Deficiency in PTH production, high in salt if aldosterone is low.
causing low calcium levels in the blood.
Causes: Often due to accidental removal or Cushing’s Syndrome
damage to the parathyroid glands during Definition: A condition caused by
thyroid surgery. prolonged exposure to high levels of
Signs and Symptoms: Hypocalcemia, cortisol, either due to overproduction
muscle cramps, tingling in fingers and lips, (endogenous) or from taking corticosteroid
tetany (muscle spasms), and seizures in medications (exogenous).
severe cases.
Treatment: Calcium and vitamin D Causes: Long-term corticosteroid use,
supplements to maintain calcium levels. adrenal or pituitary tumors.
Nursing Management: Monitor calcium
levels, educate on the importance of dietary Signs and Symptoms: Weight gain
calcium and vitamin D, and assess for (especially in the trunk), a round “moon”
symptoms of hypocalcemia or face, buffalo hump, high blood sugar, high
hypercalcemia. blood pressure, thin skin, and easy bruising.

Addison’s Disease Treatment: Reducing corticosteroid use (if

medically feasible), surgical removal of

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tumors, and medications like ketoconazole Causes: Head trauma, pituitary surgery,
to lower cortisol levels. kidney disease.

Nursing Management: Monitor blood Signs and Symptoms: Excessive thirst

sugar, blood pressure, and skin integrity, (polydipsia), large amounts of dilute urine
educate on reducing stress, and provide (polyuria), dehydration, and elevated blood
emotional support for body image changes. sodium levels.

Syndrome of Inappropriate Antidiuretic Treatment:

Hormone (SIADH) Central DI: Desmopressin (synthetic ADH).
Definition: Excessive release of antidiuretic Nephrogenic DI: Thiazide diuretics and a
hormone (ADH), leading to water retention low-salt diet.
and hyponatremia (low sodium levels).
Nursing Management: Monitor fluid intake
Causes: Brain injuries, infections, lung and output, educate on medication use and
diseases, and some medications. hydration needs, assess for dehydration,
and help maintain electrolyte balance.
Signs and Symptoms: Fluid retention, low
urine output, confusion, muscle cramps, and Pheochromocytoma
seizures due to low sodium. Definition: A rare tumor of the adrenal
gland that produces excess catecholamines
Treatment: Fluid restriction, diuretics, (adrenaline and noradrenaline), causing
hypertonic saline in severe cases, and high blood pressure.
medications to block ADH effects (e.g.,
demeclocycline). Causes: Usually due to a benign tumor on
the adrenal medulla, though genetic factors
Nursing Management: Monitor fluid may contribute.
balance and sodium levels, educate on fluid
restriction, assess neurological status, and Signs and Symptoms: Episodes of severe
provide patient support during restricted hypertension, palpitations, headache,
fluid intake. sweating, and anxiety.

Diabetes Insipidus (DI) Treatment: Alpha-blockers and

Definition: A disorder characterized by beta-blockers to control blood pressure,
decreased secretion or response to ADH, followed by surgery to remove the tumor.
leading to excessive water loss and
dehydration. Nursing Management: Monitor blood
pressure, educate on signs of hypertensive
Types: crisis, ensure preoperative and
Central DI: Due to lack of ADH production postoperative care, and provide emotional
from the pituitary. support for anxiety.
Nephrogenic DI: Due to the kidneys not
responding to ADH. Diabetes Mellitus

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Types: Types: Based on oxygenation levels (mild,
Type 1: An autoimmune disorder causing moderate, severe) as defined by the
the body to destroy insulin-producing cells PaO2/FiO2 ratio.
in the pancreas. Causes: Major causes include sepsis,
Type 2: Characterized by insulin resistance, pneumonia, trauma, inhalation of harmful
often associated with obesity and lifestyle substances, and severe inflammation.
factors.
Gestational Diabetes: Develops during Signs and Symptoms: Severe shortness
pregnancy and usually resolves after birth. of breath, labored and rapid breathing, low
blood oxygen levels (hypoxemia), cyanosis
Causes: Genetic, autoimmune for Type 1; (blue-tinted skin), and fatigue.
lifestyle and genetic factors for Type 2.
Treatment: Primarily supportive with
Signs and Symptoms: Frequent urination mechanical ventilation to assist breathing,
(polyuria), excessive thirst (polydipsia), positioning (like prone positioning), and
hunger (polyphagia), fatigue, weight loss addressing the underlying cause.
(Type 1), blurred vision, and slow-healing
wounds. Medications: Antibiotics if infection is
present, corticosteroids to reduce lung
Treatment: inflammation, and diuretics to manage fluid
Type 1: Insulin therapy. levels.
Type 2: Oral medications (e.g., metformin),
insulin if needed, and lifestyle changes. Nursing Care:
Monitor respiratory status: Regularly check
Nursing Management: Monitor blood oxygen levels, respiratory rate, and lung
glucose levels, educate on diet and sounds.
exercise, teach foot care, instruct on signs Positioning: Position patient in prone or
of hypo- and hyperglycemia, and encourage semi-Fowler's position as needed.
regular follow-ups for HbA1c testing and Suctioning: Clear airway secretions if
other health checks. necessary.
Fluid balance: Monitor fluid intake and
Respiratory output, and manage according to orders

Acute Respiratory Distress Syndrome Emphysema

(ARDS) Overview:
Overview: Emphysema is a type of Chronic
ARDS is a severe, sudden injury to the Obstructive Pulmonary Disease (COPD)
lungs caused by various illnesses or that damages the alveoli (air sacs), leading
injuries. It leads to inflammation and fluid to a decrease in lung elasticity and surface
buildup in the alveoli, making it difficult for area for gas exchange. This results in
oxygen to pass into the bloodstream. difficulty exhaling and chronic shortness of
breath.

Types:

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Centriacinar: Mostly affects the upper Pneumothorax is a condition where air
lungs; common in smokers. enters the pleural space, causing the lung to
Panacinar: Affects the entire lung; collapse. It can occur spontaneously or as a
associated with genetic factors. result of trauma or medical procedures.
Paraseptal: Can lead to spontaneous
pneumothorax (collapsed lung). Types:
Spontaneous: Can be primary (in healthy
Causes: Primarily caused by smoking, but individuals) or secondary (in people with
also due to air pollution and genetic factors lung disease).
(e.g., alpha-1 antitrypsin deficiency). Traumatic: Caused by an injury or trauma to
the chest.
Signs and Symptoms: Chronic cough, Tension pneumothorax: Life-threatening
wheezing, shortness of breath (especially form where trapped air compresses the lung
with exertion), chest tightness, and fatigue. and surrounding structures.

Treatment: Causes: Lung disease, blunt or penetrating

Lifestyle changes: Smoking cessation is trauma, or rupture of small air blisters
crucial. (blebs) on the lungs.
Pulmonary rehabilitation: Breathing
exercises and physical training to improve Signs and Symptoms: Sudden, sharp
endurance. chest pain, shortness of breath, rapid heart
Oxygen therapy: In advanced cases to rate, and reduced breath sounds on the
maintain oxygen levels. affected side.

Medications: Treatment:
Bronchodilators: Help open airways. Needle aspiration or chest tube: To remove
Corticosteroids: Reduce inflammation. trapped air.
Mucolytics: Thin mucus for easier Surgery: For recurrent cases.
clearance.
Medications: Analgesics for pain relief.
Nursing Care:
Educate on smoking cessation: Support and Nursing Care:
resources to quit smoking. Monitor respiratory status: Observe for
Assist with breathing exercises: Encourage worsening symptoms, especially signs of
deep breathing exercises like pursed-lip tension pneumothorax.
breathing. Chest tube care: Ensure the chest tube is
Monitor oxygen therapy: Ensure oxygen is functioning properly if one is in place.
administered as prescribed. Assess for lung expansion: Listen for equal
Teach inhaler techniques: Ensure correct breath sounds and monitor oxygen levels.
inhaler use.
Flail Chest
Pneumothorax Overview:
Overview: Flail chest occurs when multiple adjacent
ribs are fractured in more than one place,

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creating a free-floating segment of the chest bronchial tubes) and emphysema (damage
wall that moves independently. This can to alveoli).
severely impair breathing.
Causes: Smoking is the most common
Causes: Usually due to severe blunt cause, but it can also result from long-term
trauma, such as in car accidents or falls. exposure to pollutants and genetic factors.

Signs and Symptoms: Paradoxical chest Signs and Symptoms: Persistent cough,
movement (inward during inspiration and mucus production, shortness of breath,
outward during expiration), severe pain, wheezing, and fatigue.
respiratory distress, and bruising or swelling
of the chest. Treatment:
Smoking cessation: The most critical step in
Treatment: managing COPD.
Mechanical ventilation: If respiratory Pulmonary rehabilitation: Physical exercises
function is compromised. and education.
Pain management: Essential for effective Oxygen therapy: For patients with severe
breathing and coughing. COPD to improve oxygenation.
Surgical stabilization: In severe cases to
restore normal chest wall mechanics. Medications:
Bronchodilators: Relax airway muscles.
Medications: Analgesics to manage pain Corticosteroids: Reduce inflammation in the
and, if needed, antibiotics for associated airways.
infections. Antibiotics: For infections that can worsen
COPD.
Nursing Care:
Monitor respiratory function: Regular Nursing Care:
assessment of oxygenation and breath Educate on smoking cessation: Offer
sounds. resources and support.
Pain management: Administer prescribed Teach breathing techniques: Pursed-lip
pain medications and consider breathing and diaphragmatic breathing can
non-pharmacological interventions. help.
Assist with breathing exercises: Encourage Monitor for respiratory infections: Educate
deep breathing and coughing to prevent on early signs of infection, as they can
pneumonia. worsen COPD symptoms.

Arterial Blood Gas (ABG) Analysis

Overview:
Chronic Obstructive Pulmonary Disease ABG analysis is a diagnostic test that
(COPD) measures blood pH, oxygen (PaO2), carbon
Overview: dioxide (PaCO2), and bicarbonate levels to
COPD is a chronic inflammatory lung assess lung function and acid-base
disease that obstructs airflow. It includes balance.
both chronic bronchitis (inflammation of the

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Purpose: Evaluate respiratory function, Nursing Care: Monitor potassium levels,
monitor patients on ventilators, and assess assess heart rate and rhythm, and provide
acid-base imbalances. patient education on potassium-rich foods.

Common Abnormal Findings: Hyperkalemia (High Potassium):

Respiratory Acidosis: High CO₂ levels, Causes: Kidney failure, potassium-sparing
usually due to hypoventilation (e.g., in diuretics, tissue damage (e.g., burns or
COPD). trauma).
Respiratory Alkalosis: Low CO₂ levels, often
from hyperventilation (e.g., anxiety, pain). Signs and Symptoms: Muscle weakness,
Metabolic Acidosis/Alkalosis: pH changes fatigue, tingling, irregular heartbeats, and
due to metabolic factors (e.g., kidney risk of cardiac arrest.
disease, diabetic ketoacidosis).
Treatment: Medications to lower potassium
Nursing Care: (e.g., insulin with glucose, calcium
Sample collection: Carefully draw the gluconate, diuretics) and dietary restrictions.
sample, ensuring accuracy.
Monitor for complications: Check for Nursing Care: Monitor ECG for
bleeding or pain at the sample site. arrhythmias, check potassium levels, and
Interpret results: Communicate findings to educate patients on avoiding
the healthcare team and assist with high-potassium foods.
necessary interventions (e.g., oxygen
administration). Sodium Imbalance (Hyponatremia and
Hypernatremia)
Fluid and electrolyte Sodium helps maintain fluid balance, blood
pressure, and nerve function.
Potassium Imbalance (Hypokalemia and
Hyperkalemia) Hyponatremia (Low Sodium):
Potassium is crucial for muscle function,
nerve signals, and heart rhythm. Causes: Diuretics, vomiting, diarrhea,
excessive water intake, kidney or heart
Hypokalemia (Low Potassium): failure.
Causes: Diuretics, vomiting, diarrhea, Signs and Symptoms: Headache,
excessive sweating, and inadequate intake. confusion, seizures, muscle weakness, and
nausea.
Signs and Symptoms: Muscle weakness, Treatment: Sodium replacement (oral or IV
cramps, fatigue, irregular heart rhythms, saline), fluid restriction, and treating
and constipation. underlying causes.
Nursing Care: Monitor sodium levels,
Treatment: Oral or IV potassium assess mental status, implement fluid
supplements, dietary potassium intake (e.g., restriction if prescribed, and provide patient
bananas, oranges). education.

Hypernatremia (High Sodium):

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Causes: Dehydration, high-sodium diet, Nursing Care: Monitor vital signs, reflexes,
kidney disease, excessive sweating, and respiratory function, and magnesium levels.
diabetes insipidus.
Signs and Symptoms: Thirst, dry mouth, Calcium Imbalance (Hypocalcemia and
restlessness, irritability, seizures, and Hypercalcemia)
confusion. Calcium is essential for bone health, blood
Treatment: Gradual rehydration with IV clotting, muscle contraction, and nerve
fluids, treating underlying causes, and function.
dietary adjustments.
Nursing Care: Monitor sodium and fluid Hypocalcemia (Low Calcium):
balance, assess neurological status, and Causes: Vitamin D deficiency,
educate on low-sodium diets. hypoparathyroidism, kidney disease, and
malabsorption.
Magnesium Imbalance Signs and Symptoms: Muscle cramps,
(Hypomagnesemia and tingling (especially around the mouth),
Hypermagnesemia) seizures, and positive Chvostek’s and
Magnesium is important for muscle and Trousseau’s signs.
nerve function, energy production, and bone Treatment: Calcium supplements (oral or
health. IV), vitamin D, and dietary calcium (e.g.,
dairy products, green leafy vegetables).
Hypomagnesemia (Low Magnesium): Nursing Care: Monitor calcium levels,
Causes: Malnutrition, alcoholism, diuretics, assess for signs of tetany (muscle spasms),
diarrhea, and certain medications. provide dietary counseling, and administer
Signs and Symptoms: Muscle cramps, supplements as prescribed.
tremors, seizures, arrhythmias, and
confusion. Hypercalcemia (High Calcium):
Treatment: Oral or IV magnesium Causes: Hyperparathyroidism, cancer,
supplements, dietary sources like nuts, excessive calcium or vitamin D intake,
seeds, and green leafy vegetables. prolonged immobilization.
Nursing Care: Monitor magnesium levels, Signs and Symptoms: Weakness, fatigue,
assess for muscle spasms and neurological confusion, constipation, kidney stones, and
symptoms, and educate on magnesium-rich bone pain.
foods. Treatment: IV fluids, diuretics, medications
to reduce calcium (e.g., bisphosphonates),
Hypermagnesemia (High Magnesium): and increased mobility.
Causes: Kidney failure, excessive Nursing Care: Monitor calcium levels,
magnesium intake (e.g., antacids or assess for symptoms like confusion and
laxatives), dehydration. weakness, encourage fluid intake, and
Signs and Symptoms: Muscle weakness, educate on calcium-lowering diet if needed.
lethargy, low blood pressure, respiratory
depression, and decreased reflexes. General Nursing Care for Electrolyte
Treatment: Discontinue magnesium Imbalances:
sources, IV calcium gluconate to counteract
effects, and possibly dialysis.

COMPILED BY: DAPILAGA ARJAY V.

Monitor Laboratory Values: Regularly check
electrolyte levels and report any
abnormalities.
Assess for Symptoms: Evaluate for signs
and symptoms specific to each electrolyte
imbalance.
Administer Treatments and Medications as
Ordered: Follow the care plan for
supplements, dietary adjustments, and IV
therapy.
Educate the Patient: Inform patients about
dietary sources and lifestyle changes to
manage or prevent imbalances.
Ensure Patient Safety: Implement fall
precautions for patients with muscle
weakness or confusion due to electrolyte
disturbances.

COMPILED BY: DAPILAGA ARJAY V.