General Discussion

Parenteral

• Any other route besides GI tract absorption

• IV

• IM

• SQ

• Transdermal

• TPN (Total Parenteral Nutrition) =IV line

Enteral

• It goes through and is absorbed via the GI Tract

• PO

• NGT feeding

Trauma, Recent surgery, Acute diseases

• The stomach releases histamines & more acid

• Leads to stress ulcers

Functions of the Liver

• Filters out toxins (meds, ammonia, bilirubin, Alcohol)

• Stores Glycogen

• Produces Bile

• Metabolizes Vitamin K (Blood clotting)

• fat soluble vitamins

• Synthesizing albumin

Liver failure=Cirrhosis

• Not curable

• RUQ abdominal pain

• Pain will radiate to the right back/shoulder

• Jaundice

• Ecchymosis

• Portal HTN-----High risk for upper GI bleeds

• Hepatic encephalopathy (an accumulation of AMMONIA)

Potassium

• When potassium is elevated, it ALWAYS becomnes an ACID!!!!!

• Hyperkalemia=Metabolic Acidosis

EKG Changes

Hyperkalemia

• Absent or flattened P-waves

• Peaked T-waves

• Widened QRS

Hypokalemia

• prolonged QT interval

• prolonged PR Interval

• Flattened T-waves

• presence of a U-wave

Shock

• Hypoperfusion

• The biproduct of hypoperfusion=Lactic Acid (Lactate)

3 Blood Cells (produced in the bone marrow)

COPD

• Chronically hypoxic

• Bone marrow will make MORE RBCs=cause an Increase in Hgb levels

Gestational Diabetes

• LGA/macrosomia

• Shoulder Dystocia

• Prolapsed cord

Gestational HTN

Pre-eclampsia (occurs after 20 weeks)

" Toxemia of the pregnancy"

1. HTN BP >140/90

2. Proteinuria

3. Severe edema to the face/hands/feet/ankles

4. Hyperreflexia (Hyperactive reflexes)=Clonus

Severe pre-eclampsia

• HTN >160/110

• Having signs R/T the HTN (Blurred vision, tinnitus, headache, epistaxis)

Eclampsia

• SEIZURES!!!!!!!!