N-Trivia
| Serum Potassium Posted: 05 Feb 2011 11:24 PM PST 
Serum Potassium - Is the chemical element with the symbol K (for latin word "Kalium")
- Is important in neuron (brain and nerve) function, and in influencing osmotic balance between cells and the interstitial fluid
- Is also important in preventing muscle contraction and the sending of all nerve impulses in animals through action potentials
- Normal serum potassium levels are between 3.5 to 5.0 mEq/L
Hypokalemia - refers to the condition in which the concentration of potassium (K+) in the blood is low
Causes of Hypokalemia - Inadequate potassium intake
- Diarrhea, excessive perspiration, or losses associated with surgical procedures
- Diuretics
Signs and Symptoms of Hypokalemia - Muscular weakness
- Myalgia
- Muscle cramps (owing to disturbed function of the skeletal muscles)
- Constipation
- Flaccid paralysis
- Hyporeflexia
- Flattened or inverted T waves, a U wave, ST depression and a wide QT interval
Nursing Interventions for Hypokalemia - Eating potassium-containing foods may be recommended, such as leafy green vegetables, tomatoes, citrus fruits, oranges or bananas
- Intravenous Supplementation (such as Rapid Potassium Replacement)
- Potassium Supplement
Hyperkalemia - refers to the condition in which the concentration of the electrolyte potassium (K+) in the blood is elevated
- extreme hyperkalemia is a medical emergency due to the risk of potentially fatal abnormal heart rhythms (arrhythmia)
Causes of Hyperkalemia - Renal insufficiency
- ACE inhibitors and angiotensin receptor blockers
- Potassium-sparing diuretics (e.g. amiloride and spironolactone)
- NSAIDs such as ibuprofen, naproxen, or celecoxib
- Excessive intake of potassium supplement
Signs and Symptoms of Hyperkalemia - Malaise
- Palpitations
- Muscle weakness
- Cardiac arrhythmia or sudden death
Nursing Interventions for Hyperkalemia - Monitor Intake and Output
- Discuss the importance of avoiding foods high in potassium to prevent or control hyperkalemia
- Teach causes of hyperkalemia and the relationship between hemodialysis and hyperkalemia.
Related posts: - Fluid and Electrolyte Imbalance: Hypokalemia
- Serum Sodium Normal Values
- Blood Chemistry Overview
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| Parahemophilia (Factor V Deficiency) Posted: 05 Feb 2011 11:23 PM PST 
Definition Parahemophilia or Factor V deficiency is a rare coagulation disorder. It is an inherited condition that affects the ability of the blood to clot. It also termed as Owren's disease, proaccelerin deficiency or labile factor deficiency. Frequency - No apparent racial predilection for factor V deficiency exists.
- Factor V deficiency affects males and females with equal frequency.
- Factor V deficiency affects all ages. The age at presentation indirectly varies with the severity of disease.
- About 1 person in 1 million people is affected with this disease.
Causes Parahemophilia is caused by a large number of genetic abnormalities. It follows the inheritance pattern as being autosomal recessive. In this disorder, the plasma protein Factor V is low or missing. Thus, when certain coagulation is needed the chain reaction does not take place normally. Inheriting a defective Factor V gene or acquiring an antibody that interferes with normal Factor V function also contributes to the presence of the deficiency. Inhibitor of Factor V can be acquired in the following conditions: - After giving birth
- After being treated with a certain type of fibrin glue
- After surgery
- With an autoimmune diseases and certain cancers
Physiology of Blood Clotting Factor V is an essential component in the blood coagulation cascade. It is synthesized by the liver and in megakaryocytes. This plasma protein circulates in an inactive form. When coagulation is taking place, Factor V is converted to an active factor, Factor Va through a limited proteolysis by the presence of the serine protease a-thrombin. Factor together with the activated factor Xa forms the prothrombinase complex. This complex is the one responsible for the rapid conversion of zymogen prothrombin to the active serine protease a-thrombin. Thrombin cleaves fibrinogen to form fibrin, leading to the ultimate step in coagulation, the formation of a fibrin clot. Signs and Symptoms - Nosebleeds
- Bleeding of the gums
- Easy bruising
- Excessive menstrual bleeding (menorrhagia)
- Umbilical stump bleeding
- Excessive bleeding following injury
- Excessive bleeding following surgery
- Excessive bleeding after giving birth
- Prolonged bleeding time
Diagnosis - factor V assay (showing decreased activity)
- activated partial thromboplastin time (aPTT) test (prolonged)
- prothrombin time (PT) test (prolonged)
- thrombin clotting time (TCT) test
Treatment - Fresh frozen plasma infusions (FFP). Depending upon availability, solvent-detergent FFP may contain a more reliable level of Factor V than standard FFP.
- Fresh blood plasma infusions
- In acute cases of severe bleeding, the addition of platelet concentrates may be helpful.
- Patients with factor V deficiency can be given oral contraceptives to decrease menorrhagias, thereby improving anemia and decreasing transfusion needs.
- Tooth extraction in a patient with factor V hereditary deficiency is safely performed with both supplementation of FFP and application of local hemostasis.
Related posts: - Thrombin Time Test
- Hemophilia Symptoms and Treatment
- Iron-deficiency Anemia
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| Acyclovir – Drug Study Posted: 05 Feb 2011 10:22 PM PST 
Brand Name: Avirax, Zovirax Classification: Antiviral, purine analogues Indications - Recurrent genital herpes infection (PO)
- Localized cutaneus herpes zoster infection (shingles) – PO
- Chickenpox (varicella) – PO
- Severe initial episodes of genital herpes in nonimmunosuppressed patients – IV
- Herpes simplex encephalitis
- Recurrent herpes labialis (cold sores) – topical
- Acute mucocutaneous HSV infections in immunocompromised patients
Mechanism of Action Acyclovir interferes with viral DNA synthesis. Thus, it inhibits viral replication, decreased viral shedding and reduces time for healing of lesions. Contraindications Use cautiously in patients with the following conditions: - Pre-existing serious neurologic, hepatic, pulmonary or fluid and electrolyte abnormalities
- Renal impairment
- Geriatric patients
- Obese patients
- Pregnancy and lactation
Side Effects - Dizziness
- Headache
- Trembling
- Diarrhea
- Nausea
- Vomiting
- Abdominal pain
- Anorexia
- Acne
- Hives
- Unusual sweating
- Pain
- Phlebitis
- Local pain
- Irritation (local)
Nursing Interventions - Assess lesions before and daily during therapy.
- Shake the liquid well before each use to mix the medication evenly. (for suspension preparation)
- Acyclovir can be taken with or without food with a full glass of water.
- Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.
- Take acyclovir until you finish the prescription, even if you feel better. If you stop taking acyclovir too soon or skip doses, your infection may not be completely treated or may become more difficult to treat.
- Acyclovir treatment should be started as soon as possible after herpes simplex symptoms appear and within 24 hours of a herpes zoster break.
- For IV preparations, the infusion site should be observed for phlebitis. The infusion site should be rotated to prevent phlebitis.
- Watch out for signs of acyclovir overdose which are:
- Agitation
- Seizures
- Extreme tiredness
- Loss of consciousness
- Swelling of the hands, feet, ankles or lower legs
- Decreased urination
image courtesy of bedfordlabs.com Related posts: - Herpes Viruses: Herpes Simplex
- Herpes Viruses: Herpes Zoster
- Herpes Zoster (Shingles)
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