Exam#1 Review Ms2 Part 1

Front 1

amount of water in ECF (L)?

Back 1

15L

Front 2

amiunt of water in ICF (L)?

Back 2

25L

Front 3

blood, intersititial fluid, lymph and transcellular fluids are considered ECF or ICF?

Back 3

ECF

Front 4

Fluid contained in cells is called ECF or ICF?

Back 4

ICF

Front 5

movement of fluid through a semipermeable membrane due to hydrostatic pressure difference on both sides is called?

Back 5

filtration

Front 6

"water pushing" pressure is also called?

Back 6

hydrostatic pressure

Front 7

the free movement of particles across a permeable membrane from high to low concentration is called?

Back 7

diffusion

Front 8

This electrolyte is 10x more abundant OUTSIDE of the cell

Back 8

sodium 134-145

Front 9

insulin making the cell membrane more permeable to glucose is called?

Back 9

facilitated diffusion/facilitated transport

Front 10

the number of miliosmoles in a L

Back 10

osmolarity

Front 11

the number of miliosmoles in a kg of solution

Back 11

osmolality

Front 12

normal osmolarity of plasma and other body fluids

Back 12

270-300 mOsm/L

Front 13

greater than 300 mOsm/L

Back 13

hyperosmotic/hypertonic

Front 14

less than 270 mOsm/L

Back 14

hypoosmotic/hypotonic

Front 15

these fluids pull water from the ICF into the ECF

Back 15

hypertonic

Front 16

shrinkage of these specialized cells due to hyperosmolarity of the blood (ecxessive sweating, etc) activates the thirst center

Back 16

osmoreceptors

Front 17

the thirst center is less sensitive in ?

Back 17

older adults

Front 18

lymph fluid contains __________ proteins than blood

Back 18

less

Front 19

the fluid that causes swelling of the feet and ankles due to decreased skeletal muscle movements (i.e. long plane trip) is

Back 19

lymph

Front 20

Fat has ________ water than skeletal muscle

Back 20

less

Front 21

the average intake of fluids and from food (mL) and liquids (mL)

Back 21

food 800 mL
liquids 1500 mL

Front 22

the minimum amount of urine needed to filter toxic waste is (mL)?

Back 22

400-600 mL (16-25mL/hr average)

Front 23

the minimum amount of urine needed to filter toxic waste is called?

Back 23

obligatory urine output

Front 24

water loss through the skin, lungs and stool is called

Back 24

insensible water loss

Front 25

in the healthy adult, insensible water loss averages (mL)

Back 25

500-1000 mL/d

Front 26

for every degree of body temperature, insensible loss increases by

Back 26

10%

Front 27

factors that increase risk for insensible water loss

Back 27

hot and dry climates
mechanically ventilated patients
tachypnea

Front 28

maximum rate of water loss due to excessive sweating (L/h)

Back 28

2 L/h

Front 29

three hormones that control fluid and electrolyte balance?

Back 29

ADH
BNP
aldosterone

Front 30

a hormone secreted by the adrenal cortex whenever sodium levels in the ECF are DECREASED

Back 30

aldosterone

prevents both water and sodium loss

Front 31

aldosterone works on the kidney nephrons and triggers them to:

Back 31

reabsorb sodium and water from the urine back into the blood.

Front 32

aldosterone also prevents blood _______ levels from becoming too ________

Back 32

potassium , high

Front 33

another name for ADH

Back 33

vasopressin

Front 34

ADH is produced by the brain and stored in the ___________

Back 34

posterior pituitary gland

Front 35

___________ stimulates the posterior pituitary gland to release ADH in response to changes in blood osmolarity.

Back 35

hypothalamus

Front 36

Increased blood osmolarity, especially an increase in the level of plasma sodium, results in a shrinkage of osmoreceptors and triggers the release of ______ from the ______

Back 36

ADH , posterior pituitary gland

Front 37

__________ acts directly on the kidney tubules and collecting ducts, making them more permeable to water; more water is then ___________

Back 37

ADH, reabsorbed

Front 38

the release of ADH __________ blood osmolarity, making it more _________

Back 38

decreases, dilute

Front 39

when plasma sodium levels fall, osmoreceptors swell and ADH release is ___________. ________ water is reabsorbed and _________ urine is excreted.

Back 39

inhibited, less, more

Front 40

Natriuretic hormones are secreted by special cells that line the

Back 40

atria (ANP )and ventricles (BNP) of the heart

Front 41

NPs are released in response to

Back 41

increased blood volume and blood pressure - due to stretching of the heart

Front 42

NPs create effects opposite of ________

Back 42

aldosterone

Front 43

NPs inhibit reabsorption of ________, leading to ________ urine output

Back 43

sodium, increased

Front 44

the most common type of fluid volume deficit is _____________

Back 44

isotonic dehydration

Front 45

In isotonic dehydration, fluid is lost only from the __________. Fluid in the __________ remains the same

Back 45

ECF (including plasma and interstitial)
ICF (cells)

Front 46

beverages such as caffeine and alcohol can lead to ___________ and should not be used to treat ________

Back 46

fluid loss, dehydration

Front 47

A tool for assessing a patient's fluid status is to use this tool

Back 47

Gordon's Functional Health Patterns

Front 48

1 liter of water = ______ lbs or ______kg

Back 48

2.2 lbs or 1kg

Front 49

_______________ are the best indicator of fluid losses or gains

Back 49

changes in daily weights

Front 50

a weight change of 1lb corresponds to a fluid volume change of ________ ml

Back 50

500 mL

Front 51

when calculating fluid intake, solid foods such as ice cream, gelatin and ices should be included because they

Back 51

are liquids at body temperature

Front 52

Older adults may be at a higher risk for dehydration due to their decreased perception of thirst, and use of ___________

Back 52

diuretics and laxatives

Front 53

dehydration signs and symptoms:

Back 53

increased HR
decreased peripheral pulses - easily blocked with light pressure
decreased BP
orthostatic hTN
lightheaded/dizzy
flat neck and hand veins
increased RR if hypoxic
mucous membrane dryness
skin tenting
altered mental status
low grade fever possible
USG > 1.030

Front 54

for every degree celcsius above normal, an additional ______ mL of fluid is lost

Back 54

500 mL

Front 55

Hgb and Hct will ___________ in dehydration

Back 55

increase (become more concentrated)

Front 56

BUN will _________ in dehydration

Back 56

increase

Front 57

Isotonic / Hypertonic / Hypotonic?

0.9% NS

Back 57

isotonic

Front 58

Isotonic / Hypertonic / Hypotonic?

0.45% NS

Back 58

hypotonic

Front 59

Isotonic / Hypertonic / Hypotonic?

d5W

Back 59

isotonic

Front 60

Isotonic / Hypertonic / Hypotonic?

d10W

Back 60

hypertonic

Front 61

Isotonic / Hypertonic / Hypotonic?

d5NS

Back 61

hypertonic

Front 62

Isotonic / Hypertonic / Hypotonic?

d5 1/2NS

Back 62

hypertonc

Front 63

Isotonic / Hypertonic / Hypotonic?

d5 1/4NS

Back 63

isotonic

Front 64

Isotonic / Hypertonic / Hypotonic?

Ringer's lactate

Back 64

isotonic

Front 65

Isotonic / Hypertonic / Hypotonic?

d5 LR

Back 65

hypertonic

Front 66

Fluid replacement closest to plasma in osmolarity and pH

Back 66

Ringer's Lactate

Front 67

(ECF) Electrolyte level for:

sodium

Back 67

135-145 mEq/L

Front 68

(ECF) Electrolyte level for:

potassium

Back 68

3.5-5 mEq/L

Front 69

(ECF) Electrolyte level for:

chloride

Back 69

96-109 mEq/L

Front 70

(ECF) Electrolyte level for:

calcium

Back 70

8.5-10 mEq/L

Front 71

(ECF) Electrolyte level for:

magnesium

Back 71

1.3-2.1 mEq/L

Front 72

(ECF) Electrolyte level for:

protein

Back 72

7-8g/L

Front 73

foods low in Na+

Back 73

fresh fish, poultry, fresh vegetables and fruit

Front 74

sodium is stored deep within the ______ tissue and can be released into the ECF as needed

Back 74

kidney

Front 75

Serum sodium balance is influenced by ________, _______, and _______ (hormones)

Back 75

ADH, aldosterone and NP

Front 76

low serum sodium levels inhibit the secretion of _____ and ______ and trigger the secretion of _______

Back 76

ADH, NP

aldosterone

Front 77

high serum sodium levels inhibit the secretion of _____ and directly stimulate the secretion of _______ and ______

Back 77

aldosterone

ADH and NP

Front 78

Almost all foods contain potassium, but it is highest in:

Back 78

meat, fish, many fruits and vegetables.

Front 79

potassium is low in these foods:

Back 79

eggs, bread and cereal grains

Front 80

___% of potassium is removed via the kidneys

Back 80

80%

Front 81

Kidney excretion of potassium is enhanced by ____________

Back 81

aldosterone

Front 82

_______% of total body potassium is found inside the cells

Back 82

98%

Front 83

__ % of total body potassium is inside the cells

Back 83

98%

small changes have profound effects - every body system is affected

Front 84

low serum potassium causes __________ excitability of cells and make them ______ responsive to stimuli

Back 84

reduced, less

Front 85

_______ status should be assessed first in any patient who might have hypokalemia.

Back 85

respiratory status - skeletal muscle weakness cuases shallow respirations. Should be assessed q2h

Front 86

hypokalemia causes a _____ response to DTRs

Back 86

decreased

Front 87

in patients with hypokalemia, the peripheral pulses are generally _________

Back 87

thready and weak. Easily blocked with light pressure

Front 88

severe hypokalemia can cuase ________ (musculoskeletal)

Back 88

flaccid paralysis

Front 89

neurological changes of hypokalemia include:

Back 89

short-term irritability and anxiety followed by lethargy, acute confusion and coma

Front 90

Hypokalemia - a patient may become lethargic and unable to perform simple problem solving tasks such as :

Back 90

counting by threes

Front 91

hypokalemia - smooth muscle contractions in the GI tract are _____, which leads to ________ peristalsis. Bowel sounds will be ______

Back 91

decreased, decreased, decreased or absent

Front 92

paralytic ileus can be cuased by ___________

Back 92

severe hypokalemia

Front 93

EKG changes in hypokalemia:

Back 93

ST depression, flat T waves, prominent U waves

Front 94

A dilution of no more than ____ mEq/10mL of solution is recommended for potassium infusion.

Back 94

1mEq/10ml

Front 95

the max infusion rate of potassium is

Back 95

5 to 10 mEq/hr, never to exceed 20

Front 96

postassium is never given (route):

Back 96

IM or SQ. Tissue irritant. Also never IVP

Front 97

If infiltration of potassium infusion occurs (burning or pain at the site):

Back 97

stop solution, remove access, notify provider and call a rapid response

Front 98

Potassium shoul dbe taken on an empty stomach? T/F

Back 98

false. can cuase n/v. also has an unpleasant taste.

Front 99

Which is a potassium sparing diuretic? furosemide, spironolactone, bumetanide

Back 99

spironolactone

Front 100

Hyperkalemia causes _______ cell excitability and _____ stimulus is needed for depolorization

Back 100

increased , less

cells may even fire spontaneously.

Front 101

the most serious complication of hyperkalemia is ____

Back 101

altered cardiac function

Front 102

hyperkalemia is rare in people with ______

Back 102

normal renal function

Front 103

most cases of hyperkalemia occur in __________ patients

Back 103

hospitalized

Front 104

potassium movement into the cells is enhanced by ________ (hormone)

Back 104

insulin - increases the activity of the Na/K pump

Front 105

foods high in potassium:

Back 105

meat (organ and preserved)
dairy
dried fruit
bananas/cataloups/kiwi/oranges
Veg: avos, broccoli, dired beans/peas, mushrooms, seaweed, soybeans, spinach

Front 106

foods low in potassium:

Back 106

eggs
bread
butter
cereal
sugar
fruits: apple, apricots, berries, cherries, grapefruit, peaches, pinapple, cranberries
vegs: cabbage, carrots, caulifolower, celery, eggplant, green beans, lettuce, onions, peas, peppers, squash

Front 107

aldosterone is secreted by the _______ glands

Back 107

adrenal - in response to decreased ECF volume

Front 108

normal albumin level

Back 108

3-5

Front 109

normal K level

Back 109

3.5-5

Front 110

normal Na level

Back 110

135-145

Front 111

normal water loss from skin

Back 111

1000 mL/d

Front 112

normal water loss from lungs

Back 112

300-400 mL/d

Front 113

normal wate rloss frmo GI

Back 113

100-200 mL/d

Front 114

normal water due to urine loss

Back 114

1-2L/d

Front 115

normal water loss due to evaporation (insensible)

Back 115

600 mL/d

Front 116

the gut sequesters water, so loss can occur by

Back 116

NG suction

Front 117

Disease rsulting from posterior pituitary not releasing ADH - pt gets very dehydrated due to excessive urination.

Back 117

Diabetes insipidus (not related to DM)

Front 118

three Ps of hyperglycemia

Back 118

polydipsia, polyphagia, polyuria

Front 119

type of fluid for rapid ECF expansion

Back 119

isotonic solution

Front 120

fluid for treatment of cellular dehydration

Back 120

hypotonic solution

Front 121

type of fluid to treat water intoxication

Back 121

hypertonic solution

Front 122

What does LR contain that NS does not?

Back 122

NS:
154 mEq/L of Na+ and
154 mEq/L of Cl−

Lactated Ringer's:

130 mEq/L of Na+ but total cations of 137 mEq/L , so still is isotonic.
109 mEq/L of Cl−
28 mEq/L of lactate
4 mEq/L of potassium
3 mEq/L of calcium.

Front 123

SASH - in CVL?

Back 123

saline, administer, saline, heparin.

when accessing a CVL. some facilities do not use heparine

Front 124

adverse reaction to IV medications given too quickly

Back 124

speed shock

signs: flushed face, headache, chest tightness, irreg pulse, LOC, cardiac arrest

Front 125

Can TPN infuse via PIV?

Back 125

no - CVL only

Front 126

Can PPn infuse via PIV?

Back 126

yes - less osmotic

Front 127

max amount of glucose in PPN

Back 127

10%

Front 128

this test should precede TPN administration (panel)

Back 128

Chem-10

Front 129

Components of TPN

Back 129

proteins, 25% glucose, electrolytes, trace elements (b vit). May also have insulin, heparin, pepcid.

Front 130

Can lipids infuse via PIV?

Back 130

no - CVL only

Front 131

What should be monitored at one and two hours after parenteral nutrition dministration?

Back 131

blood glucose level

Front 132

TPN should be run through a ____

Back 132

dedicated line

Front 133

TPN tubing shoul dbe changed every _____ hours

Back 133

24

Front 134

Inspect TPN solutions for _________

Back 134

crackling

Front 135

if TPN runs out, hang _______

Back 135

d10

Front 136

after 3 days of TPN, how would you know nutritional status is improving?

Back 136

albumin level

Front 137

added to bloopd prodcuts to prevent clotting

Back 137

calcium citrate

Front 138

Only fluid that blood can hang with

Back 138

NS. Others cause hemolysis or clumping

Front 139

#1 sign of an acute hemolytic reaction to blood products

Back 139

flank pain

Front 140

TRALI

Back 140

transfusion related acute lung injury. Acute onset of non cardiogenic pulmonary edema.

Front 141

Vital sign routine after blood administration?

Back 141

q15 min 1st hour, then qh

Front 142

If transfusion reaction is suspected:

Back 142

disconnect line from catheter, keep blood attached, return to blood bank. Connect new IV set with SN or flush with NS. Collecta urine sample.