Fluid And Electrolytes Chapter 14

Front 1

The average daily urinary output in an adult is:

Back 1

1.5 L

Front 2

A febrile patient's fluid output is in excess of normal because of diaphoresis. The nurse should plan fluid replacement based on the knowledge that insensible losses in an afebrile person are normally not greater than:

Back 2

600 mL/24 h

Front 3

A patient's serum sodium concentration is within the normal range. The nurse estimates that the serum osmolality should be:

Back 3

280 mOsm/kg

Front 4

The nurse notes that a patient's urine osmolality is 980 mOsm/kg. The nurse knows to assess for the possible cause of:

Back 4

Acidosis

Front 5

One of the best indicators of renal function is:

Back 5

Serum creatinine

Front 6

A patient is hemorrhaging from multiple trauma sites. The nurse expects that compensatory mechanisms associated with hypovolemia would cause all of the following symptoms:

Back 6

Oliguria; tachycardia; tachypnea

Front 7

A clinical manifestation found in hypovolemia is:

Back 7

Muscle weakness; postural hypotension; oliguria

Front 8

Laboratory findings consistent with hypovolemia in a female would include all of the following:

Back 8

Hematocrit greater than 47%; urine specific gravity of 1.027; urine osmolality greater than 450 mOsm/kg

Hint 8

Hematocrit: Adult male range is 42-52%, adult female 36-48%; specific gravity: 1.010-1.030; Osmolality: 280-300 mOsm/kg

Front 9

The nurse should expect that a patient with mild fluid volume excess would be prescribed a diuretic that blocks sodium reabsorption in the distal tubule, such as:

Back 9

HydroDIURIL

Front 10

When assessing the weight of a patient who is on a sodium-restricted diet, the nurse knows that a weight gain of approximately two pounds (2.2 16 = 1 kg) is equivalent to a gain of how much fluid?

Back 10

1.0 L

Front 11

Nursing intervention for a patient with a diagnosis of hyponatremia includes all of the following:

Back 11

Assessing for symptoms of nausea and malaise; monitoring neurologic status; restricting tap water intake

Front 12

A patient with abnormal sodium losses is receiving a house diet. To provide 1600 mg of sodium daily, the nurse could supplement the patient's diet with:

Back 12

One beef cube and 8 oz of tomato juice

Front 13

One of the dangers of treating hypernatremia is:

Back 13

Cerebral edema

Front 14

A nurse is directed to administer a hypotonic intravenous solution. She should choose:

Back 14

0.45% sodium chloride

Front 15

An isotonic solution that contains electrolytes similar to the concentration of electrolytes used in plasma is:

Back 15

Lactated Ringer's solution

Front 16

A patient is admitted who has had severe vomiting for 24 hours. She states that she is exhausted and weak. The results of an admitting electrocardiogram (ECG) show flat T waves and ST-segment depression. What is a likely potassium (K+) value for this patient.

Back 16

2.0 mEq/L

Front 17

The ECG change that is specific to hypokalemia is:

Back 17

An elevated U wave

Front 18

To supplement a diet with foods high in potassium, the nurse should recommend the addition of:

Back 18

Fruits such as bananas and apricots

Front 19

If a patient has severe hyperkalemia, it is possible to administer clacium gluconate intravenously to:

Back 19

Antagonize the action of K+ on the heart

Front 20

Cardiac efffects of hyperkalemia are usually present when the serum potassium level reaches:

Back 20

8 mEq/L

Hint 20

Potassium: 3.5-5.0 mEq/L

Front 21

The most characteristic manifestation of hypocalcemia and hypomagnesmia is:

Back 21

Tetany

Front 22

A patient complains of tingling in his fingers. He has positive Trousseau's and Chvostek"s signs. He says that he feel depressed. What is a likely serum calcium (Ca++) value for this patient

Back 22

7 mg/dL

Hint 22

Calcium: 8.5-10.9 mg/L

Front 23

Management of hypercalcemia includes all the following actions:

Back 23

Fluid to dilute the clacium levels; inorganic phosphate salts; intravenous phosphate therapy

Front 24

Cardiac arrest will probably occur with a serum calcium level of:

Back 24

18 mg/dL

Hint 24

Calcium: 8.5-10.9 mg/L

Front 25

A patient is admitted with a diagnosis of renal failure. He also mentions that he has had stomach distress and has ingested numerous antacid tablets over the past 2 days. His blood pressure is 110/70 mm Hg, his face is flushed, and he is experiencing generalized weakeness. What is a likely magnesium (Mg++) value for this patient

Back 25

5 mEq/L

Hint 25

Magnesium: 1.5-2.5 mEq/L (toxic level: 4.8-9.6 mEq/L)

Front 26

A patient is admitted with a diagnosis of renal failure. He also mentions that he has had stomach distress and has ingested numerous antacid tablets over the past 2 days. His blood pressure is 110/70 mm Hg, his face is flushed, and he is experiencing generalized weakeness. Management should include:

Back 26

Discontinuance of any oral magnesium salts

Front 27

A clinical indication of hypophosphatemia is:

Back 27

Tetany

Front 28

The most common buffer system in the body is the:

Back 28

Bicarbonate-carbonic acid buffer system

Front 29

The kidneys regulate acid-base balance by all to the following mechanisms:

Back 29

Excreting hydrogen ions (H+); reabsorbing or excreting HCO3- into the blood; retaining ydrogen ions (H+)

Front 30

The lungs regulate acid-base balance by all of the following mechanisms:

Back 30

Slowing ventilation; controlling carbon dioxide levels; increasing ventilation

Front 31

The condition that exhibits blood values with a low pH and a low plasma bicarbonate concentration.

Back 31

Metabolic acidosis

Front 32

The nursing assessment for a patient with metabolic alkalosis includes evaluation of laboratory data for all of the following:

Back 32

Hypocalcemia; hypokalemia; hypoxemia

Front 33

The condition that exhibits blood values with a low pH and a high PCO2:

Back 33

Respiratory acidosis

Front 34

A normal oxygen saturation value for arterial blood is:

Back 34

95%

Front 35

If you were walking across the Sahara Desert with an empty canteen, the amount of ADH secreted would most likely:

Back 35

Increase

Hint 35

Because your body would probably be dehydrated, it would try to retain as much fluid as possible. To retain fluid, ADH secretion increases.

Front 36

If you placed two containers next to each other, separated only by a semipermeable membrane, and the solution in one container was yhpotonic relative to the other, fluid in the hypotonic container would:

Back 36

Move out of the yhpotonic container into the other.

Hint 36

Fluid would move out of the hypotonic container into the other container to equalize the concentration of fluid within the two containers. Osmosis occurs when fluid moves from an area with more fluid to an area with less fluid.

Front 37

Hydrostatic pressure, which pushes fluid out of the capilllaries, is opposed by colloid osmotic pressure, which involves:

Back 37

The pulling power of albumin to reabsorb water.

Hint 37

Albumin in capillaries draws water toward it, a process called reabsorption.

Front 38

When a person's blood pressure drops, the kidneys respond by:

Back 38

Secreting renin

Hint 38

Juxtaglomerular cells in the kidneys secrete renin in response to low blood flow or a low sodium level. The eventual effect of renin secretion is an increase in blood pressure.

Front 39

Giving a hypertonic I.V. solution to a patient may cause too much fluid to be:

Back 39

Pulled from the cells into the bloodstream, which may cause the cells to shrink.

Hint 39

Because the concentration of solutions in the I.V. solution is greater than the concentration of solutes in the patient's blood, a hypertonic solution may cause fluid to be pulled from the cells into the bloodstream, causing the cell to shrink.

Front 40

Factors that increase BUN

Back 40

Decreased renal function, GI bleeding, dehydration, increased protein intake, fever, and sepsis

Front 41

Fatctors that decrease BUN

Back 41

end-stage liver disease, a low-Protein diet, starvation, and any condition that results in expanded fluid volume (eg, pregnancy).

Front 42

The usual daily urine volume in the adult is ___ to ___.

Back 42

1 to 2 L

Front 43

Urin volume output is approximately ___ of urine per kilogram of body weight per hour (1 mL/kg/h) in all age groups.

Back 43

1ml

Front 44

Continuous water loss by evaporation (approximately ___/day) occurs through the skin as insensible perspiration, a nonvisible form of water loss.

Back 44

600 mL

Front 45

The lungs normally eliminate water vapor (insensible loss) at a rate of approximately ___ every day.

Back 45

400 mL

Front 46

The usual fluid loss through the gastrointestinal (GI) tract is only ___to ___ daily,

Back 46

100 to 200 ml

Front 47

Normal serum osmolality is ___to ___ mOsm/kg

Back 47

275 to 300

Front 48

Normal urine osmolality is ___to ___ mOsm/kg.

Back 48

250 to 900

Front 49

The normal range of urine specific gravity is ___ to ___.

Back 49

1.010 to 1.025

Front 50

The normal BUN is ___ to ___ mg/dL (3.6 to 7.2 mmol/L).

Back 50

10 to 20

Front 51

The normal serum creatinine is approximately ___ to ___ mg/dL (62 to 124 mmol/L).

Back 51

0.7 to 1.4

Front 52

Hematocrit measures the volume percentage of red blood cells (erythrocytes) in whole blood and normally ranges from ___ to ___ for males and ___ to ___ for females.

Back 52

42 to 52%; 35 to 47%

Front 53

Normal urine sodium levels range from ___ to ___ mEq/24 h (75 to 200 mmol/24 h).

Back 53

75 to 200

Front 54

Vital to the regulation of fluid and electrolyte balance, the kidneys normally filter 170 L of plasma every day in the adult, while excreting only ___ of urine.

Back 54

1.5 L

Front 55

Through exhalation, the lungs remove approximately ___ of water daily in the normal adult.

Back 55

300 ml

Front 56

The hypothalamus manufactures ADH, which is stored in the posterior pituitary gland and released as needed. ADH is sometimes called the water-conserving hormone because it causes the body to ______ water.

Back 56

retain

Front 57

Functions of ADH include maintaining the osmotic pressure of the cells by controlling the retention or excretion of ______ by the kidneys and by regulating ______ volume.

Back 57

water; blood

Front 58

IAldosterone, a mineralocorticoid secreted by the zona glomerulosa (outer zone) of the adrenal cortex, has a profound effect on fluid balance. Increased secretion of aldosterone causes ______ retention (and thus water retention) and potassium loss.

Back 58

sodium

Front 59

Aldosterone, a mineralocorticoid secreted by the zona glomerulosa (outer zone) of the adrenal cortex, has a profound effect on fluid balance. Decreased secretion of aldosterone causes sodium and water ______ and potassium ______.

Back 59

loss; retention

Front 60

Urine sodium levels are used to assess volume status and are useful in the diagnosis of ______ and ______ ______ ______.

Back 60

hyponatremia; acute renal failure

Front 61

Organs involved in homeostasis include the ______, ______,______, ______ ______, ______ ______, and ______ ______.

Back 61

kidneys, lungs, heart, adrenal glands, parathyroid glands, and pituitary gland