Med Surg Ch 14 Fluid & Electrolytes

Front 1

with increasing age, body water

Back 1

decreases

Front 2

fat cells contain (more/less) water than other cells

Back 2

less

Front 3

females have (higher/lower) body water percentage than males

Back 3

lower

Front 4

an obese person has a (higher/lower) percentage of body water than a thin person

Back 4

lower

Front 5

examples of electrolytes

Back 5

magnesium, phosphate, sodium, potassium, chloride, and calcium

Front 6

these conditions have great potential for altering fluid balance

Back 6

burns, ulcerative colitis, vomiting, kidney disease, diarrhea, and congestive heart failure

Front 7

what are locations where skin turgor is best measured?

Back 7

sternum, inner aspects of thighs, sternum

Front 8

what are common parts of the body against which skin is pressed to test for edema?

Back 8

tibia, fibula, sternum, sacrum

Front 9

which are related to fluid volume excess (hypervolemia)?

Back 9

dilute urine, decreased urination, stimulates aldosterone

Front 10

stimulates ADH release

Back 10

increased plasma osmolality

Front 11

inhibits ADH release

Back 11

decreased plasma osmolality

Front 12

stimulates aldosterone release

Back 12

hyperkalemia

Front 13

inhibits aldosterone release

Back 13

hyponatremia

Front 14

which are vital sign changes (assessment) are related to fluid volume deficit?

Back 14

fall in systolic blood pressure >20 mmHg from lying to standing, fever, increased pulse rate

Front 15

what respiratory changes occur with metabolic alkalosis?

Back 15

slow, shallow respirations and intermittent apnea

Front 16

with metabolic alkalosis, cause: vomiting, HCO-3 rentention, diarrhea, renal insufficiency

Back 16

pH rises, HCO-3 rises, Paco2 normal

Front 17

with metabolic acidosis, cause: vomiting, HCO-3 retention, volume depletion, K+ depletion

Back 17

pH falls, HCO-3 falls, Paco2 normal

Front 18

with respiratory alkalosis, cause: hyperventilation

Back 18

pH rises, HCO-3 falls, Paco2 falls

Front 19

the major electrolytes in extracellular fluid are

Back 19

sodium and chloride

Front 20

examples of anions

Back 20

chloride, bicarbonate, phosphate

Front 21

the concentration of electrolytes in a solution or body fluid compartment is measured in

Back 21

millilitres (ml)

Front 22

in what type of environment does water loss via the skin and lungs increase?

Back 22

hot, dry environment

Front 23

because the retention of sodium causes wter retention, aldosterone acts as a regulator of

Back 23

blood volume

Front 24

one way the body tries to compensate for fluid volume deficits is to

Back 24

increase heart rate

Front 25

ADH is decreased in response to

Back 25

fluid volume excess

Front 26

the body tries to compensate for fluid volume excess by

Back 26

inhibiting aldosterone

Front 27

which electrlytes cause a majority of health problems when there is an electrolyte imbalance?

Back 27

potassium, sodium

Front 28

when the body goes without fluid intake, which hormone increases water reabsorption?

Back 28

ADH

Front 29

which disturbances are a result of low levels of serum potassium?

Back 29

neuromuscular function, cardiac function

Front 30

which drugs can cause hypokalemia?

Back 30

anticholinergics, diuretics, corticosteroids

Front 31

if more calcium is needed in the bones, it is taken from the blood as well as being reabsorbed through the

Back 31

kidneys

Front 32

one liter of fluid retention equals weight gain of

Back 32

2.2 pounds

Front 33

puffy eyelids and fuller cheeks suggest

Back 33

fluid volume excess

Front 34

if a depression remains in the tissue after pressure is applied with a fingertip, the edema is descried as

Back 34

pitting

Front 35

a deep persistent pit that is approximately 1 inch deep is described as

Back 35

4+

Front 36

if the veins take longer than 3 to 5 seconds to fill when placed in a dependent position, the patient may have

Back 36

hypovolemia

Front 37

weakness and muscle cramps are symptoms of

Back 37

hypokalemia

Front 38

the normal range for urine pH is

Back 38

4.6-8.0

Front 39

a urine specimen that is not tested within 4 hours of collection may become

Back 39

alkaline

Front 40

a measure of the kidneys' ability to dilute or concentrate urine is called

Back 40

specific gravity

Front 41

in most instances, normal urine specific gravity is between

Back 41

1.010 and 1.025

Front 42

a 24-hour urine specimen is required for:

Back 42

creatinine clearance

Front 43

BUN provides a measure of

Back 43

renal function

Front 44

what are some symptoms of hyponatremia

Back 44

confusion, orthostatic hypotension, headache, apathy

Front 45

what amount of fluid per day is needed by the average person for adequate hydration?

Back 45

1500-2000 ml/day

Front 46

to prevent hyponatremia in patients with feeding tubes, what should be used for irrigation?

Back 46

normal saline

Front 47

the heart rate of patients on digitalis should be closely watched because hypokalemia can contribute to

Back 47

digitalis toxicity

Front 48

in order to prevent gastrointestinal irrigation, oral potassium supplements should be given with

Back 48

a full glass of water or fruit juice

Front 49

what occurs when the respiratory system fails to eliminate the appropriate amount of carbon dixoide to maintain the normal acid-base balance

Back 49

respiratory acidosis

Front 50

the most common cause of respiratory alkalosis is

Back 50

hyperventilation

Front 51

patients may develop high levels of magnesium in their blood if they are taking

Back 51

antacids

Front 52

which patient should be encouraged to breathe slowly into a paper bag

Back 52

patient who is hyperventilating

Front 53

what occurs when the body retains too much hydrogen ions or loses too many bicarbontae ions

Back 53

metabolic acidosis

Front 54

potassium is a critical factor for the transmission of nerve impulses because it is necessary for

Back 54

membrane excitability

Front 55

in addition to its role in regulating fluid balance, sodium is also necessary for

Back 55

nerve impulse conduction

Front 56

the most common cause of hypocalcemia is related to problems with which hormone?

Back 56

PTH

Front 57

what is the normal total daily intake of fluids?

Back 57

2500 ml

Front 58

what is the best position for the patient who is experiencing dyspnea?

Back 58

elevate the head of the bed 30 degrees

Front 59

a bounding pulse occurs in patients with

Back 59

circulatory overload

Front 60

what is the patient at risk for when the total intake is substantially less than the total output?

Back 60

fluid volume deficit

Front 61

what is the normal hourly adult urine output

Back 61

40-80 ml/hour

Front 62

a rapid weight gain of 8% is considered to be

Back 62

severe

Front 63

if the patient has a rapid weight loss fo 2 kilograms, what is the equivaletn loss of fluid

Back 63

2 liters

Front 64

which electrolytes are present in greater amounts in the extracellular fluid (ECF) than in the intracellular fluid (ICF)?

Back 64

sodium (Na), chloride (Cl), bicarbonate (HCO3), calcium (Ca++)

Front 65

what factors arerelated to causes of hypovolemia

Back 65

decreased oral fluid intake, vomiting, diarrhea

Front 66

which are indicators of dehydration?

Back 66

hypotension, increased temperature, weight loss

Front 67

what are signs of fluid volume excess in a patient being treated for dehydration who receives excessive fluid replacement?

Back 67

increased pulse and dyspnea

Front 68

what are indicators of fluid volume excess?

Back 68

increased blood pressure, bounding pulse, irritability

Front 69

what is the treatment for fluid volume excess?

Back 69

restrict sodium intake and give diuretics

Front 70

which are nursing interventions for the patient with fluid volume excess?

Back 70

offer ice chips, use small fluid containers, turn every 2 hours, inspect skin for breakdown

Front 71

a patient has been admitted to a long-term care facility with fluid volume deficit. which nursing diagnoses would the nurse expect with this patient?

Back 71

acute confusion, risk for impaired skin integrity and constipation

Front 72

which aspects of the health and physical exam are important in determining the fluid and electrolyte status of a patient?

Back 72

vomiting, use of diuretics, dyspnea and skin turgor

Front 73

which foods are high in sodium?

Back 73

natural cheese, sausage, and pizza

Front 74

which foods are high in potassium?

Back 74

fresh apricots, broccoli, banana, and watermelon

Front 75

which are manifestations of acid-base imbalance?

Back 75

dyspnea, confusion, muscle weakness, numbness

Front 76

which are reasons older people are at high risk for fluid and electrolyte imbalance?

Back 76

decreased renal response and decreased sense of thirst

Front 77

which assessment finding is the least reliable indicator of fluid status in an 80-year-old person?

Back 77

poor tissue turgor

Front 78

when the blood is more concentrated in a patient with fluid volume deficit, which blood study result is expected?

Back 78

increased blood urea nitrogen (BUN) and increased hematocrit

Front 79

when breathing problems occur in a patient with fluid volume excess, the patient should

Back 79

have head of ed elevated 30 degrees

Front 80

the patient with heart failure has fluid volume excess with pitting edema. what is the priority nursing intervention for this patient?

Back 80

turn the patient every 2 hours

Front 81

the nurse is taking care of a patient with hypokalemia. which are nursing interventions for this patient?

Back 81

monitor serum potassium levels, monitor heart rate and rhythms, and encourage oranges and bananas in the diet

Front 82

what is the best way to decrease the incidence of serious fluid and electrolyte imbalances?

Back 82

monitor records of fluid intake and output carefully

Front 83

a patient has fluid volume excess. which nursing diagnoses would the nurse expect with this patient?

Back 83

acute confusion r/t cerebral edema, ineffective tissue perfusion r/t reduced cardiac output with heart failure, and risk for impaired skin integrity r/t edema

Front 84

with respiratory acidosis, cause: hypoventilation

Back 84

pH falls, HCO3 normal, PaCO2 rises