Nursing Exam 3

Front 1

Describe the distribution of body fluids?

Back 1

ICF (Intracellular) inside cell
ECF (extracellular) Outside cell.

Front 2

What are the composition of body fluids?

Back 2

water, electrolytes, nonelectrolytes, minerals, and cells.

Front 3

Identify the purpose water serves in the body?

Back 3

universal solvent, transports nutrients and carries waste products from the cell. Medium for chemical reactions, participates in chemical reactions. Maintains stable body temp. Absorbs heat in the body.

Front 4

Describe the variation in the amount of body fluid according to age?

Back 4

Decreases with age. Infants 80%H2O, Men 50-60% H2O. Women 45-50% H2O

Front 5

Name the body fluid compartments?

Back 5

Intravascular, interstitial, transcellular

Front 6

Identify major constituents of intracellular and extracellular fluid compartments and body secretions?

Back 6

1) plasma found within vascular system ARTERIES and VEINS
2) surrounds cell, includes lympth fluid and fluid tissue (EDEMA)
3) cerebrospinal, pleural, peritoneal, and synovial fluids

Front 7

Describe the ways in which fluids and electrolytes move through the body?

Back 7

osmosis, diffusion, filtration, active transport.

Front 8

Describe the ways in which osmotic and hydrostatic pressure influence movement of fluids through membrane?

Back 8

osmotic-movement from lower concentration to higher solute concentration.
hydrostatic- when venous pressure is greater than or equal to arterial pressure fluid is forced out (BP)

Front 9

Describe how body mechanism regulate fluid and electrolyte balance?

Back 9

balanced by the water loss through the feces, skin, and the respiratory process. Fluid intake, ingested H2O, ingested food, metabolic oxidation.

Front 10

Identify sources of fluid output?

Back 10

Kidneys, skin, insensible (something that cannot be seen), Sensible ( you can see this stool, mucous), lungs, GI

Front 11

Identify the role of the kidneys and lungs in regulating acid-base balance

Back 11

regulate hydrogen ions. They are part of buffer system. controll PH. Respiratory system short term PH balance. Kidneys long term PH balance.

Front 12

Describe the main functions of the major and minor electrolytes.

Back 12

Read pg 1674-1676

Front 13

The major electrolytes are?

Back 13

Na,K, Ca, Mag

Front 14

Describe how acid-balance is maintained in the body?

Back 14

Buffer system, respiratory mechanisms, renal regulation

Front 15

Identify the factors that affect body fluid, electrolytes and acid-balance?

Back 15

age, gender and size, environmental temp, lifestyle.

Front 16

Identify different types of fluid imbalances?

Back 16

fluid volume deficit (hypotonic), fluid volume excess.(Hypertonic)

Front 17

Identify causes of water deficits and excesses?

Back 17

Fluid deficit-vomiting, diaherra, gastric suction, elevated body temp, hemorrage, profound urine loss.
Fluid vol excess- kidney and circulatory impairments, liver impairments

Front 18

Describe the typical clinical signs of a dehydrated person?

Back 18

dry skin, mucous membrane, oliguria, weight loss, VS, decreased BP, high resp, increased heart rate, increased hemocrit, Na-normal

Front 19

Compare effects of extracellular fluid deficits and excesses?

Back 19

Hypovolemia-fluid loss (fluid deficit)
Hypervolemia-excess of fluid. (fluid excess) EDEMA

Front 20

Hyponatremia(Sodium Deficit)
Serum Na+ <125mEq/L
Causes, Signs, Medical Therapy

Back 20

*Causes:Excess perspiraton or drinking, excess vomiting or diarrhea, nasogastric suction, infusion of Lg. volumes of electrolyte free IV solutions, diuretic administration, low sodium diets* Signs: abdominal cramps, nausea, vomiting or diarrhea, rapid pulse, orthostatic or postural hypotension, cold clammy skin, convulsions, apprehension, anxiety, confusion, decreased urine output, dry mucous membranes, decreased skin turgor. *Medical Therapy: administration of sodium chloride (IV-NS)

Front 21

Hypernatremia(Sodium Excess)
Serum Na+ >145mEq/L
Causes, Signs, Medical Therapy

Back 21

inadequate water intake, excess salt intake, vomiting, diarrhea, tube feedings, diabetes insipidus or polyuria(Steroid Therapy), heat stroke. *Signs: thirst, dry, sticky mucous membranes, flushed skin, short attention span, agitated behavior, confusion, restlessness, disorientation, hallucinations, fever, oliguria, tachycardia, hypotension, and muscle weakness as it gets worse. *Treatment: treat reason for excess;IV fluids of choice being D5W, unless diabetic.

Front 22

Hypokalemia(Potassium Deficit) Serum K level <3.5mEq/L (MOST COMMON ELECTROLYTE IMBALANCE)
Causes, Signs, Medical Therapy

Back 22

*Causes: vomiting, diarrhea or NG suctioning, excess perspiration, polyuria, prolonged use of K+ wasting diuretics, poor intake of K+ use of strong laxatives, hyperaldosteronism or excess IV fluid administration w/out potassium replacement. * Signs: Parethesias, muscle weakness & fatigue, anorexia, nausea , vomiting, abdominal distention, decreased bowel sounds, irregular pulse, cardiac arrhythmias, hypotension. *Treatment: Replacement of potassium

Front 23

Hyperkalemia(Potassium Excess) Serum K+Level >5.0mEq/L
Causes, signs, medical therapy

Back 23

*Causes: RENAL FAILURE, dehydration or fluid volume deficit, intake of K+ conserving diuretics, high potassium intake, Infusion of stored blood administration or large amts of potassium IV fluid administrations, Seen in patients w/Large areas of tissue damage such as burns or trauma.*Signs: paresthesia, weakness, GI hyperactivity, diarrhea, irritability, anxiety, confusion, cardiac arrhythmias.*Treatment: reduction of K+levels, Kaexelyate ememas

Front 24

Hypocalcemia(Calcium Deficit) Serum Ca level <4.5mEq/L
Causes, signs, medical therapy

Back 24

*Causes: Hypoparathyroidism, Vitamin D deficiencies, inadequate dietary intake of calcium, high protein diets, pancreatitis, diarrhea, administration of multiple units of blood, caffeine, laxative, and nicotine use. *Signs: Numbness and tingling of extremities and around mouth, hyperactive reflexes, tetany, muscle spasms, Positive Chvostek's and Trousseau's sign. *Treatment: Oral or IV calcium administration, increase Vitamin D intake.

Front 25

Hypercalcemia(Calcium Excess) Serum Ca levels >5.5 mEq/L
Causes, signs, medical therapy

Back 25

Causes: Hyperparathyroidism, Osteoporosis, prolonged immobilization or immobility, related to cancer newplasms, multiple fractures, use of thiazide diuretics or excess intake of calcium supplements.
*Signs: anorexia, nausea, vomiting, weakness, lethargy, decreased level of consciousness, anxiety, cardiac arrhythmias. *Treatment: indentify cause, increasing the excretion of calcium by giving NS and diuretics.

Front 26

Hypomagnesium(Magnesium Deficit) Serum Mg level < 1.5 mEq/L
Causes, signs, medical therapy

Back 26

Causes: chronic alcoholism in the MOST COMMON CAUSE, inadequate intake, malnutrition, inadequate absortption, vomiting, fdiarrhea, intestinal disorders, dseptic infections, *Signs: muscle tremors, hyperactive reflexes, confusion and disorientation, will also have a positive Chvostek's and Trousseau's sign, cardiac arrhythmias. *Treatment: identify & treat cause, Improve nutritional intake

Front 27

Hypermagnesium(Magnesium Excess) Serum Mg level > 2.5 mEQ/L
Causes, signs, medical therapy

Back 27

*Causes; patients with remal failure, overuse, of antacids or laxatives in the elderly. *Signs: Hypoactive deep tendon reflexes, decreased rate and depth of respirations, drowsiness, sedation, bradycardia, hypotension, coma, and death. *Treatment: indentify cause. Patients with renal failure will require dialysis

Front 28

Hypochloremia(Chloride Deficit) Serum Cl level < 95mEq/L
Causes, signs, medical treatment

Back 28

Causes: Most Common cause is GI loss from vomiting or nasogastric suctioning, excess urination or sweating. *Signs: muscle tremors, hyperexcitability, respiratory depression due to acid base imbalance the body trying to conserve Co2 and hypotension. *Treatment: identify & treat cause, Monitor for electrolyte imbalancecs

Front 29

Hyperchloremia(Chloride Excess) Serum Cl levels > 105mEQ/L
Causes, signs, symptoms

Back 29

*Causes: may occur in patients w/metabolic acidosis. *Signs: weakness, lethargy, deep rapid breathing as acidosis gets worse, decreased level of consciousness and cardiac arrhythmias and death. *Treatment: identify cause, treat patient for acidosis.

Front 30

Respiratory Alkalosis
pH>7.45, Pa)2 80-100, PaCO2<35, HCO3 22-26

Back 30

hyperventilation, blowing off too much CO2. causes: fever, anxiety pulmonary infection anemia, cns injury asa overdose, Treatment; removal of cause, rebreather mask or paper bag, relief of anxiety, reduction of fever

Front 31

Respiratory Acidosis

Back 31

occurs when exhalation of Co2 inhibited and hypoventiolation occurs. Causes; CNS depression, COPD, chest wall injuries, drug overdoses, neuro disease. Signs; rapid bounding pulse, slow shallow respirations, dyspnea, increased BP confusion, lethargy. Treatment; IV or oral
sodium bicarbonate or sodium lactate. correction of cause

Front 32

Metabolic Alkalosis
pH>7.45, PaO2 in range, PaCO in range, HCO3>26

Back 32

excess intake of bicarbonates, other alkalies; prolonged vomiting, gastric suction, prolonged diuretic use (K-wasting) adrenal gland imp. signs; decreased respiratory rate & depth, dizziness, confusion, agitation, paresthesia, muscle hypertonicity, nausea, & vomiting

Front 33

Metabolic Acidosis
pH<7.35, PaO2 in range, PaCO2 in range, HCO3<22

Back 33

when bicarbinate is low in rrelation to carbonic acid levals. Cause; diabetes, mellitus, renal impairments, starvation, prolonged diarrhea, shock, drug use, alcohol intoxication. Signs; headache, lethargy, confusion, weakness, tachycardia, increased repid deep respirations(Kussmaul's) , flushed skin, fruity, acetone smelling breath

Front 34

Nursing Measurements for identifying fluid and electrolyte balance

Back 34

dietary modification, modicication of fluid intake, medicine administration, IV therapy, blood and blood product replacement, TPN, alleviating anxiety, appropraiate family, PT teaching

Front 35

Identify labratory test used for identifying fluid & electrolyte imbalance

Back 35

CBC, Serum electrolytes, BUN, Creatin, Uring pH, specific gravity, ABG

Front 36

Give examples of nursing diagnoses R'T fluid, electrolyte, and acid base imbalances

Back 36

Fluid & Electrolyte Problems:
Excess Fluid Volume, Deficient Fluid Volume, Risk for Imbalanced Fluid Volume,

Front 37

Common purposes of IV therapy

Back 37

FASTER response

Front 38

Identify various types of IV solutions

Back 38

Isotonic, Hypotonic, Hypertonic Solutions, pgs 1705

Front 39

Identify typical measures required to maintain IV therapy

Back 39

pg 1710 iniation of IV infusion, regulation and monitoring, solution and tubing changes, infusion site care,

Front 40

Identify potential complications of IV therapy and nursing interventions.

Back 40

Patient most source of information for complications, pt. position, circulatory status, pt. anxiety, inffiltration, phlebitis, thrombophlebitis, fluid overload, embolus, sepsis (pgs 1713)

Front 41

Identify what is to be marked on IV bottle and how it is to be labeled

Back 41

Name, Date, Time

Front 42

Technique used for discontinuing iv infusions, changing IV solution and tubing, crediting iv fluids and assessing iV site.

Back 42

pg 1719.
wear clean gloves, supine postion, slowly remove cath, apply pressure, measure cath to length in chart, document procedure and how pt tolerated