Fluid And Electrolytes Exam Review -All

Front 1

what is the major cation in blood?

Back 1

what is your major cation in blood?

Sodium (Na+)

Front 2

What is main cation in interstitial fluid?

Back 2

What is main cation in interstitial fluid?

Sodium (Na+)

Front 3

What is the major cation in intracellular fluid?

Back 3

What is the major cation in intracellular fluid?

Potassium (K+)

Front 4

what is the difference between blood plasma and interstitial fluid?

Back 4

what is the difference between blood plasma and interstitial fluid?

plasma is inside blood & interstitial is around each cell. both are extracellular compartments

Front 5

Your obtaining history from an 80 year old pt., what statement made by the pt is going to indicate to you that they have a possible electrolyte imbalance?
a. I sometime have a problem with dribbling urine
b. I always like to drink a lot of ice tea.
c. my skin is always dry
d. I use laxatives for constipation

Back 5

Your obtaining history from an 80 year old pt., what statement made by the pt is going to indicate to you that they have a possible electrolyte imbalance?

D. I use laxatives for constipation

Front 6

The body can adapt to excessive fluid loss from diarrhea, where is the body going to pull the water from?

Back 6

The body can adapt to excessive fluid loss from diarrhea, where is the body going to pull the water from?
interstitial fluid 1st. then intracellular leading to dry mucus membranes. Skin turgor will tent

Front 7

your pt has extracellular fluid excess, how are you going to assess this pt? where are you going to find the fluid? (this will be a multiple choice question)

Back 7

your pt has extracellular fluid excess, how are you going to assess this pt? where are you going to find the fluid? (this will be a multiple choice question)
- edema (rt side of the heart is dependent edema. Lft side of the heart is pulmonary edema)
- Ascites (Ascites is excess fluid in the space between the tissues lining theabdomen and abdominal organs (the peritoneal cavity)
- Jugular vein distention

Front 8

what is the best way of assessing a pt’s fluid status?

Back 8

what is the best way of assessing a pt’s fluid status?

-Daily Weights

Front 9

Why can’t insensible fluid loss come from the GI tract, Urinary output or from wound drainage?

Back 9

Why can’t insensible fluid loss come from the GI tract, Urinary output or from wound drainage?

- Because insensible is fluid loss that is unmeasurable. The above is all measurable.

Front 10

If dr. wrote insensible fluid loss of 800, where did it come from?
A. Gi Tract
B. urinary output
C. wound drainage
D. perspiration

Back 10

If dr. wrote insensible fluid loss of 800, where did it come from?

D. perspiration

Front 11

Your reading the physicians progress notes and u notice the Dr. has written insensible fluid loss of 800 ml per day, where do we get insensible fluid loss from? How much loss for each?

Back 11

Your reading the physicians progress notes and u notice the Dr. has written insensible fluid loss of 800 ml per day, where do we get insensible fluid loss from? How much loss for each?

- Respiratory tract= 4-500 ml’s in a 24 hr period.

- Sweating= around 500 ml (perspiration from the skin (med term diaferiesis)is the most likely place it came from for test reasons)

- Solid Feces= 100 ml’s

Front 12

what is the difference between blood plasma and interstitial fluid?

Back 12

what is the difference between blood plasma and interstitial fluid?

- plasma is inside blood & interstitial is around each cell. both are extracellular compartments

Front 13

Where is the most likely place of insensible fluid loss on regular basis?

Back 13

Perspiration is the most likely place of insensible fluid loss on regular basis?

Front 14

what is the fastest way to replenish fluids and electrolytes?

Back 14

what is the fastest way to replenish fluids and electrolytes?

-IV

Front 15

when water moves from an area of low concentration of solutes, to an area of high concentration, what do we call that?

Back 15

when water moves from an area of low concentration of solutes, to an area of high concentration, what do we call that?

- Osmosis

Front 16

When substances move from high concentration of the substance to low concentration of the substance, what do we call that?

Back 16

When substances move from high concentration of the substance to low concentration of the substance, what do we call that?

- Diffusion

Front 17

When substances move from high pressure to low pressure, what called?

Back 17

When substances move from high pressure to low pressure, what called?

- filtration

Front 18

What is the name we give to the increase in pressure (from too much fluid) within the blood vessels?

Back 18

What is the name we give to the increase in pressure (from too much fluid) within the blood vessels?

- Hydrostatic pressure
- orthostatic pressure
- osmotic pressure
- oncotic pressure

Front 19

your taking care of a 60 yr client who given plasma protein, what problem might you expect from the pt?

Back 19

your taking care of a 60 yr client who given plasma protein, what problem might you expect from the pt?

- edema, fluid overload

-serum albumin will also increase edema

Front 20

pt has develop excessive edema, which electrolyte has the greatest response?

Back 20

pt has develop excessive edema, which electrolyte has the greatest response?

- sodium

Front 21

your client has a low sodium level <130, what is the best way to increase sodium level?

Back 21

your client has a low sodium level <130, what is the best way to increase sodium level?

- restricting fluids

Front 22

pt has a high sodium level, what is the level of consciousness?

Back 22

pt has a high sodium level, what is the level of consciousness?

- agitated, restless

Front 23

after prolong surgery, what electrolyte are we concerned about pt losing?

Back 23

after prolong surgery, what electrolyte are we concerned about pt losing?

- sodium and potassium, but more with potassium

- the heart if affect more with potassium loss

Front 24

which electrolyte of intracellular is the most important?

Back 24

which electrolyte of intracellular is the most important
- potassium

Front 25

which electrolyte of extracellular is the most important?

Back 25

which electrolyte of extracellular is the most important?

- sodium

Front 26

what is your normal potassium level?

Back 26

what is your normal potassium level?

- 3.5-5.0

Front 27

hyperkalemia, what are the s/s

Back 27

hyperkalemia, what are the s/s

- bradycardia
- diarrhea
- weakness

Front 28

low potassium causes, what?

Back 28

low potassium causes irritability

Front 29

checking potassium levels on a pt, are high, what would you do?

Back 29

checking potassium levels on a pt, are high, what would you do?
-check vital signs and call the doctor

Front 30

what would you anticipate him doing with high levels of potassium

Back 30

what would you anticipate him doing with high levels of potassium
- hold the potassium drug so levels can go down

Front 31

k exalate

Back 31

k exalate
- drug that gets rid of potassium from the body. decreases potassium levels

Front 32

normal and abnormal levels:
- potassium level of abnormal
- sodium level
- chloride
- calcium
***make sure you know the ranges***

Back 32

normal and abnormal levels:
- potassium level of abnormal
- sodium level of 138 normal
- chloride 110 abnormal
- calcium 9.6 normal
***make sure you know the ranges***

Front 33

pt has been on Lasix, what should you check?

Back 33

pt has been on Lasix, what should you check?

- potassium levels

Front 34

if your patient has abdominal distention or ascites, what electrolyte would be elevated?

Back 34

if your patient has abdominal distention or ascites, what electrolyte would be elevated?
- sodium, and if sodium is elevated potassium will decrease

Front 35

what do we need chloride for, what is it combined with?

Back 35

what do we need chloride for, what is it combined with?

- combines with sodium, potassium, calcium, and produces hydrochloric acid

Front 36

when stroking a pt's cheek and twitching occurs (aka Shavestic sign), what does that tell you, what electrolyte it imbalance?

Back 36

when stroking a pt's cheek and twitching occurs (aka Shavestic sign), what does that tell you, what electrolyte it imbalance?
- calcium imbalances, hypocalcemia

Front 37

troussou sign (finger spasm)

Back 37

troussou sign (finger spasm)
- low calcium, hypocalcemia

Front 38

hyperparathyroidism, thyroid glands are over active, pt serum calcium level is elevated, what drug is going to force calcium back into blood

Back 38

hyperparathyroidism, thyroid glands are over active, pt serum calcium level is elevated, what drug is going to force calcium back into bones
- calcitonin

Front 39

what 2 system help maintain your normal body pH?

Back 39

what 2 system help maintain your normal body pH?
- lungs and kidneys (respiratory and urinary)

Front 40

your taking care of pt with chronic renal failure and has high ammonia levels,

Back 40

your taking care of pt with chronic renal failure and has high ammonia levels,

Front 41

PaCo2 levels?

Back 41

PaCo2 levels
- if its high how is the pt breathing, breathing swallow and slow
- breathing fast Co2 would be low
- PaCO2 level goes up, what kind of acidosis= respiratory acidosis

Front 42

make pt breath in a brown paper bag when they are, what?

Back 42

make pt breath in a brown paper bag when they are hyperventilating

Front 43

when your blowing off co2, may end up with a carbonic deficiency aka: ?

Back 43

when your blowing off co2, may end up with a carbonic deficiency aka respiratory alkalosis

Front 44

your pt pH is 7.30, PaCO2 is 40, bicarb is 20, what's abnormal?

Back 44

your pt pH is 7.30, PaCO2 is 40, bicarb is 20, what's abnormal?
- pH is low
- PACo2 is normal
- bicarb is a little low
we have a metabolic acidosis because co2 is normal

Front 45

pt came into ER for metabolic acidosis, has diarrhea, what drug would the doctor prescribe?

Back 45

pt came into ER for metabolic acidosis, has diarrhea, what drug would the doctor prescribe?

- IV sodium bicarbonate

Front 46

pt is came to the ER and has prolonged vomiting, what is that going to do to the acid base balance?

Back 46

pt is came to the ER and has prolonged vomiting, what is that going to do to the acid base balance?

- metabolic alkalosis

Front 47

pt is came to the ER and has prolonged vomiting, has alkalosis, what is going to happen to his bicarb level?

Back 47

pt is came to the ER and has prolonged vomiting, has alkalosis, what is going to happen to his bicarb level?

- it is going to increase

Front 48

bicarb goes up, pH goes (up or down?)

Back 48

bicarb goes up, pH goes up too

Front 49

pt diagnosed with peptic ulcer, uses antacid, pH blood alkaline or acid?

Back 49

pt diagnosed with peptic ulcer, uses antacid, pH blood alkaline or acid?

-alkaline, suspect a metabolic alkalosis

Front 50

Define each of the solutions:
- Hypertonic
- Hypotonic
- Isotonic

Back 50

Define:

- Hypertonic solutions - solutions that we have in our nursing arsinal as it were higher than normal (higher than 0.9%)

- Hypotonic is lower than normal (lower than 0.9%)

- Isotonic is the same as normal (normal is 0.9%)

Front 51

What would be considered a Isotonic solution and why?

Back 51

What would be considered a Isotonic solution and why?

-Normal Saline

- Why is normal saline considered a isotonic solution?

it is the same sodium concentration as the rest of fluids in the entire body (0.9%)

Front 52

Dr. tells you to give a liter of normal saline over 30 min., would you expect the pt to develop any type of edema (ex: dependent edema, pulmonary edema, or fluid in the sacrum)?

Back 52

Dr. tells you to give a liter of normal saline over 30 min., would you expect the pt to develop any type of edema (ex: dependant edema, pulmonary edema, or fluid in the sacrum)?

- No. You would expect a Isotonic solution to stay wherever you put it. So, if you give it intravenously, you would expect it to stay in the vascular compartment. You would NOT expect it to move because the saline solution is normal and the same concentration as all around it.

Front 53

Define Osmosis:

Back 53

Define Osmosis:

- the movement from of water from an area of high concentration to an area of low concentration.

Front 54

infiltration vs. extravasation

Back 54

infiltration vs. extravasation

- Infiltration is when the needle has come out of the vein and the IV fluid is dripping into the interstitial spaces causing edema.

- Extravasation: when we are infusing medications with high osmotic pressure (example: 50% dextrose; a thick fluid) will draw fluid, increasing pressure even more when that happens some of the fluid just oozes out into the cells of your vessles & interstitial spaces.

end result for infiltration vs. extravasation, edema. Both has a solution for the prob. insert the iv somewhere else.

Front 55

What is your responsibility when you are told to monitor a IV?

Back 55

What is your responsibility when you are told to monitor a IV?

Check for:
- Rate of flow: the rate at which it is running compared to the amount that the Dr. ordered.
- Site of IV- infiltration & extravasation.
- Kink in the Line: a pinched line from pt moving or tube twisting. cutting off the flow, or a kink in the line, or needle fell out of vein
- Phlebitis: Signs of Phlebitis are inflamation, redness, heat (skin will feel warm to the touch).

Front 56

math problem calculating a IV rate given a solution doctor wants you to run at 240ml per hour, IV tubing 20 drop per ml, how fast do run IV?

Back 56

math problem calculating a IV rate given a solution doctor wants you to run at 240ml per hour, IV tubing 20 drop per ml, how fast do run IV?

multiply 240x20/by 60= 80 gtt per min

FYI: V infusion is (mL / min) x gtt per mL

Front 57

Dr. writes order for IV to run at 125 ml per hr., your admin says 15 drops per ml. How fast do u run the IV?

Back 57

Dr. writes order for IV to run at 125 ml per hr., your admin says 15 drops per ml. How fast do u run the IV?

- 31.25 (31)

Front 58

What is Albuminuria?

Back 58

What is Albuminuria?

- protein in the urine, which is abnormal

Front 59

1. Osmosis =

2. Diffusion =

Back 59

1. Osmosis = areas of HIGH concentration to LOW concentration

2. Diffusion = also areas of HIGH to LOW

Front 60

your taking care of a 65 yr old pt and needs plasma proteins. what should you be monitoring pt for?

Back 60

your taking care of a 65 yr old pt and needs plasma proteins. what should you be monitoring pt for?

- edema. -- check fluid overload