Chapter 11

Question 1

Sodium

Answer 1

135-145 mEq/L

Question 2

Potassium k+

Answer 2

3.5-5 mEq/L

Question 3

Calcium (Ca)

Answer 3

9-10.5 mg/dL

Question 4

Chloride

Answer 4

98-106 mEq/L

Question 5

Magnesium

Answer 5

1.3-2.1 mEq/L

Question 6

Phosphorus

Answer 6

3-4.5mg/dL

Question 7

Significance of Hypernatremia

Answer 7

Dehydration, kidney disease, hypercortisolism

Question 8

Significance of Hyponatremia

Answer 8

Fluid overload, liver disease, adrenal insufficiency

Question 9

Significance of Hyperkalemia

Answer 9

Dehydration, kidney disease, acidosis, adrenal insufficiency, crush injuries

Question 10

Significance of Hypokalemia

Answer 10

Fluid overload, diuretic therapy, alkalosis, insulin administration, hyperaldosteronism

Question 11

Significance of Hypercalcemia

Answer 11

Hyperthyroidism, hyperparathyroidism,

Question 12

Significance of Hypocalcemia

Answer 12

Vitamin D deficiency, hypothyroidism, kidney disease, excessive intake of phosphorus containing foods/drinks

Question 13

Significance of Hyperchloremia

Answer 13

Metabolic acidosis, respiratory alkalosis, hypercortisolism

Question 14

Significance of Hypochloremia

Answer 14

Fluid overload, excessive vomiting or diarrhea, diuretic therapy

Question 15

Significance of Hypermagnesemia

Answer 15

Kidney disease, hypothyroidism, adrenal insufficiency

Question 16

Significance of Hypomagnesemia

Answer 16

Malnutrition, alcoholism, ketoacidosis

Question 17

Significance of Hyperphosphatemia

Answer 17

Kidney disease, hypothyroidism, adrenal insufficiency

Question 18

Significance of Hypophosphatemia

Answer 18

Chronic antacid use, hyperparathyroidism, vitamin D deficiency, malnutrition

Question 19

Obligatory urine output

Answer 19

The minimum amount of urine per day needed to excrete toxic waste products is 400-600 ml

Question 20

3 hormones to help control fluid and electrolyte balance

Answer 20

Aldosterone, Antidiuretic hormone (ADH), Natriuretic peptide (NP)

Question 21

Isotonic dehydration

Answer 21

Water and electrolyte loss-most common type of fluid loss problem

Question 22

Relative dehydration

Answer 22

No actual loss of total body water, such as when water shifts from the plasma into the interstitial space

Question 23

Common causes of dehydration

Answer 23

Hemorrhage, vomiting, diarrhea, burns, GI suctioning, fever

Question 24

Common causes of fluid overload

Answer 24

Kidney failure, heart failure, SIADH, water intoxication

Question 25

Weigh pt directly

Answer 25

1 liter=1 kg

Weight change of one pound=fluid volume change of 500 ml

Question 26

0.9% normal saline

Answer 26

Isotonic

Question 27

0.45% saline

Answer 27

Hypotonic

Question 28

5%dextrose in water

Answer 28

Isotonic

Question 29

10% dextrose in water

Answer 29

Hypertonic

Question 30

5% dextrose in 0.9% saline

Answer 30

Hypertonic

Question 31

5% dextrose in LR

Answer 31

Hypertonic

Question 32

LR

Answer 32

Isotonic

Question 33

Fluid overload signs and symptoms

Answer 33

Increased pulse rate, elevated BP, distended neck and hand veins, weight gain, increased respiratory rate, SOB, edema, altered LOC, HA

Question 34

Signs and symptoms of Hyponatremia

Answer 34

Involves cerebral, neuromuscular, intestinal smooth muscle, and cardiovascular functions.
Confusion, seizures, coma
General muscle weakness, diminished deep tendon reflexes
N/V/D, hyperactive bowel sounds
Rapid weak threads pulse, severe orthostatic hypotension

Question 35

Signs and symptoms of Hypernatremia

Answer 35

Changes seen in excitable membrane activity, especially in nerve, skeletal muscle, and cardiac function.
Short attention span, lethargic, drowsy
Twitching, reduced or absent deep tendon reflexes, muscle weakness bilaterally

Question 36

Signs and symptoms of Hypokalemia

Answer 36

Life threatening, every body system is affected.
Shallow respirations
Skeletal muscle weakness, deep tendon reflexes diminished, flaccid paralysis
Threads weak pulse, dysthymia, orthostatic hypotension
Altered mental status, anxiety
Decreased peristalsis, hypoactive bowel sounds, paralytic ileum

Question 37

Signs and symptoms of Hyperkalemia

Answer 37

Cardiovascular changes are the most severe problems and most common cause of death in patients with Hyperkalemia.
Bradycardia, hypotension, vfib
Parasthesia, muscle weakness, flaccid paralysis

Question 38

Signs and symptoms of Hypocalcemia

Answer 38

Parasthesia, cramps, spasms
Weak and Thready pulse, hypotension
Increased perstaltic activity, abdominal cramping, diarrhea
Bone pain

Question 39

Symptoms of Hypercalcemia

Answer 39

Occurs first in the excitable tissues, affects all body systems.
Increased HR and BP, depressed electrical conduction, slowing HR
Blood clotting
Muscle weakness, decreased deep tendon reflexes, confusion
Decreased peristalsis, constipation, nausea

Question 40

Trousseau sign

Answer 40

BP cuff on upper arm, inflate greater than four minutes, hands and fingers go into spasms in palmar flexion
Hypocalcemia

Question 41

Chvosteks sign

Answer 41

Tap on cheek area to trigger facial twitching on one side of the face
Hypocalcemia

Question 42

Signs and symptoms of Hypophosphatemia

Answer 42

Decreased cardiac output, weak skeletal muscles, rhabdomyolysis, seizures

Question 43

Signs and symptoms of Hyperphosphatemia

Answer 43

Increased membrane excitability

High levels tolerated by body

Question 44

Signs and symptoms of Hypomagnesemia

Answer 44

Hyperactive deep tendon reflexes, parasthesia, painful muscle contractions, tetany, seizures
Anorexia, paralytic ileum

Question 45

Signs and symptoms of Hypermagnesemia

Answer 45

Bradycardia, hypotension
Drowsy, lethargic, coma
Absent deep tendon reflexes

Question 46

Give for Hyperkalemia

Answer 46

Kaexalate or insulin and dextrose