Electrolytes III Q&A Flashcards
Maria, an 85-year-old patient with a feeding tube, has been experiencing severe watery stool. The patient is lethargic and has poor skin turgor, a pulse of 120, and hyperactive reflexes. Nursing interventions would include:
A. Measuring and recording intake and output and daily weights.
B. Administering salt tablets and monitoring hypertonic parenteral solutions.
C. Administering sedatives.
D. Applying wrist restraints to avoid displacement of the feeding tube.
Correct Answer: A. Measuring and recording intake and output and daily weights.
The patient is exhibiting signs of hypernatremia and dehydration.
Restrict sodium intake and administer diuretics as indicated.
Christoff is diagnosed with hypermagnesemia. Symptoms of her condition may include:
A. Hypertension
B. Tachycardia
C. Hyperactive deep-tendon reflex
D. Cardiac arrhythmias
D. Cardiac arrhythmias
Cardiac arrhythmias are associated with hypermagnesemia.
For higher values (over 12.0 mg/dL) muscle paralysis, paralytic ileus, decreased breathing rate, low blood pressure, electrocardiogram (ECG) changes including an increase in PR and QRS interval with sinus bradycardia, and atrioventricular block, coma and cardiac arrest (exceeding 15.0 mg/dL) may occur.
Hypertension, tachycardia, and hyperactive reflexes are signs of hypomagnesemia.
In severe _________ (greater than 12 mmol/dL), there is muscle flaccid paralysis, decreased breathing rate, more evident hypotension and bradycardia, prolongation of the P-R interval, atrioventricular block, and lethargy are common.
Coma and cardiorespiratory arrest can occur for higher values (over 15 mg/dL).
Hypercalcemia
GI fluid loss through diarrhea is an etiology of ( hypotonic FVD / hypertonic FVD)
Hypertonic dehydration
Sodium loss is greater than water loss, resulting in a decrease in serum osmolality.
This causes a shift of water from the extracellular space into the intracellular space.
The cells swell and cerebral edema may occur.
Insensible water loss during prolonged fever is a cause of (hypotonic / hypertonic) FVD.
Hypertonic
Fever will increase the respiratory rate and therefore, water loss.
Sweating also increases to lower the body temperature.
Water intake is commonly decreased during a fever which will aggravate dehydration.
Impaired thirst regulation is a cause of ( hypotonic/ hypertonic ) FVD.
Hypertonic dehydration
Water excretion from the body exceeds that of sodium excretion, resulting in increased sodium concentration in the extracellular fluid (hypernatremia).
Blood osmolality is increased, causing water to shift from the intracellular to the extracellular space.
The majority of the body’s water is contained in which of the following fluid compartments?
A. Intracellular
B. Interstitial
C. Intravascular
D. Extracellular
Intercellular
Etiologies associated with hypomagnesemia include:
A. Decreased vitamin D intake
B. Constipation
C. Malabsorption syndrome
D. Renal failure
Malabsorption syndrome is associated with hypomagnesemia.
Increased vitamin D intake and diarrhea are also associated with hypomagnesemia.
Magnesium deficiency and hypomagnesemia can result from a variety of causes including gastrointestinal and renal losses.
Magnesium deficiency can cause a wide variety of features including hypocalcemia, hypokalemia, and cardiac and neurological manifestations.
Inflammatory Conditions:
Inflammation, such as in severe burns, trauma, or inflammatory disorders, can increase capillary permeability
Kidney Disorders:
Conditions such as nephrotic syndrome can result in the loss of proteins, particularly albumin, leading to decreased colloidal osmotic pressure and fluid accumulation in interstitial spaces.
Heart Failure:
In heart failure, decreased cardiac output can lead to inadequate perfusion of tissues, causing fluid to accumulate in interstitial spaces.
Liver Disease:
Cirrhosis of the liver can lead to portal hypertension and ascites, where fluid accumulates in the peritoneal cavity as a result of increased pressure in the portal vein.
Can all cause this problem
The consequences of third-spacing fluid can include edema, decreased circulating blood volume, and compromised tissue perfusion. Management involves addressing the underlying cause, optimizing fluid balance, and sometimes using interventions like diuretics or albumin infusions to re-establish normal fluid distribution.
Magnesium performs all of the following functions except:
A. Contributing to vasoconstriction.
B. Assisting in cardiac muscle contraction.
C. Facilitating sodium transport.
D. Assisting in protein metabolism.
Magnesium contributes to vasodilation, not vasoconstriction. Magnesium plays a vital role in over 300 reactions involving metabolism. It is involved with hormone receptor binding, muscle contraction, neural activity, neurotransmitter release, vasomotor tone, and cardiac excitability.
diet containing the minimum daily sodium requirement for an adult would be:
A. A no-salt diet
B. A diet including 2 gm sodium
C. A diet including 4 gm sodium
D. A 1500 calorie weight-loss diet
B. 2gm daily
Orly Khan is suffering from fluid volume deficit (FVD), which of the following symptoms would the nurse expect to assess in the patient?
A. Rales
B. Bounding pulse
C. Tachycardia
D. Bulging neck veins
Correct Answer: C. Tachycardia
Tachycardia, poor tissue turgor, and hypotension are symptoms of FVD.
Rales, Bounding Pulse, Bulging Neck Veins are FVE Fluid Volume Excess
A decrease in circulating blood volume can cause hypotension and tachycardia.
John Reid is admitted to the hospital and is currently receiving hypertonic fluids. Nursing management for the client includes monitoring for all of the following potential complications except:
A. Water intoxication
B. Fluid volume excess (FVE)
C. Cellular dehydration
D. Cell shrinkage
Water intoxication is a potential complication associated with hypotonic fluid administration. Water intoxication provokes disturbances in electrolyte balance, resulting in a rapid decrease in serum sodium concentration and eventual death.
The development of acute dilutional hyponatremia causes neurological symptoms because of the movement of water into the brain cells, in response to the fall in extracellular osmolality.
Other choices are potential complications of hypertonic fluid administration.
Which of the following statements provides the rationale for using a hypotonic solution for a patient with FVD?
A. A hypotonic solution provides free water to help the kidneys eliminate the solute.
B. A hypotonic solution supplies an excess of sodium and chloride ions.
C. Excessive volumes are recommended in the early postoperative period.
D hypotonic solution is used to treat hyponatremia.
A hypotonic solution provides free water to help the kidneys eliminate the solute.
Hypotonic solutions provide free water, which helps the kidneys eliminate solute.
Hypotonic solutions are commonly used to give fluids intravenously to hospitalized patients in order to treat or avoid dehydration.
Causes of Hyponatremia (Select all)
A. Vomiting
B. Diuretics
C. Constipation
D. Heart Failure
A,B,D
