Exam 1

Question 1

Regulation of Water Balance

Answer 1

Thirst, ADH, RAAS, Cardiac Regulation, GI Regulation

Question 2

Osmolality less than 275

Answer 2

Water Excess

Question 3

Osmolality greater than 295

Answer 3

Water deficit

Question 4

Plasma Osmolality is betweeen

Answer 4

280 - 295

Question 5

Hypovolemia

Answer 5

Loss of water and electrolytes from the ECF in similar promotions.

Question 6

Causes of hypovolemia

Answer 6

Abnormal loss of body fluids
Insensible fluid losses
Inadequate fluid intake
Shift from Plasma to interstitial fluid (third spacing)

Question 7

Patients at risk of developing fluid Volume Deficit are?

Answer 7

Patients with a nasogastric/orogastric tube who are being continuously suctioned.

Question 8

Clinical indications of fluid volume deficit may include:

Answer 8

Urine Output
H&H will be elevated
BUN - normal 10-20
Vital signs
Mucous membranes
Skin: cold, clammy, decreased skin turgor
Decreased capillary refill
Flattened neck vein

Question 9

What is the normal urine output necessary to maintain kidney function?

Answer 9

30ml/hr

Question 10

Nursing interventions for a patient who is hypovolemic are.

Answer 10

Strict I&O
IV Access
VS: Cardiac monitoring, pulse oximetry, continuous blood pressure monitoring
Safety Precautions.
Daily Weights:
2% = Mild FVD loss
5% = Moderate FVD loss
8% = Severe FVD loss

Question 11

A patient who is hypovolemic would need which fluid?

Answer 11

3% (hypertonic solution)

Question 12

3% hypertonic solution is used to treat.

Answer 12

Hyponatremia and trauma patients with head injury.
Give slowly as it may cause volume overload and pulmonary edema.

Question 13

Normal Saline (0.9%)

Answer 13

Isotonic Solution (similar to water)
The only solution compatible with blood products.
Used for the fluid in our flushes, expand intravascular volume, and replace extracellular fluid losses/rehydration. May cause volume overload in patients with heart or kidney disease.

Question 14

5% Dextrose (D5W)

Answer 14

Starts as isotonic solution and then changes to a hypotonic solution when the dextrose is metabolized.
Uses to treat water loss and hypernatremia.
Contains free water only, no electrolytes.

Question 15

Gerontological Considerations for hypovolemia.

Answer 15

Structural changes in kidneys decrease the ability to conserve water.
Hormonal changes include a decrease in renin and aldosterone and increases in ADH and ANP.
Subcutaneous tissue loss leads to increased moisture loss.

Question 16

Isotonic Solutions - ISO = In the Cell.

Answer 16

Normal Saline
Lactaid Ringers.