fluid/electrolyte

Question 1

What are the assessment findings of fluid volume excess?

Answer 1

Weight gain, edema, JVD, pulmonary/peripheral edema, polyuria, dyspnea, crackles upon auscultation, bounding pulse.

Question 2

Which patients commonly experience fluid volume excess?

Answer 2

Congestive heart failure (CHF) patients.

Question 3

What is the priority intervention for fluid volume excess?

Answer 3

Treating the underlying cause.

Question 4

How can fluid be removed without altering electrolyte composition or osmolality of ECF?

Answer 4

By carefully managing treatment strategies such as diuretics and fluid restriction.

Question 5

What should be done with IV infusions in cases of fluid volume excess?

Answer 5

Decrease or stop the IV infusion rate.

Question 6

What medications are commonly used to manage fluid volume excess?

Answer 6

Diuretics.

Question 7

What dietary modification is recommended for fluid volume excess?

Answer 7

Low-sodium diet.

Question 8

What procedures can be performed for patients with ascites or pleural effusion?

Answer 8

Abdominal paracentesis or thoracocentesis.

Question 9

Why should daily weights be checked in fluid volume excess patients?

Answer 9

To monitor fluid retention and treatment effectiveness.

Question 10

When should daily weights be measured?

Answer 10

At the same time and under the same conditions each day.

Question 11

What are the assessment findings of fluid volume deficit?

Answer 11

Weight loss, decreased capillary refill, increased thirst, dry mucous membranes, oliguria, concentrated urine, increased respiratory rate, cold and clammy skin, weak pulse, orthostatic hypotension.

Question 12

What is the priority intervention for fluid volume deficit?

Answer 12

Treating the underlying cause.

Question 13

What are the treatment options for fluid volume deficit?

Answer 13

Oral or IV fluid replacement therapy.

Question 14

Why should daily weights be checked in fluid volume deficit patients?

Answer 14

To monitor fluid status and treatment effectiveness.

Question 15

When should daily weights be measured?

Answer 15

At the same time and under the same conditions each day.

Question 16

What can be done to help with dry skin in fluid volume deficit patients?

Answer 16

Moisturize the skin.

Question 17

Is dehydration the same as fluid volume deficit?

Answer 17

No, dehydration is the loss of only water, while fluid volume deficit involves the loss of both water and electrolytes.

Question 18

What are common causes of fluid volume deficit?

Answer 18

Vomiting, diarrhea, excessive sweating, hemorrhage, burns, diuretic overuse, inadequate fluid intake.

Question 19

What vital sign changes are seen in fluid volume deficit?

Answer 19

Increased respiratory rate, weak pulse, orthostatic hypotension.

Question 20

What are common urine characteristics in fluid volume deficit?

Answer 20

Oliguria (low urine output) and concentrated urine.

Question 21

What are the EKG changes seen in hypokalemia?

Answer 21

ST depression, U wave, shallow T wave, slightly peaked P wave, prolonged QRS complex.

Question 22

How does hypokalemia affect the gastrointestinal (GI) system?

Answer 22

Decreased GI motility, leading to constipation, nausea, etc.

Question 23

What are the neuromuscular symptoms of hypokalemia?

Answer 23

Skeletal muscle weakness or paralysis, hyporeflexia.

Question 24

How does hypokalemia affect the respiratory system?

Answer 24

Shallow respirations.

Question 25

What cardiovascular signs may be present in hypokalemia?

Answer 25

Weak pulse.

Question 26

What are the priority interventions for hypokalemia?

Answer 26

Oral/IV potassium intake, increasing dietary potassium, monitoring EKG for cardiac changes, and monitoring urine output.

Question 27

How should IV potassium chloride be administered?

Answer 27

It must be diluted, given slowly, never as a push or bolus, and never added to an existing bag.

Question 28

Why should the IV potassium chloride site be monitored closely?

Answer 28

Because it is an irritant and can cause infiltration, extravasation, or phlebitis.

Question 29

What are good dietary sources of potassium?

Answer 29

Bananas, oranges, spinach, potatoes, avocados, beans, yogurt.

Question 30

What should be assessed before administering IV potassium?

Answer 30

Urine output to ensure adequate kidney function and prevent hyperkalemia.

Question 31

What are the EKG changes seen in hyperkalemia?

Answer 31

Flat P wave, widened QRS complex, depressed ST segment, tall T wave.

Question 32

What neuromuscular symptoms are associated with hyperkalemia?

Answer 32

Tetany, loss of muscle tone.

Question 33

How does hyperkalemia affect the gastrointestinal (GI) system?

Answer 33

Abdominal cramping.

Question 34

How does hyperkalemia impact glucose levels?

Answer 34

It can cause hyperglycemia due to insulin impairment.

Question 35

What is the first step in managing hyperkalemia?

Answer 35

Stop oral or IV potassium intake.

Question 36

What types of diuretics are used to treat hyperkalemia?

Answer 36

Loop or thiazide diuretics.

Question 37

What medication binds potassium in the bowel for excretion?

Answer 37

Potassium polystyrene sulfonate (Kayexalate).

Question 38

What treatment is used for hyperkalemia in patients with renal failure?

Answer 38

Hemodialysis.

Question 39

How does glucose and insulin therapy help in hyperkalemia?

Answer 39

It draws potassium from the plasma into the cells.

Question 40

Why should continuous EKG monitoring be done for hyperkalemia patients?

Answer 40

To detect and manage potentially life-threatening cardiac changes.

Question 41

What are the mild symptoms of hyponatremia?

Answer 41

Headache, irritability, trouble concentrating.

Question 42

What are the severe symptoms of hyponatremia?

Answer 42

Confusion, vomiting, seizures, coma.

Question 43

What type of fluids are used to replace sodium in hyponatremia?

Answer 43

Isotonic sodium-containing solutions.

Question 44

What oral intervention is encouraged for hyponatremia?

Answer 44

Encouraging oral sodium intake.

Question 45

What should be done with diuretics in hyponatremia management?

Answer 45

Stop diuretics to prevent further sodium loss.

Question 46

Why are daily weights important in hyponatremia management?

Answer 46

To monitor fluid balance and treatment effectiveness.

Question 47

What supplements might be used to manage hyponatremia?

Answer 47

Sodium and potassium supplements.

Question 48

What medication can be given to increase sodium levels?

Answer 48

Salt tablets (salt tabs).

Question 49

What complications can arise from untreated severe hyponatremia?

Answer 49

Seizures and coma.

Question 50

What causes hyponatremia?

Answer 50

Excess water intake, heart failure, renal disease, SIADH (syndrome of inappropriate antidiuretic hormone), diuretic overuse.

Question 51

What are the neurological symptoms of hypernatremia?

Answer 51

Drowsiness, confusion, lethargy.

Question 52

What cardiovascular sign is commonly seen in hypernatremia?

Answer 52

Tachycardia.

Question 53

What musculoskeletal symptoms can occur with hypernatremia?

Answer 53

Muscle weakness, hyporeflexia.

Question 54

What is the treatment for hypernatremia due to water excess?

Answer 54

Oral/IV rehydration with isotonic fluids (0.9% normal saline).

Question 55

What is the treatment for hypernatremia due to sodium excess?

Answer 55

Oral/IV rehydration with diluted sodium fluids (5% dextrose in water), sodium restriction, diuretics.

Question 56

What type of fluid is D5W, and how does it behave in the body?

Answer 56

D5W is isotonic but becomes hypotonic in the body.

Question 57

What dietary restriction is recommended for hypernatremia?

Answer 57

Sodium restriction.

Question 58

What type of diuretics are used to manage sodium excess?

Answer 58

Diuretics that promote sodium excretion, such as loop diuretics.

Question 59

Why is careful monitoring needed when treating hypernatremia?

Answer 59

Rapid correction can cause cerebral edema.

Question 60

What are common causes of hypernatremia?

Answer 60

Dehydration, excessive sodium intake, diabetes insipidus, heat stroke, osmotic diuresis.