Review questions from WS Flashcards
What respiratory problem can a decreased calcium level cause?
Laryngospasm and bronchospasm
What problem from a decrease in Cl can manifest.
Metabolic alkalosis; can cause slow respirations and shallow breathing; arrhythmias, and respiratory arrest
Increased Cl can cause _______. This may lead to ____ and _____ breathing pattern.
Metabolic acidosis; tachypnea and Kussmaul breathing
An increase in this electrolyte may cause muscle weakness which can include respiratory muscle weakness.
Mg
An decrease in these electrolytes may lead to muscle weakness which would affect respiratorymuscles.
K, P
A decrease in phosphorous may lead to decreased contracting which can cause _____.
cyanosis
T or F; Increased or decreased levels of K can cause muscle weakness.
True
A respiratory side effect of hypernatremia is____.
dyspnea
If you hear moist crackles this could be a sign of _____.
Fluid overload; overhydration, possible pulmonary edema
Hyperventilation may be a sign of ________ ______ or too much of this electrolyte?
Respiratory alkalosis (with or without metabolic acidosis) Hyperchloremia
Hypoventilation may be a sign of imbalance of which two electrolytes?
Hypokalemia (too little K)
HyperMg
Also respiratory acidosis with or without metabolic acidosis
Kussmaul’s breathing is often seen with _____ ______.
Metabolic acidosis
Dyspnea may be seen with ______.
hypervolemia, fluid volume excess or overhydration
When assessing skin if it is cold or clammy you might suspect _______. If you see cold skin with poor skin turgor you might suspect ________. Warm moist skin may indicate ______. While flushed skin is a sign of too little of this electrolyte?
Hyponatremia
Dehydration, or fluid volume deficit
Overhydration, too much fluid
Mg
How does cirrhosis of the liver affect electrolyte balance?
Fluid volume excess; Hypokalemia due to too much aldosterone
Respiratory alkalosis: most common acid base disorder with cirrhosis of liver
Can treat with potassium sparing diuretic
How does CHF affect electrolytes?
Fluid volume excess is most common imbalance with CHF; causes low CO; peripheral edema often accompanies
Metabolic acidosis: poor tissue perfusion due to low cardiac output
Diabetes insipidus effects electrolyte & fluid balance how?
Fluid volume deficit due to inadequate amts of ADH
Hypernatremia as water excreted in excess
Diabetic ketoacidosis affects fluid & electrolytes how?
Fluid volume deficit Hyponatremia Hypokalemia Metabolic acidosis Respiratory alkalosis: secondary to met acidosis as compensatory mechanism
Renal failure in patients with oliguria or anuria may lead to these imbalances:
Hypernatremia Hyperkalemia Hyperphosphatemia Hypermagneseia Hypervolemia Hypocalcemia Metabolic acidosis So increased Na, K, P, Mg & fluid & decreased Ca
SIADH can lead to what imbalances?
Hyponatremia
Fluid volume excess
treat with restricting water intake and giving diuretic
Which type of solution raises serum osmolarity and pulls fluids and electrolytes from the intracellular and interstitial compartments into the intravascular compartments? A. Isotonic B. Hypertonic C. Electrotonic D. Hypotonic
B. Hypertonic
Raises serum osmolarity
Pulls fluids from Icf and interstitial to intravascular
The sodium potassium pump is an example of: A. diffusion B. active transport C. osmosis D. passive transport
B. active transport
Which of the following is a cation? A. chloride B. phosphorus C. glucose D. sodium
D. sodium
Osmosis is:
A. movement of solutes from area of higher concentration to lower one
B. Movement of water and some solutes with hydrostatic pressure through cell membranes
C. movement of solutes from an area of lower concentration to higher one using energy
D. movement of solutes from an area of lower solute concentration to higher one using energy
E. movement of water through a semipermeable membrane from an area of lower solute concentration to higher one
E.
Which of the following hormones is secreted when extracellular fluid osmolarity increses? A. ADH B. Renin C. Aldosterone D. Angiotensin I
A. ADH
When fluid osmolarity increases in ECF then ADH is secreted
The nurse documents that a patient is oliguric. Oligura is defined as:
A. A urine output of greater than 1500 in 24 hrs
B. No urine output in 24 hrs
C. A urine output less than 75 ml in 24 hrs
D. A urine output less than 500 ml in 24 hrs
D. Urine output less than 500 ml in 24 hrs is oliguria
low
The patient's K level is 5.0; this is interpreted as: a: hypokalemia B. hyperkalemia C. normal value D. Hyponatremia
C. Normal value:
normal is 3.5 - 5.0
Which statement accurately describes one of the sodium’s functions?
A. maintains osmotic pressure and intracellular fluid concentration
B. maintains osmotic pressure and ECF concentration
C. Regulates renal function
D. is essential for digestion.
B.
How does PTH help maintain calcium homeostasis?
A. it mobilizes Ca from bone
B. it raises serum phosphorous level, increasing serum Ca
C. It decreases renal tubular reabsorption of Ca
D. promotes mg excretion via kidneys
A. mobilizes Ca from bone
Which of the following is a major extracellular buffer system? A. phosphate buffer system B. Carbonic acid bicarb C. protein buffer system D. lungs
B. carbonic acid-bicarb buffer system
A patient is receiving an IV solution of D5W and lactated ringer's solution at 125 ml/hour to treat fluid volume deficit. Which of these signs indicates need for additional IV fluids? A. Serum Na level of 135 mEq/L B. Temp of 99.6 F C. Neck vein distention D. Dark, amber urine
D.
A patient with shock due to hemorrhage has these vitals; temp 97.6, pulse 140, respirations 28; BP 60/30; for this patient what should the physician order be?
A. Monitor urine output every hour
B. Infuse IV fluids at 83 ml/hr
C. administer O2 by nasal cannula at 3lpm
D. Draw specimens for Hgb & Hct every 6 hours
B. Infuse IV fluids at 83ml/hr
A 10 month old is admitted to hospital with fluid volume deficit & metabolic acidosis. What is the most common cause of dehydration and acidosis in infants? A. early introduction of solid foods B. Inadequate hygiene C. tachypnea D. diarrhea
D.
A patient is admitted with serum glucose level of 618 mg/dl. The patient is awake and oriented with hot, dry skin, a temp of 100.6F, HR 116, BP 108/70. Which one takes highest priority?
A. Fluid volume deficit related to osmotic diuresis
B. Decreased CO related to increased HR
C. Altered nutrition; less than body requires related to insulin deficiency
D. ineffective thermoregulation related to dehydration
D.
Which life threatening event is related to hypercalcemia? A. HB and cardiac arrest B. prolonged Qt interval C. Seizures D. Laryngospasm
A.
Which of the following are interventions in correcting hypercalcemia?
A. implementation of bed rest and administering phosphorous supplements and hypotonic solution
B. Administer diuretics, phosphorous supplements, and NSS
C. implementation of bed rest and administer diuretics and D5W
D. Fluid restriction and administration of diuretics and Vit D
B
Which measure would be appropriate for treating hypernatremia?
A. Administering a hypotonic solution or diuretic
B. Administering a diuretic or restricting water intake
C. Replacing free water or initiating dialysis
D. Restricting free water or starting dialysis
A. administering hypotonic solution or diuretic
What intervention is best for a patient with serum Mg level of 3.0 mEq/L
A. avoiding Mg containing laxatives and antacids
B. inducing diuresis to promote Mg loss if no evidence of renal failure exists
C. Monitoring ECF for peaked T waves
D. Using sorbitol to promote Mg loss via defecation
D.
Which is most appropriate for a patient with SIADH?
A. risk for injury related to seizures
B. impaired skin integrity due to peripheral edema
C. fluid volume excess due to increased thyrotropin secretion
D. impaired gas exchange related to pulmonary edema
A.
Which intervention is critical to managing a patient with chronic SIADH?
A. administering diuretics
B. infusing hypotonic sodium chloride replacement solution
C. restricting fluid intake
D. administering K supplements
C. restricting fluid intake
The largest compartment of body fluid is? A. ICF B. ECF C. ISF D. intravascular space
A. ICF
What is correct about the process of diffusion?
A. solutes move from an area of higher solute concentration to area of lower concentration
B. Solutes move from area of lower concentration to area of higher concentration
C. hydrostatic pressure forces solutes through a semipermeable membrane as hydrostatic pressure builds to force fluids and solutes through capillary walls to prevent excessive loss of intravascular fluid volume?
A
As hydrostatic pressure builds to force fluids and solutes through capillary walls, which force acts to prevent excessive loss of intravascular fluid volume? A. osmosis B. Colloid osmotic pressure C. Active transport mechanisms D. Diffusion
B.
A physician is infusing a hypotonic solution into a patient. He knows this type of solution will affect the fluid status by:
A. decreasing water content in blood vessels
B. Not changing water content
C. Increasing water content in blood vessels
D. Drawing water into the blood vessels
A. Hypotonic solution will decrease water content in blood
If osmolality of ICF increases, you can expect
A. colloid osmotic pressure to force water from ICF to ECF
B. No water movement between compartments
C. Water will shift from ICF to ECF
D. Water will shift from ECF to ICF
D. Water will shift from ECF to ICF if osmolality of ICF increases
In response to thirst, fluids are ingested which causes:
A. increase in concentration of solutes
B. decrease in concentration of solutes
C. No change in concentration of solutes
D. increase in serum osmolality
B. Decrease in concentration of solutes occurs when thirst causes you to ingest fluids
How does ANP work to decrease BP and reduce intravascular blood volume? Select all that apply A. Decreasing aldosterone release B. increasing aldosterone release C. Decreasing ADH release D. Increasing ADH release E. Causing Vasodilation F. Causing vasoconstriction
A, C, E
ANP will decrease aldosterone release
Decrease ADH release
Cause vasodilation
In a patient with GI hemorrhage you can expect the kidneys to respond by: A. Less secretion of renin B. Causing vasodilation C. Secreting more renin D. Secreting angiotensin II
C. Secreting more renin
The health care provider is testing specific gravity of a client with hypervolemia. You can expect the value to be: A. 1.005 B. 1.015 C. 1.020 D. 1.035
A. Specific gravity will be reduced below 1.005 in a person with hypervolemia
So, hypervolemia causes smaller specific gravity
What role does aldosterone play in fluid & electrolyte balance?
A. Aldosterone reduces circulating blood volume
B. It expands circulating blood volume
C. It promotes Na and H2O excretion from kidneys
D. Is responsible for converting angiotensin I to angiotensin II
B. Aldosterone excretion expands circulating blood volume
PAWP readings provide information about: A. colloid osmotic pressure B. Plasma concentration C. Left heart function D. Circulating red blood cell concentration
C. Left heart function
A client has a pulmonary artery catheter following surgery. His CO is 9-10 L/min. What action should be done next?
A. Notify physician and prepare to reduce IV fluid rate
B. Examine for signs of hemorrhage
C. Prepare to increase IV fluid after notifying physician
D. Assess for signs of hypovolemia
A. reduce IV fluids
Although electrolytes exist inside & outside the cell, measurements of electrolytes occur A. only inside cell B. Outside cells in blood stream C. outside cells in interstitial fluid D. in transcellular space
B.
Sodium is one of the most important elements in the body. Which statements are true, select all that apply.
A. Na is most abundant anion found in ECF
B. Sodium maintains proper ECF osmolality
C. 99% of Na is found in bones & teeth
D. Na preserves ECF volume and fluid distribution throughout body
E. Na aids in nerve & muscle fiber impulse transmission
F. Na plays crucial role in cell membrane integrity
B, D, E
Na is most abundant cation, not anion so A is incorrect
A client’s serum Ca level is 7mg/dl. Which is most appropriate action next?
A. encourage him to eat peanut butter and bananas
B. Remove all Ca from IV fluids
C. Encourage him to eat yogurt and green, leafy vegetables
D. Prepare to administer phosphorus supplements as the level is too low
C.
A state of acidosis places a patient at risk for which electrolyte imbalance? A. hypokalemia B. Hyperkalemia C. Hypo-mg D. Hyper-Mg
B. Hyperkalemia can be seen with acidosis
The AG indicates
A. difference in arterial H and bicarb concentrations
B. body’s risk of certain alkalotic conditions
C. relationship between arterial CO2 and O2 concentrations
D. Relationship between body’s cations & anions
D.
What indicator is a good indicator of rapid fluid change? A. Weight B. BUN & creat C. Skin turgor D. Temperature
D. Temperature
To compensate for decreased fluid volume you can expect which response by the body? A. bradycardia B. tachycardia C. Vasodilation D. increased urine output
B.
You would expect to administer NSS to a client with? A. hypovolemia B. Hypervolemia C. Water intoxication D. Pulmonary edema
A. hypovolemia
3rd spacing results from fluid shifting to A. arteries B. Veins C. intracellular space D. abdominal cavity
D. ascites or abdominal cavity
When you have diabetes insipudus it involves a large amount of highly dilute urine, this puts the patient at increased risk for: A. dehydration B. hypovolemia C. Hypervolemia D. Water intoxication
A. dehydration
What is the major risk of dehydration A. excecssive circulating blood B. Low Hct C. cellular shrinkage D. pulmonary edema
C. cell shrinkage is major risk of dehydration
Rapid administration of hypotonic solutions to a severely dehydrated patient should be avoided to prevent: A. Pulmonary edema B. Cerebra Edema C. Heart failure D. Hypotension
B. Cerebral edema as fluid moves from ECF to ICF
A health care professional is giving IV fluids to a client with hyponatremia. The nurse auscultates & hears crackles bilaterally over lungs and client complains of dyspnea. What is the most appropriate action next:
A. obtain blood sample to check serum sodium level
B. Stop the infusion
C. Weigh the client and record result on bedside flow sheet
D. Maintain present rate of IV and continue to monitor respiratory status
B. Notify physician to stop infusion
When taken by a client with electrolyte imbalance, levels of which drug must be watched closely: A. Diamox B. Morphine C. Digoxin D. Lasix
C. Digoxin
Name all that apply to hyperkalemia? A. Widened QRS B. Prominent U wave C. Shortened Qt D. Tall, tented t waves E. Prolonged PR F. Lengthened QT interval
A, D, E
Widened QRS
Prolonged PR
Pointed T waves
Which intervention is best for a patient with hypercalcemia?
A. Ambulate the patient asap
B. Encourage compliance with fluid restrictions
C. Maintain on bed rest
D. Encourage consumption of leafy green vegetables
A. Ambulate asap
A tracheotomy tray should be readily available for a hypocalcemia patient because of potential for: A. Bronchodilation B. Vasoconstriction C. Laryngospasm D. Cardiac arrhythmias
C. Laryngospasm can be complication of too little calcium
Signs and symptoms of acute hyperphosphatemia are usually caused by effects of which electrolyte imbalance? A. hypocalcemia B. Hypokalemia C. Hypomagnesemia D. Hypochloremia
A. hypocalcemia
Which S&S indicate hypermagnesemia
A. edema, tachycardia, hypertension
B. Decreased mental function, muscle spasms, seizures
C. emotional lability, laryngeal stridor, hyperactive DTR
D. Lethargy, slow, shallow respirations & bradycardia
D.
What electrolyte should be kept available for hypermagnesemia? A. K B. Ca C. Sodium D. Phosphorus
B. Calcium
Kussmauls respirations are associated with which acid base imbalance?
Metabolic acidosis
A patient has an NG tube set to low continuous suction. Which acid base disturbance are you at risk> A. respiratory acidosis B. respiratory alkalosis C. metabolic acidosis D. metabolic alkalosis
D.
Respiratory acidosis results from which process? A. alveolar hyperventilation B. Hypocapnia C. Alveolar hypoventilation D. lactic acidosis
C.
In acidosis which electrolyte imbalance should you expect A. hyperkalemia B. hypokalemia C. hypercalcemia D. hypocalcemia
A.
A client has kidney failure and has developed hypocalcemia. Which other electrolyte imbalance should you expect? A. Hyper-Mg B. hyponatremia C. hyper-P D. hypo-P
C. hyperphosphatemia
During fluid accumulation phase of a burn injury, which condition can you expect? A. hypovolemia B. hypervolemia C. hypokalemia D. increased urine output
A. hypovolemia, then develops to hypervolemia
What is the most common fluid imbalance associated with heart failure? A. hypovelemia B. hypervolemia C. 3rd space fluid shift D. osmotic diuresis
B. Hypervolemia
Which drug may be administered to treat conditions of acidosis? A. mannitol B. Lasix C. epinephrine D. Sodium Bicarb
D. Sodium Bicarb
Administration of colloid solution places one at risk for: A. hyperkalemia B. hypervolemia C. hypernatremia D. hypovolemia
B.
