unit 3

Question 1

aldosterone

Answer 1

adrenals, prevents water and sodium loss in kidney nephrons, increase blood vol

Question 2

antidiuretic hormone-ADH, vasopressin

Answer 2

pituitary, retaind water in kidney tubules and collecting ducts

Question 3

natriuretic peptides

Answer 3

heart, released due to increase BP and vol, increases urine output

Question 4

angiotensinogin 2

Answer 4

converted by ACE, activated by low BP and sodium, vasoconstriction, triggerd by shock and stress, manage HTN

Question 5

important labs w ACE

Answer 5

BUN, Cr, protein, K, glucose

Question 6

dehydration elderly

Answer 6

less total body water, lower thirst sensation, poor motor skill for obtaining water, meds that increase fluid excretion

Question 7

dehydration symptoms

Answer 7

wt loss 0.5 lb day
increse-HR, RR, urine specific gravity (1.030), Hct, Hgb, glu, BUN, serum osmolarity
decrease- BP, urine (less 500 mL)
-orthostatic hypotension, confusion, fever, flat veins, dry skin

Question 8

dehydration treatment

Answer 8

monitor vitals, falls, fluid replacement 2-4 oz /hr, weigh q 8, treat underlying issues, oral hydration solutions

Question 9

fluid overload symptoms

Answer 9

increase- pulse, BP, veins, weight, RR, GI, liver
decrease- pulse pressure, shallow resp, SOB, muscle
moist crackles, skin pale and cool, altered LOC, headache, visual disturbances

Question 10

hemodilution on labs

Answer 10

decrease HnH and serum protein levels

Question 11

fluid overload interventions

Answer 11

skin breakdown, lasix, (electrolytes)conivaptan or tolvaptan, EKG, Na and K q8, restrict Na and H2O, Iand O, urine specific gravity less than 1.005

Question 12

weight 1 lb

Answer 12

500mL

Question 13

weight gain and fluid overload

Answer 13

more than 2 lbs a day or 3 lbs a week

Question 14

hyponatremia causes

Answer 14

diuretics, heart failure, SIADH, kidney disease, diaphoresis, GI wound drainage

Question 15

hyponatremia assessment

Answer 15

cerebral edema- confusion, seizures, death

muscle weakness, diarrhea/cramping, weak rapid pulse

Question 16

hyponatremia nursing care

Answer 16

low Na and volume-normal saline
if severe low Na- hypertonic saline 3%
low Na and high volume (SIADH)- conivaptan or tolvaptan

Question 17

Na in diet

Answer 17

high in processed and preserved foods, low in fresh fish, poultry, and most fruits and veg

Question 18

hypokalemia causes

Answer 18

excess loss, cell damage, diuretics, digitalis (toxicity), corticosteroids, high aldosterone, cushing syndrome, diarrhea/vomit, wound drainage

Question 19

hypokalemia assessment

Answer 19

respiratory status
decrease- muscle, cardiac, GI (constipation/vomit)
neuro- irritable to lethargic
-ST segment depression, flat or inverted T wave, increase U wave

Question 20

potassium infusion

Answer 20

max of 1/10ml, rate no faster than 5-10 hr (never more than 20), large vein w high flow, no hands, check q 1 hr, stop w pain, burn, infiltration

Question 21

potassium sparing diuretics

Answer 21

spironolactone, triamterene, amiloride

Question 22

hypocalcemia meds

Answer 22

direct Ca replacement, vit D, aluminum hydroxide, calcium chloride, calcium glutonate

Question 23

hyperglycemia meds

Answer 23

normal saline, lasix, plicamcin, penicillamine, phosphates, corticosteroids, aspirin

Question 24

hypomagnesium causes

Answer 24

malnutrition, starvation, diarrhea, celiac, crohns, ethanol

Question 25

heart failure

Answer 25

fluid overload, edema, abdominal distension, dyspnea, tachypnea, increase BNP, diuretics, digoxin, ACE inhibitors

Question 26

albumin infusion

Answer 26

fluid overload

Question 27

respiratory acidosis

Answer 27

CO2 retention, not breathing, oxygenate

Question 28

respiratory alkalosis

Answer 28

hyperventilating, decrease respirations

Question 29

metabolic alkalosis

Answer 29

retainig HCO3 arrythmias

Question 30

meabolic acidosis

Answer 30

excreting HCO3, renal failure

Question 31

D5W

Answer 31

isotonic, hypernatremia

Question 32

1/2 normal saline

Answer 32

hypotonic, does not replace electrolytes

Question 33

normal saline

Answer 33

isotonic, replace ECF loss

Question 34

3% normal saline

Answer 34

hypertonic, hyponatremia