Unit 3 - Fluids & Electrolytes Part 2

Question 1

T/F: As an adult ages, the thirst mechanism declines

Answer 1

T

*In a client with an altered level of consciousness, this can increase the risk of dehydration and high serum osmolality
A poor intake of water (i.e only 2 glasses) could indicate a loss of the thirst response, which occurs as a normal age-related change.

Question 2

_____ is a poor indicator of fluid balance in an older adult client.

Answer 2

Skin turgor (due to normal skin aging elasticity changes)

Question 3

A body mass index within normal limits (Would/Would Not) contribute to dehydration. A body mass index associated with overweight or obesity could be associated with dehydration, as fat cells contain little or no water.

Answer 3

would not

Question 4

_____ _____ _____ may occur if clients, especially the very young or old, are receiving IV fluid rapidly

Answer 4

Fluid volume excess

Question 5

Older adult clients are (less/more) able to concentrate their urine, making them susceptible to dehydration. In addition, there is a deficit of the thirst response. However, fever, nausea, and vomiting resulting from these changes are not considered normal but can contribute to the problem of dehydration

Answer 5

less

Question 6

For children with mild to moderate dehydration, _____ _____ _____ is the first intervention, given in frequent, small amounts

Answer 6

oral rehydration therapy

Question 7

Individuals with a higher percentage of body fat have _____ body fluid

Answer 7

less

Question 8

Women had proportionally _____ body fat, _____ body fluid than men

Answer 8

more, less

Question 9

Water accounts for _____ of an adult man’s body weight

Answer 9

60%

Question 10

Water accounts for _____ of an adult woman’s body weight

Answer 10

52%

Question 11

Water accounts for only _____-_____ of an obese individual’s body weight

Answer 11

30%-40%

Question 12

A body mass index associated with overweight or obesity could be associated with _____, as fat cells contain little or no water.

Answer 12

dehydration

Question 13

The elderly usually have _____ body mass muscle putting them even more at risk

Answer 13

less

Question 14

Suggested sodium intake is = _____-_____

Answer 14

1500-2300 mg/day

Question 15

_____ _____ have a greater sensitivity to sodium

Answer 15

African Americans

Question 16

_____ _____ occurs when fluid loss is characterized by a proportionately greater loss of sodium than water, causing serum sodium to fall below normal levels.

Answer 16

Hypotonic dehydration

Question 17

_____ ______ occurs when fluid loss is not balanced by intake, and the losses of water and sodium are in proportion.

Answer 17

Isotonic dehydration

Question 18

T/F: the body continually attempts to compensate for a fluid and electrolyte imbalance by shifting fluids and electrolytes from one component to another

Answer 18

T

Question 19

Is it rare for only one type of imbalance to occur?

Answer 19

Yes

Question 20

stress can _____ cellular metabolism, blood glucose concentration, and catecholamine levels

Answer 20

increase

Question 21

stress can _____ production of ADH

Answer 21

increase

Question 22

_____ _____ _____ and _____ levels are commonly increased following the stress response before, during, and immediately after surgery. This increase leads to _____ _____ _____ _____.

Answer 22

Antidiuretic hormone (ADH)
aldosterone
sodium and water retention

Question 23

_____ _____ comes first for fluid volume deficit

Answer 23

GI Assessment

Question 24

The most common cause of fluid volume deficit is excessive loss of _____ _____, which can result from vomiting, diarrhea, suctioning, intestinal fistulas, or intestinal drainage.

Answer 24

gastrointestinal fluids

Question 25

Low potassium: Hypokalemia What to do?

Answer 25

encourage to consume potassium-rich foods. Which would include: bananas.

Question 26

Nursing Assessment for Infant

Answer 26

sunken Fontanel for fluid deficit

Question 27

Nursing Assessment: | The nurse is concerned that a client with a fluid imbalance is at risk for an _____ _____ _____.

Answer 27

alteration in perfusion

Question 28

Nursing Assessment: | Data indicates that the client is experiencing an alteration in perfusion may include:

Answer 28

- Peripheral pulses present and are they full - Capillary refill of nail beds 3 seconds - Are they Oriented to person, place, and time - Low BP - possibly an elevated pulse as a compensatory measure

Question 29

Nursing Assessment: Fluid Volume Deficit: What happens?

Answer 29

The internal vasoconstrictive compensatory reactions within the body are responsible for the symptoms exhibited (tachycardia; pale, cool skin; and a decreased urine output.) The body naturally attempts to conserve fluid internally specifically for the brain and heart. *Avoid diuretics, they would cause further fluid loss, and is contraindicated.

Question 30

T/F: Edema increases the client's risk for impaired skin integrity, especially feet, coccyx areas.

Answer 30

T

Question 31

First place you'll notice a change when body is low on fluid

Answer 31

in the vessels *hypovolemia)

Question 32

``` Vital Signs with someone with Hypovolemia: Pulse: Temperature: BP: Respirations: Central Veinous Pressure: Cap refill: Cognitive: GI: Renal: Skin: ```

Answer 32

``` Pulse: racing Temperature: elevated BP: low = weaker pulse Respirations: faster Central Veinous Pressure: decreased Cap refill: sluggish Cognitive: dizziness/weakness GI: thirsty, acute wt. loss Renal: decreased urine volume Skin: cool/clammy/pale ``` ....initial orthostatic hypotension...lead to a hypotensive state

Question 33

``` Vital Signs with someone with Hypervolemia: Heart Rate: BP: Central Veinous Pressures: Cognitive: GI: Respiratory: ```

Answer 33

Opposite of Hypovolemia Heart Rate: fast, because there's so much fluid = easy to feel pulse BP: increase Central Veinous Pressures: increase Cognitive: Confusion, Weakness, edema GI: weight gain Respiratory: pulmonary edema (as it leads to Heart Failure)

Question 34

An elevated blood pressure could indicate _____ _____ _____ or _____ ______.

Answer 34

fluid volume overload | sodium sensitivity

Question 35

The _____ measures the volume of whole blood that is composed of RBCs

Answer 35

hematocrit

Question 36

normal hematocrit value for a female is _____ to _____

Answer 36

37% to 47%

Question 37

The hematocrit level will _____ in overhydration

Answer 37

decrease

Question 38

_____ _____ is a measure of the solute concentration of the blood and are used to evaluate fluid balance

Answer 38

Serum osmolality

Question 39

Normal of serum osmolality values are __________

Answer 39

280-300 mOsm/kg

Question 40

An increase in serum osmolality indicates a _____ _____ _____; a decrease reflects _____ _____ _____

Answer 40

fluid volume deficit | fluid volume excess.

Question 41

Serum potassium is _____ an electrolyte used to determine an alteration in fluid balance. _____ _____ values would be more appropriate

Answer 41

not | Serum sodium

Question 42

_____: can occur from immobility. Ambulation of the client helps to prevent leaching of calcium from the bones into the serum.

Answer 42

Hypercalcemia

Question 43

_____: The client will need additional dietary phosphorus. Providing phosphorus-rich foods such as milk and yogurt is a good way to provide that additional phosphorus..

Answer 43

Hypophosphatemia

Question 44

Client Education for _____ _____ _____: the electrolyte will need to be restricted, in the form of a low-sodium diet, and diuretics provided. Diuretics will remove excess fluid being held in the body because of the extra sodium.

Answer 44

elevated sodium level

Question 45

_____ _____: Monitoring of heart rate and rhythm would be more appropriate with a potassium imbalance.

Answer 45

Potassium imbalances

Question 46

_____ _____ _____: Elevating the head of the bed would be appropriate if the client were demonstrating signs of fluid volume overload..

Answer 46

Fluid Volume Overload

Question 47

Client Education: Low-sodium salt substitutes are not really _____. They may contain half as much sodium as regular salt. The client should be instructed to use salt substitutes sparingly because larger amounts often taste bitter instead of salty. Clients should be instructed to read food labels for the amount of sodium in the food item. Baking soda and baking powder contain sodium and should be restricted on a sodium-restricted diet. In place of salt or salt substitutes, the client should be instructed to use herbs, spices, lemon juice, vinegar, and wine as flavoring when cooking.

Answer 47

sodium-free

Question 48

For fluid and electrolyte imbalance. Initiate _____ _____

Answer 48

intravenous therapy

Question 49

_____: fluid administered subcutaneously, may be employed as a fluid delivery method, especially among older adults.

Answer 49

Hypodermoclysis

Question 50

_____ _____ _____: symptoms may include crackles, shortness of breath, and jugular vein distention.

Answer 50

Fluid Volume Excess

Question 51

_____ _____ _____ : you may be administering diuretics

Answer 51

Fluid Volume Excess

Question 52

The client on hemodialysis is expected to have a reduction of _____ _____

Answer 52

extracellular fluid

Question 53

_____ is vital in regulating muscle contraction and relaxation.

Answer 53

Calcium

Question 54

_____ controls and regulates water balance in the body.

Answer 54

Sodium

Question 55

_____ is used in the body to synthesize ingested protein.

Answer 55

Magnesium

Question 56

_____: water soluble (i.e. glucose, NACL)

Answer 56

Crystalloid