Unit I

Question 1

Salt follows…

Answer 1

water!

Question 2

low sodium =

Answer 2

low potassium and magnesium

Question 3

Great emphasis is put on sodium and potassium because…

Answer 3

imbalances are common and can lead to major cardiac or neurological damage

Question 4

Causes of F & E imbalances

Answer 4

output greater than intake and absorption
output less than intake and absorption
Altered distribution of F & E

Question 5

Kidney impairment can cause…

Answer 5

malfunction in absorption or excretion of water and electrolytes

Question 6

what can cause extra fluid to be lost due to an increased metabolic rate?

Answer 6

fever, stress. thyroid issues, burns, stress, trauma, increased respirations, severe diarrhea, wound drainage

Question 7

extracellular fluid

Answer 7

fluid outside of the cell

Question 8

interstitial fluid

Answer 8

fluid between the cells

Question 9

vascular fluid

Answer 9

the fluid inside the blood vessels

Question 10

normal EFC is

Answer 10

isotonic and contains NA+ to hold water in the extracellular compartment

Question 11

isotonic solution

Answer 11

ECF concentration and ICF concentration are equal

Question 12

hypertonic solution

Answer 12

ECF concentration is greater than ICF concentration

Question 13

hypotonic solution

Answer 13

ECF concentration is less than ICF concentration

Question 14

If ECF is hypertonic it can cause…

Answer 14

water to move out of cells therefore, they will dehydrate and shrink

Question 15

If ECF is hypotonic it can cause…

Answer 15

water to be drawn into the cells causing them to swell and burst

Question 16

When there is not enough sodium-containing fluid in the extracellular compartment it is called

Answer 16

Extracellular fluid volume deficit

Question 17

When there is too much sodium which is drawing in excess fluid it is called

Answer 17

Extracellular fluid volume excess

Question 18

A loss of 2.2 lbs or 1kg within 24 hrs indicates a loss of…

Answer 18

1 liter of fluid

Question 19

A gain of 2.2 lbs or 1 kg within 24 hours indicated a gain of…

Answer 19

1 liter of fluid

Question 20

In older adults, checking skin turgor is _____ a valid indicator of fluid status due to loss of ________.

Answer 20

NOT

elasticity

Question 21

a combination of ECVD and hypernatremia is…

Answer 21

Dehydration

Question 22

The concentrations of NA+ primarily reflects…

Answer 22

osmolality

Question 23

Normal ways of output

Answer 23

urine, feces, skin (sweat), or respirations

Question 24

Abnormal ways of output

Answer 24

vomiting, diarrhea, excessive sweating (diaphoresis)

Question 25

What is ascites? What is it an example of?

Answer 25

ascites is a collection of fluid in the abdominal cavity that occurs during liver failure. It is an example of third-spacing

Question 26

Signs of too little volume or extracellular volume deficit

Answer 26

``` weight loss skin tenting dry mucous membranes flat neck veins when lying flat vascular underload (rapid thready pulse, orthostatic hypotension, or low BP) lightheadedness/syncope low urine output ```

Question 27

signs of too much volume or extracellular volume excess

Answer 27

``` weight gain edema vascular overload (bounding pulse, distended neck veins when upright) pulmonary edema dyspnea ```

Question 28

``` weight gain edema vascular overload (bounding pulse, distended neck veins when upright) pulmonary edema dyspnea ```

Answer 28

Signs of too much volume or extracellular volume excess

Question 29

``` weight loss skin tenting dry mucous membranes flat neck veins when lying flat vascular underload (rapid thready pulse, orthostatic hypotension, or low BP) lightheadedness/syncope low urine output ```

Answer 29

signs of too little volume of extracellular volume deficit

Question 30

Hyponatremia

Answer 30

``` sodium less than 135 impaired cerebral function decreased LOC nausea seizures decrease in BP ```

Question 31

``` sodium less than 135 impaired cerebral function decreased LOC nausea seizures decrease in BP ```

Answer 31

hyponatremia

Question 32

Hypernatremia

Answer 32

``` sodium greater than 145 impaired cerebral function decreased LOC thirst (not always in older adults) seizures restrict sodium intake for this patient ```

Question 33

The main function of sodium in the body

Answer 33

body water balance

Question 34

``` Signs and Symptoms are: Low HR Low BP Low RR Decreased DTR ```

Answer 34

HYPERmagnesmia | LOW EVERYTHING

Question 35

Risk factors of HYPERmagnesemia

Answer 35

Increased Mg intake;excessive admin of Mg IV, Mg containing antacids or laxatives Renal Insufficiency

Question 36

Factors contributing to respiratory acidosis

Answer 36

COPD, sleep apnea, opioid toxicity, asthma, anesthesia

Question 37

Factors contributing to metabolic acidosis

Answer 37

diarrhea, renal disease, small intestine illness/surgery, laxative abuse

Question 38

Factors contributing to respiratory alkalosis

Answer 38

hyperventilation, panic, anxiety

Question 39

Factors contributing to metabolic alkalosis

Answer 39

vomiting, NG tube suctioning, bulimia, renal disease

Question 40

impaired cerebral function, decreased LOC, nausea, seizures, decreased BP. Can occur from heat/sweating,

Answer 40

Hyponatremia

Question 41

impaired cerebral function, decreased LOC, thirst (not in older adults), seizures. Sodium intake should be restricted for these pt’s.

Answer 41

hyprernatremia

Question 42

dietary sources of sodium

Answer 42

table salt, processed foods, milk, animal products, eggs, carrots, beets, leafy greens, celery

Question 43

muscle weakness/ flaccid, ABD distention, decreased deep tendon reflexes (DTR), orthostatic hypotension, urinary retention, Patients taking potassium wasting diuretics (lasix or furosemide) should be taught to increase their daily potassium intake.

Answer 43

hypokalemia

Question 44

muscle weakness/flaccid, cardiac dysrhythmias, can lead to cardiac arrest. Hyperkalemia can occur when extensive tissue damage occurs from burns or crush injuries. Severe hyperkalemia causes life threatening cardiac dysrhythmias.

Answer 44

hyperkalemia

Question 45

food sources of potassium

Answer 45

unprocessed foods, fruits, vegetables, fish whole grains, legumes, seeds, and milk products. K+ is lost when food is boiled or blanched, unless you drink the water it was sitting in.

Question 46

increased muscle excitability, muscle cramps, hyperactive reflexes, twitching, laryngo-spasms, carpopedal spasm, tetany, seizures, cardiac dysrhythmias. Can result from any disorder that shifts/moves more calcium into the bone. Removal or injury of the parathyroid gland during a thyroidectomy can cause hypocalcemia.

Answer 46

hypocalcemia

Question 47

decreased muscular activity/ muscle weakness, anorexia, nausea, constipation, diminished reflexes, decreased LOC, cardiac dysrhythmias, formation of kidney stones.

Answer 47

hypercalcemia

Question 48

food sources of calcium

Answer 48

milk/milk products, green vegetables, nuts, soybeans, and grains

Question 49

increased muscular excitability/tetany, insomnia, hyperactive reflexes, muscle cramps, twitching, nystagmus (twitching of the eye which can often result in reduced vision and depth perception), seizures, and cardiac dysrhythmias.

Answer 49

hypomagnesemia

Question 50

Mg deficiency

Answer 50

rare, persistent vomiting and diarrhea, loss of GI fluids, renal disorders, alcoholism, is life threatening.

Question 51

For patients who are A&O and who are not receiving an irritant or vesicant their IV should be assessed every ...

Answer 51

4 hrs

Question 52

patients who - are critically ill - adult pt's who have a cognitive or sensory impairment - unable to notify nurse of any adverse reactions - recieving sedatives - have an IV in a joint or in the jugular vein their IV should be assessed every ....

Answer 52

2 hrs

Question 53

a pedi or neonate pt's IV should be assessed every...

Answer 53

hour

Question 54

symptoms of dehydration in the elderly

Answer 54

SKin tenting on the forehead and the sternum dry mucous membranes weight loss of 1-2 lbs in a day

Question 55

What is BPH

Answer 55

benign prostate hyperplasia; enlargement of the prostate. The main issue is obstruction of urine flow. usually starts around age 30 and worsens over time.

Question 56

S&S of BPH

Answer 56

``` difficulty voiding nocturia frequent UTI's weak urine stream urine flow is completely blocked ```

Question 57

When the urine backs up into the ureters causing the ureters to dilate. Which is painful and is a result of a complete urine blockage

Answer 57

Hydroureter

Question 58

When urine backs up into the kidneys. It can be painful and is a result of a complete urine blockage

Answer 58

Hydronephrosis

Question 59

the build-up of nitrogen in the blood. result of a complete urine blockage

Answer 59

azotemia

Question 60

Dx tests for BPH

Answer 60

digital rectal exam pressure flow studies ultra sound UAC

Question 61

Tx for BPH

Answer 61

``` Alpha-adrenergic blockers 5-Alpha reductase inhibitors (ARI's) acupuncture saw palmetto Echinacea ```

Question 62

decreased ,muscle activity, diminished activity, diminished reflexes, muscle weakness, flushing, diaphoresis, hypotension, bradycardia, decreased LOC, respiratory depression, cardiac dysrhythmias.

Answer 62

hypermagnesemia

Question 63

what causes hypermagnesemia

Answer 63

renal failure or overuse of magnesium containing antacids.

Question 64

food sources of mg

Answer 64

nuts, soybeans, legumes, whole grain, oats, and cocoa