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NURS 3310 Exam 1- Fluid & Electrolyte
Questions With Correct Answers
EFC |Defecit |- |VERIFIED |ANSWER✔✔-Etiology: Decreased |fluid |intake Prolonged |fever Vomiting Excessive |use |of |diuretics Diabetes |Insipidus Hemorrhage |(acute) Treatment: Administer |hypotonic |or |isotonic |fluids Vasopressin, |transfusion |if |blood |loss S&S: Increased |thirst Dry |skin |and |mucous |membranes Increased |temperature Flushed |skin Rapid, |thready |pulse Decreased |BP Increased |HCT, |Na, |BUN, |and |specific |gravity EFC |Excess |- |VERIFIED |ANSWER✔✔-Etiology: Heart |failure Liver |failure Malnutrition |(decreased |plasma |protein)
Renal |disease Excessive |parenteral |fluids Treatment: Administer |diuretics Fluid |restriction S&S: Weight |gain Crackles Edema Ascites Confusion Weakness Increased |BP Bounding |pulse Distended |neck |veins NS |0.9% |NaCl |- |VERIFIED |ANSWER✔✔-Used |to |expand |volume, |dilute |medications |and |keep |vein | open -Isotonic Lactated |Ringers |- |VERIFIED |ANSWER✔✔-Used |for |fluid |resuscitation -Isotonic D5W |- |VERIFIED |ANSWER✔✔--Isotonic |but |becomes |hypotonic |after |dextrose |is |metabolized |b/c | only |water |remains -A |source |of |calories -A |source |of |free |water; |moves |to |ICF
D: |Decreased |Cardiac |Contractility | E: |EKG |Changes R: |Reflexes Hyponatremia |S&S |- |VERIFIED |ANSWER✔✔-Lethargy H/A Confusion Apprehension Seizures Coma Assessment |for |F/E |Imbalances |- |VERIFIED |ANSWER✔✔-History |to |identify |etiology |of |fluid |and | electrolyte |imbalances Vital |Signs Skin |turgor, |hydration, |and |temperature Breath |sounds Daily |weights I&O Changes |in |behavior, |energy |level, |and |level |of |consciousness Lab |tests -(urine |specific |gravity, |serum |pH |and |ABG, |serum |electrolytes, |hematocrit, |BUN, |Creatinine |clearance Hypernatremia |S&S |- |VERIFIED |ANSWER✔✔-Hypotension Thirst Fever Tach Restlessness Low |jugular |pressure
Normal |GFR |- |VERIFIED |ANSWER✔✔-125mL/min Dehydration |- |VERIFIED |ANSWER✔✔-•Dehydration |is |a |common |body |fluid |disturbance |in |the |nursing |care |of |infants |and |children; |it |occurs |whenever |the |total |output |of |fluid |exceeds |the |total |intake, | regardless |of |the |underlying |cause. •Can |result |from |impaired |oral |intake, |more |often |it |is |a |result |of |abnormal |losses, |such |as |those |that |occur |in |vomiting |or |diarrhea 3 |types |of |Dehydration |- |VERIFIED |ANSWER✔✔-Hypotonic: |electrolyte |loss |excess |water |loss Isotonic: |water |and |electrolytes |are |lost |equally Hypertonic: |water |loss |exceeds |electrolyte |loss S&S |Dehydration |- |VERIFIED |ANSWER✔✔-Gray, |cold |skin Poor |skin |turgor | Dry |skin Dry |mucous |membranes Tearing |and |salivation |absent Eyeballs |sunken Fontanels |sunkin Body |temp |subnormal |or |elevated RR |rapid PR |rapid BP |low Which |patient |is |at |more |risk |for |an |electrolyte |imbalance? A. |An | 8 |month |old |with |a |fever |of |102.3 |'F |and |diarrhea B. |A | 55 |year |old |diabetic |with |nausea |and |vomiting C. |A | 5 |year |old |with |RSV D. |A |healthy | 87 |year |old |with |intermittent |episodes |of |gout |- |VERIFIED |ANSWER✔✔-The |answer |is |A.
The |client |who |is |dehydrated |will |have |a |urine |specific |gravity |greater |than |1.030. |Normal |values |for | urine |specific |gravity |are |1.010 |to |1.030. |A |temperature |of |98.8° |F |is |only |0.2 |point |above |the |normal |temperature |and |would |not |be |as |specific |an |indicator |of |hydration |status |as |would |the |urine |specific |gravity. |Pale |yellow |urine |is |a |normal |finding. |A |blood |pressure |of |120/80 |mm |Hg |is |within |normal | range. The |nurse |is |planning |care |for |a |client |with |hypokalemia. |Which |interventions |should |be |included |in | the |plan |of |care? |Select |all |that |apply. A. |Ensure |adequate |fluid |intake. B. |Implement |safety |measures |to |prevent |falls C. |Encourage |low |fiber |foods |to |prevent |diarrhea. D. |Instruct |the |client |about |foods |that |containpotassium. E. |Encourage |the |client |to |obtain |assistance |toambulate. |- |VERIFIED |ANSWER✔✔-•Answer: |A,B, |D, | and |ERationale:Clients |with |hypokalemia |will |need |instruction |on |potassium-rich |foods, |and |all |clients | should |maintain |adequate |hydration, |Safety |is |also |a |priority |because |hypokalemia |may |cause |muscle | weakness, |resulting |in |falls |and |injury. |Hypokalemia |is |associated |with |constipation, |not |diarrhea, | owing |to |decreased |peristalsis. Gestational |Hypertension |- |VERIFIED |ANSWER✔✔-•Blood |pressure |higher |than |140/90 |mm |Hg |x2 | (normal |blood |pressure |prior |to | 20 |weeks) •No |proteinuria •Usually |resolved |after |birth Risk |factors: •Multifetal |gestation •Nulliparity •Age |(<20 |y/o, |>40 |y/o) •Obesity/Diabetes/Family |History |of |Hypertension •Previous |history |of |gestational |HTN |or |Preeclampsia •African-American |Women Gestational |HTN |vs |Preeclampsia |- |VERIFIED |ANSWER✔✔-no |proteinuria |in |g. |HTN
Preeclampsia |- |VERIFIED |ANSWER✔✔-he•Caused |by |decreased |placental |perfusion |and |endothelial | cell |dysfunction •Spiral |arteries |of |the |uterus |do |not |remodel |to |thinner, |larger |vessels, |making |them |unable |to | handle |the |increased |blood |volume |of |pregnancy •Placental |ischemia |leads |to |vasospasms. |This |causes |decreased |tissue |perfusion, |increases |BP ** |the |main |pathogenic |factor |is |not |an |increase |in |BP |but |poor |perfusion |as |a |result |of |vasospasm | and |reduced |plasma |volume** | •Expulsion |of |placenta |begins |resolution |of |disease Risk |factors: •Multifetal |gestation •Nulliparity •Hx |of |preeclampsia •Chronic |HTN
- |Preexisting |Diabetes •Preexisting |thrombophilia •Underlying |kidney |disease Early |signs |of |preeclampsia |- |VERIFIED |ANSWER✔✔-•High |blood |pressure |(>140/90 |mm |Hg) •Proteinuria |(>300mg |in |24-hour |specimen |OR |>1+ |on |dipstick) Late |signs |of |preeclampsia |- |VERIFIED |ANSWER✔✔-•Severely |high |BP |(>160/110 |mm |Hg) •Massive |Proteinuria |(>5 |g |in |a |24-hour |specimen) •Edema/Weight |gain/Pulmonary |edema •Severe |headaches •CNS |irritability |(i.e.: |Hyperreflexia, |headaches) •Visual |changes |(i.e.: |blurred |or |double |vision) |or |cerebral |disturbances •N/V •Severe |persistent |epigastric |or |RUQ |abdominal |pain
the |primary |health |care |provider |if |noted |on |assessment. |Options |a, |b, |and |c |are |normal |occurrences | in |the |last |trimester |of |pregnancy. Why |is |it |important |for |the |nurse |to |encourage |a |client |with |preeclampsia |to |lie |in |the |left-lateral | recumbent |position? a.Uterine |and |kidney |perfusion |are |maximized, |and |compression |of |the |major |vessels |is |relieved. b.Intra-abdominal |pressure |on |the |iliac |veins |is |maximized, |and |there |is |increased |blood |flow |to |the | pelvic |area. c.Aortic |compression |is |maximized, |thereby |decreasing |uterine |arterial |pressure |and |increasing | uterine |blood |flow. |- |VERIFIED |ANSWER✔✔-Answer: |A In |the |left-lateral |position |the |gravid |uterus |no |longer |compresses |major |vessels, |cardiac |output |is | maintained; |glomerular |filtration |and |uterine |perfusion |rates |increase. |Maximizing |intra-abdominal | pressure |on |the |iliac |veins |will |decrease, |not |increase, |blood |flow |to |the |pelvic |area. |Maximizing | aortic |compression |will |decrease, |not |increase, |uterine |blood |flow. A |primigravida |at | 32 |weeks' |gestation |is |diagnosed |with |severe |preeclampsia. |Which |findings |are | consistent |with |the |diagnosis? |(Select |all |that |apply) a.Blood |pressure |of |170/110 |mm |Hg b.Blood |glucose | 200 |mg/dL c.4+ |proteinuria d."Board-like" |abdomen e.Edema |on |the |face |and |extremities f.1+ |proteinuria |- |VERIFIED |ANSWER✔✔-Answer: |A, |C, |E With |severe |preeclampsia, |arteriolar |spasms |result |in |hypertension |and |decreased |arterial |perfusion | of |the |kidneys. |This |in |turn |causes |an |alteration |in |the |glomeruli, |resulting |in |proteinuria(>1+), | retention |of |sodium |and |water, |and |edema. |Gestational |diabetes |is |characterized |by |elevated |blood | glucose |levels, |not |preeclampsia. An |RN |concludes |that |Jennie |is |at |risk |of |developing |a |hypertensive |disorder |because |of |her |age |(15). | Which |other |factor(s) |add |to |Jennie's |risk |of |developing |gestational |hypertension? a.History |of |C-Section b.Nulliparity c.Thyroid |Disease
d.Family |History |of |Hypertension e.History |of |STDs f.African-American |Women |- |VERIFIED |ANSWER✔✔-Answer: |B,D,F Risk |factors |for |gestational |hypertension |include |nulliparity, |family |history |of |hypertension, |and | African |American |race. |Previous |C-section |and |history |of |STDs |are |not |a |risk |factor. Which |lab |value |is |likely |to |be |decreased |in |a |patient |with |CKD? |- |VERIFIED |ANSWER✔✔-Calcium; Cr, |BUN, |K, |and |phosphorous |are |all |increased |in |CKD Which |best |describes |the |pathology |resulting |in |HTN |for |a |patient |with |CKD? |- |VERIFIED |ANSWER✔✔- Activation |of |the |RAA |pathway |and |excretion |of |aldosterone |will |cause |HTN. Protein |intake |and |CKD |- |VERIFIED |ANSWER✔✔-The |pt |needs |a |low |protein |intake |due |to | accumulation |of |waste |products |associated |with |protein |metabolism.
