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A concise overview of fluid and electrolyte imbalances, including their etiologies, signs and symptoms, and treatments. It covers various conditions such as efc deficit and excess, hyponatremia, hypernatremia, hypokalemia, hyperkalemia, hypocalcemia, and hypercalcemia. The document also includes questions and answers related to electrolyte imbalances, making it a useful resource for nursing students preparing for exams. It also touches on dehydration and gestational hypertension, offering a broad review of key concepts in fluid and electrolyte management. Designed to help students understand the complexities of fluid and electrolyte balance and how to manage related conditions effectively. It includes practical information and test questions.
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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
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.