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NUR 235

Test 1

QuestionAnswer
Fluid assessment Most reliable are daily weights. Thirst is NOT a good indicator in the elderly. VS changes with fluid imbalances. A good place to evaluate for for skin turgor is over the sternum.
Examples of osmotic pressure impacting the body poor nutritional status results in albumin of 2.5 untreated diabetic w/serum glucose of 732 giving Mannitol to reduce cerebral edema a person with liver failure w/an albumin of 2.2 administering 3% saline (hypertonic)
Examples of hydrostatic pressure impacting the body a person who has been bleeding, therefore has a decreased blood volume. a person with CHF, with a backup of fluid into the venous system and has increased hydrostatic pressure. a person with liver failure, who has an interference with the flow and blood through the liver and resulting increased venous hydrostatic pressure. a person given iv fluids at a rapid rate.
Why is sodium intake limited for a person with CHF? Increased sodium can increase osmotic pressure leading to the more fluid in the vascular system. The heart is failing and can not handle increased amount s of fluid.
Majority of fluid is found where in the body? Intra-cellular space
Osmosis movement of Water from area of low concentration to area of high concentration
Osmolarity an indicator of whether a person is adequately hydrated, over-hydrated, or dehydrated. Normal is :275-295
Serum osmolarity to estimate a patient's osmolarity at 2X's sodium if glucose and BUN is normal.
Diffusion the random movement of solutes (molecules and atoms) that result in an even distribution of those solutes.
Isotonic fluids that have the same osmolarity as the fluid inside the cell. Has the same salt concentration as inside the cells Example-Normal saline 0.9NS
Hypotonic Fluid contain more water than the intracellular fluids. Fluid surrounds the cell and causes than water to move inside the cell. Example-1/2NS (0.3NS)
Hypertonic Fluids that contain less water (more concentrated)than the intracellular fluids. Fluid is very salty. This fluid draws water from the cells
Hypovalemia occurs when water and electrolytes are loss or unavailable to circulation. May cause an abrupt decrease in fluid intake, acute loss of secretions or excretions.
Signs of Hypovolemia decreased temp decreased BP increased HR weak pulse increased resp. weakness n/v shock decreased urinary output
When is 0.9 NS the preferred fluid?> Blood product being administered Hyponatremia (low sodium) Vascular volume is low Patient is diabetic (elevated blood sugars)
True or False: A person with a NORMAL sodium balance drinks A LOT of water, they will develop hypernatremia. FALSE
True or False: A person with a NORMAL sodium balance, eats very salty food PLUS drinks a lot of fluids, it is likely that their sodium will remain in a normal range TRUE
Tue of False: A person with Hyponatremia, increasing their water intake as a way to correct the problem. TRUE (or limit sodium)
A person has hyponatremia, increasing their water intake as a way to correct their problem. FALSE (Decrease water or increase sodium)
Abnormalities in sodium balance often result in symptoms in which body system? Neuro-Confusion, irritability, coma, seizures
Which IV fluid can lead to vascular overload? Hypertonic-3% or 5% Osmotic pressure is increased, causing fluid to leave the calls and enter the extracellular space.
When assessing a patient with FVE (low osmolarity), the nurse can expect to find: Hypernatremia confusion headache
When assessing a patient for hypernatremia (low sodium), the nurse can expect to find: Thirst Dry mucous membranes serum sodium level >145 reflexes are hyperactive
What IV solution would be used for a patient with hypernatremia? 0.33% saline
When ECF sodium is decreased, the adrenal glands send aldosterone to the kidneys to: increase sodium reabsorption.
Intracellular fluid(ICF) 3/4 of the body's fluid
Extracellular fluid(ECF) 1/4 of the is plasma of the intravascular fluid; 3/4 of ECF is interstitial fluid.
Interstitial fluid is found where ? Lymph system and in between cells
Dehydration Water moves out of the cells to dilute the Extracellular fluid (ECF) Happens when water loss is greater than electrolyte loss or when more electrolytes are taken in.
Causes of dehydration concentrated tube feedings, hyperglycemia, diarrhea, or sweating
Signs of dehydration flushed skin thirst dry mucous membranes increased temp weight loss decreased urinary output
Hypervolemia Occurs when there is an excess of water and electrolytes in the extracellular fluid.
Signs of Hypervolemia acute weight loss decreased Hct and Hgb skin -warm and moist bounding pulses Pitting edema Dyspnea
treatment of hypervolemia restrict sodium limit fluids give diuretics
Water intoxication the body accumulates water w/o excess electrolytes. the extracellular fluid becomes hypotonic and water moves into the the cells causing them to swell.
Signs of water intoxication cerebral edema confusion lethargy JVD sudden weight gain
Treatment for water intoxication Isotonic solutions strict I&O Daily weights
Uses for D5W Mixing with medications for IVPB or continuous drip cellular dehydration a person who should limited sodium intake to keep an IV open treatment of hypernatremia
Appropriate IV type for an elevated sodium >145mEq Hypotonic 0.45NS D5W D5 and 0.33NS
Which finds would a nurse NOT find when assessing a patient with FVE? Tachycardia and hypotension
Most common colloids are: Albumin Hetastarch Dextran
Colloids Large molecular weight substances composed of proteins, carbohydrates or gelatin
what are the functions of electrolytes? regulation of water distribution regulation of acid-base balance maintenance of a balanced degree of neuromuscular excitability
Signs of Hypokalemia (low potassium) fatigue
Created by: shondell1971
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