Question | Answer |
bacterial pneumonia causes | alveoli to fill with exudate that impairs gas exchange, causing the patient to retain carbon dioxide, which leads to increased PaCO2 and respiratory acidosis. |
Burns place patients at high risk for ECV deficit from numerous mechanisms, including | plasma-to-interstitial fluid shift and increased evaporative and exudate output |
Hemorrhage from any type of trauma causes | ECV deficit from blood loss |
crush injuries cause | hyperkalemia |
Head injury typically alters | ADH secretion. |
Patients who have chronic heart failure have diminished cardiac output, which reduces kidney perfusion and activates the | RAAS. |
Oliguria occurs when the kidneys have | a reduced capacity to make urine. |
Blood pressure: Hypotension or orthostatic hypotension is a | Extracellular fluid volume deficit. |
Light-headedness on sitting upright or standing causes | ECV deficit |
Rapid, thready indicates | ECV deficit |
Bounding indicates | answer: ECV excess |
Neck veins Flat or collapsing with inhalation when supine | answer: ECV deficit |
neck veins Full or distended when upright or semi-upright | answer: ECV excess |
Capillary refill: Sluggish | answer: ECV deficit |
Lung auscultation, dependent portions: Crackles or rhonchi with progressive dyspnea indicate | answer: ECV excess |
Urine output: Small volume of dark yellow urine, indicate | answer: ECV deficit |
Presence of edema: Present in dependent areas (ankles or sacrum) and possibly fingers or around eyes, indicate | answer: ECV excess |
Mucous membranes: Dry between cheek and gum, decreased or absent tearing indicates | answer: ECV deficit |
Skin turgor: Pinched skin fails to return to normal position within 3 seconds indicates | answer: ECV deficit |
Presence of thirst: Thirst present indicates | answer: Hypernatremia, severe ECV deficit |
Restlessness and mild confusion indicate | answer: Severe ECV deficit |
Decreased level of consciousness (lethargy, confusion, coma) indicates several imbalances such as | answer: Hyponatremia, hypernatremia, hypercalcemia, acid-base imbalances |
Pulse rhythm and ECG: Irregular pulse and ECG changes indicate | answer: K, Ca, Mg, and/or acid-base imbalances |
respirations Increased rate and depth indicate | answer: Metabolic acidosis (as a compensatory mechanism); respiratory alkalosis (as the cause) |
respirations Decreased rate and depth indicate | answer: Metabolic alkalosis (as a compensatory mechanism); respiratory acidosis (as a cause) |
Muscle weakness indicates | answer: Hypokalemia, hyperkalemia |
assessing Muscle Reflexes and sensations for Decreased deep tendon reflexes indicates | answer: Hypercalcemia, hypermagnesemia |
assessing Hyperactive reflexes, muscle twitching and cramps, tetany indicate | answer: Hypocalcemia, hypomagnesemia |
Numbness, tingling in fingertips, around mouth indicates | Hypocalcemia, hypomagnesemia, respiratory alkalosis. |
Muscle cramps, tetany indicates | answer: Hypocalcemia, hypomagnesemia, respiratory alkalosis |
Tremors indicates | answer: hypomagnesemia |
Inspection and auscultation of GI for Abdominal distention indicates | answer: Hypokalemia, third-spacing of fluid |
Inspection and auscultation of GI for Decreased bowel sounds indicates | answer: Hypokalemia |
Inspection and auscultation of GI for Motility: Constipation indicates | answer: Hypokalemia, hypercalcemia |
0.225% sodium chloride (quarter normal saline; 1/4 NS; 0.225% NaCl) is
Hypotonic that | answer Expands ECV (vascular and interstitial) and rehydrates cells |
0.45% sodium chloride (half normal saline; 1/2 NS; 0.45% NaCl) is | answer: Hypotonic that Expands ECV (vascular and interstitial) and rehydrates cells |
0.9% sodium chloride (normal saline; NS; 0.9% NaCl) is | answer: Isotonic that Expands ECV (vascular and interstitial); but does not enter cells |
3% or 5% sodium chloride (hypertonic saline; 3% or 5% NaCl) is | answer: Hypertonic that Draws water from cells into ECF by osmosis |
Phlebitis and infiltration are the most frequent complications of peripheral IV therapy. To prevent these and other complications such as catheter dislodgement, nurses traditionally | stabilized the catheter by taping the hub to the skin |
How do diuretics effect fluid balance & electrolytes? | can cause metabolic alkalosis, hyper & hypo kalemia |
How do steroids cause a fluid or electrolyte imbalance? | can cause metabolic alkalosis |
How does K supplements cause fluid and electrolyte imbalance? | they GI distrbance, intestinal & gastric ulcer 7 diarrhea. |
How does respiratory depressants (opioid analgesics) cause fluid and electro imbalances? | decrease rate & depth of RR causing respiratory acidosis. |
How can antibiotics cause fluid and electro imbalance? | Nephrotoxicity from meds like ( vancomycin, methicillin, aminoglycosides) or Hyper K or Na from meds like( azlocillin, carbenicillin, piperacillin, ticarcillin, unasyn) |
how does calcium carbonate (tums) cause fluid and electro imbalances? | mild metabolic alkalosis with nausea and vomiting |