Adult Health 1 South College Exam 1 Questions With Correct Solutions, Already Passed!!

Adult Health 1 South College Exam 1
Electrolytes - CORRECT ANSWER-Active chemicals that carry positive (cations) and
negative (anions) electrical charges
-Major cations: Na, K, CA, Mg, hydrogen ions
-Major anions: Chloride, Bicarb, Phosphate, Sulfate, proteinate ions
-Expressed in terms of milliequivalents (mEq)/liter

Electrolyte concentrations differ in fluid compartments

Normal values - CORRECT ANSWER-Na: 135-145
K: 3.5-5
Chloride: 98-106
Bicarb: 24-31
Ca: 8.8-10.5
Phosphorus: 2.5-4.5
Mag: 1.8-3.6

Regulation of Fluid Hydrostatic vs Osmotic (Oncotic) - CORRECT ANSWER-Movement
of fluid thru capillary walls depend on:
Hydrostatic pressure: pressure of fluid exerted on walls of blood vessels (pushes fluid)
Osmotic (oncotic) pressure: exerted by protein in plasma (pulls fluid)

Direction of fluid movement depends on difference if hydrostatic, osmotic pressure

Regulation of Fluid - CORRECT ANSWER-Osmosis: the diffusion of water from an area
of low solute concentration to area of high solute concentration

Diffusion: solutes moves from area of higher concentration to one of lower concentration
(electrolytes move)

Water Content of the body - CORRECT ANSWER-60% of body weight in adult
45% - 55% in older adults
70% - 80% in infants

Body Fluid - CORRECT ANSWER-Approximately 60% of typical adult is fluid -varies
with age, body, size, gender

Intracellular fluid (ICF)- 2/3 of body fluid, body fluids in the cell.

,Body Fluid cont. - CORRECT ANSWER-Extracellular fluid (ECF)
-intravascular: plasma, erythrocytes, leukocytes, thrombocytes= homeostasis
-interstitial: between the cells & outside the blood vessels lymph
-transcellular: cerebrospinal, pericardial, synovial
-electrolyte, hormones & enzymes are carried throughout the body by ECF
-fluid is constantly shifting between ICF, ECF to maintain homeostasis


Regulation of Fluid cont. - CORRECT ANSWER-Filtration: movements of water, solutes
occurs from area of high hydrostatic pressure to area of low hydrostatic pressure (one
way movement of fluid & electrolytes, some material is retained)

Active transport: Sodium-potassium pump
Maintains higher concentration of extracellular sodium, intracellular potassium

Homeostatic Mechanisms - CORRECT ANSWER-Multiple organs involved:
Kidneys (major role)
Lungs
Heart & blood vessels
Pituitary
Adrenal functions
Parathyroid

Regulators of Fluid Status - CORRECT ANSWER-Anti Diuretic Hormone: retain water

Aldosterone: increase NA reabsorption, and K excretion = retain fluid

Baroreceptors: decreased pressure= increased sympathetic response

RAAS & Natriuretic Peptides - CORRECT ANSWER-RAAS (renin angiotensin
aldosterone system): senses decreased renal perfusion & releases renin

Natriuretic peptides are in direct opposition to RAAS
Released by either atrial (ANP) or ventricle (BNP) due to increased pressure (volume).
Suppresses action of RAAS. Decrease NA retention

Labs to evaluate fluid status - CORRECT ANSWER-Osmolaity
Specific gravity
Creatinine
Hematocrit
Albumin

Body Fluid Osmolality - CORRECT ANSWER-Serum osmolality:
Measures the concentration of osmoses within the serum
Primarily reflects the concentration of NA

,Normal= 275-290 mOsm/kg

Urine osmolality:
Measure the concentration of osmoses within urine
Primarily relects urea, creatinine & uric acid
Normal= 200-800 mOsm/kg

Specific Gravity (1.005-1.03) - CORRECT ANSWER-Measures the kidneys ability to
excrete or conserve water
-compared to density of water (1.000)
-higher specific gravity indicates a denser urine
-dehydration (elevated serum Na)
-decreased antidiuretic hormones (not holding on to water) - diabetes insipidus

Lower specific gravity indicates a less dense urine (more dilute)
-less than 1.010 is not always considered pathological
-diuretics
-increased ADH (holding onto water)
-syndrome of Inappropriate Antidiuretic hormone secretion (SIADH)

BUN/Creatinine - CORRECT ANSWER-Blood urea nitrogen: normal 10-20mg/dl
Less than optimal gauge of kidney function

Normal creatinine is less than 1.4mg/dl

Simple & accurate value demonstrating level of kidney function (GFR)

Almost always checked before administering IV contrast

Creatinine is a byproduct of muscle breakdown that occurs at a constant rate

Can vary with medication

If the kidney is losing the ability to filter, this byproduct will accumulate in the
bloodstream

Dialysis pts will routinely have creatinine levels of 7 or higher

Hematocrit - CORRECT ANSWER-Measures the % of RBCs in whole blood

42%-52% for males
35%-47% for females

Albumin - CORRECT ANSWER-Made by the liver
Impermeable to capillary membranes
Protein that exerts oncotic pressure in the vessel (pulls fluid)

, Counteracts hydrostatic pressure
Keeps fluid within the vasculature
Normal level is 3.5-5.5

Gerontologic Considerations - CORRECT ANSWER-Clinical manifestations of
imbalance may be subtle
Fluid deficit may cause delirium
Decreased cardiac reserve
Reduced renal function
Dehydration is common
Age-related thinning of the skin and loss of strength and elasticity

Fluid Volume Imbalances - CORRECT ANSWER-Fluid volume deficit (FVD):
hypovolemia
Fluid volume excess (FVE): hypervolemia

Fluid Volume Deficit (FVD) - CORRECT ANSWER-May occur alone or in combination
with other imbalances

Loss of extracellular fluid exceeds intake ratio of water: electrolyte lost in same
proportion as they exist in normal body fluids

Dehydration:
Not the same as FVD
Loss of water alone, with increased serum sodium levels

Causes of FVD - CORRECT ANSWER-Abnormal fluid losses:
Vomiting, diarrhea, sweating, GI suctioning

Decreased intake:
Nausea, lack of access to fluids

Third-space fluid shifts:
Due to burns, as cites

Additional causes:
Diabetes insipidus, adrenal insufficiency, hemorrhage

Clinical Manifestations of FVD - CORRECT ANSWER-Can develop rapidly & severity
depends on degree of loss.
Vitals sign changes: hypotension, tachycardia, fever
Dizziness, syncope, weakness, fatigue
Thirst, acute weight loss, tenting of skin
Concurrent s/s of electrolyte imbalance
Oliguria (<400ml urine/day)