Alterations in Fluids & Solutes, Altered Cellular and Tissue Biology; Altered Cellular Proliferation
Academic honesty reminder: It is ok to discuss the assignments with other students as a learning tool, but it is considered a
breach of academic honesty to copy answers directly from each other. Also, when taking a test, do
Instructions:
1. Read and study RRD #2 and any other documents that are referred to.
2. Fill in this worksheet after you finish your readings. (Not mandatory to fill in worksheet, but it will
help when you are ready to enter your answers into Assignment Submission section.)
3. Click on the Assignment Submission offering when you are ready to enter your answers, and follow
the instructions there. Note: the electronic assignment format LOOKS like a test, but you will be able
to access the assignment freely UP UNTIL THE DUE DATE. At the due date and time, the assignment
submission module will become inaccessible. If you have not submitted your assignment by then you
will receive a zero.
NOTE: The test questions are all critical thinking questions (CTQs) similar to the ones in these Assignments.
Use the ones provided in these assignments as study tools and representatives of how information will be
asked on a test. In your studying, remember to approach material via “front-door” and “back door”—for
example, if in a test you are given the name of a disease (front door), be able to answer questions about its
pathophysiology & S&S. If you are given the patho or S&S (back door), be able to trace them back to the name
of the disease….and so forth. Also, read scenarios and questions carefully. Be SURE you understand what is
being asked. Then when you go to choose an answer, first read ALL the offerings & choose the one that fits
the scenario, plus fits the reading that you have done—the RRD and concept maps. Do not overthink—that is,
do not weave in other ungrounded assumptions. Have a good rationale for why you chose the answer that you
did…. AND also why you DIDN’T choose the other answers.
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1. Remember the patient in Assignment #1, with cancer who can’t eat and has lost 80 pounds? Let’s add
to his
assessment findings: let’s say he has generalized edema and a serum protein of 4gm/dl (normal = 6.0
to 8.3 gm/dl ). Which is the most accurate mini-concept map linking his blood protein level with
edema?
a. hypoproteinemia concentration in blood is now lower than the normal concentration of
fluids inside cells fluid goes from blood to tissue (B to T).
b. hypoproteinemia concentration in blood is now higher than the normal concentration
of fluids inside cells fluid goes from B to T
c. hypoproteinemia blood is now hyperosmolar compared to the cells fluid goes from T to B
d. hyperproteinemiablood now has lower oncotic pressure than normal fluid goes from T to B
2. All of the following are accurate possible findings in the patient above EXCEPT that
a. he has confusion due swollen brain cells.
b. he has crackles in his lungs from fluid in the alveoli (lung tissue).
c. his serum osmolality is 302 (norm = 280- 295).
d. he will need a hypertonic IV solution to return fluid status to normal.
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, 3. A 28-year-old man presents with a low blood pressure due to blood loss from a gunshot wound. The
regulatory
action that will best compensate for this patient’s fluid volume deficit is:
a. increased action of the natriuretic peptide system.
b. increased action of the RAAS.
c. inhibition of renin secretion.
d. conversion of aldosterone into angiotensin II.
4. As a result of the action in the previous question, all the following will occur EXCEPT:
a. the patient’s body will “hang on” to fluids.
b. Na+ will be retained by the kidneys.
c. water excretion into the urine will increase.
d. blood pressure will increase.
(Normal labs: Na+ = 135 to 145; K+ = 3.5 – 5.0; serum osmolality (“osmo”) = 280- 295; HCO3 = 22-28).
5. A patient is hospitalized in renal failure. Because of her kidneys’ inability to excrete water, she
has generalized edema & a serum sodium of 129. Because the kidneys have also lost the ability to
appropriately regulate potassium, she also has a serum potassium of 5.9. These lab results show:
a. hypernatremia & hypokalemia.
b. hyperkalemia & hyponatremia.
c. hyperosmolality & hypernatremia.
d. hypoosmolality & hypocalcemia.
6. In the previous question, the edema is most likely due to fluid shifting from the intravascular space
into interstitial spaces secondary to all the following EXCEPT:
a. hypertonicity of the plasma space.
b. hypotonicity of the plasma space.
c. hypoosmolality of the blood.
d. diminished osmotic pressure of the blood.
7. A patient has advanced liver disease. Blood tests reveal that his serum albumin (albumin is one of
the protein molecules found in the blood) level is very low. What eventually happens in this
patient
situation?
a. Water would shift from blood (B) to tissue (T) because of decreased plasma oncotic pressure.
b. There would be an increased intravascular volume due to increased plasma oncotic pressure.
c. There would be dehydrated brain cells due to fluid shifting from T to B.
d. Water would shift from T to B because of increased osmolality of the vascular space.
8 The physiologic process underlying fluid shifts in the patient situation above is that
a. “concentration calls” fluid into hypoosmolar compartments from hyperosmolar ones.
b. the principle of diffusion results in albumin molecules going from lower to higher concentration.
c. “concentration calls” fluid into compartments with higher oncotic pressure from
compartments with lower oncotic pressure.
d. the proteinemia means that protein molecules will diffuse throughout the blood and tissue.
P a t h o MsoourdceuwleasTdwowonlAoasdseidgnbym10e0n0t0,08S2u981798664 from
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CourseHero.com on 02-09-2022 02:18:35 GMT -06:00
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