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NUR 3129 Patho Finals study
guide
Hypodipsia in elderly Ch 8 p. 146-147
1. Recognizing the prevalence and incidence of dehydration
among older adults, a care
aide at a long-term care facility is in the habit of encouraging
residents to drink even
though they may not feel thirsty at the time. Which of the following
facts underlies the
care aide's advice?
A) Older adults often experience a decrease in the sensation of
thirst, even when
serum sodium levels are high.
B) The metabolic needs for both fluid and sodium in older adults
differ from those of
younger individuals.
C) Regulation and maintenance of effective circulating
volume by the kidneys is less
effective in the elderly.
D) The renin–angiotensin–aldosterone system (RAAS) is less able
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,NUR 3129 Patho Finals study guide Questions
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to facilitate sodium clearance in older adults.
Ans: A
Feedback:
The elderly are prone to hypodipsia even when osmolality and
serum sodium levels are
elevated, a fact that is compounded by sensory and/or neurological
deficits.
Hypodipsia
in the elderly is not related to differing metabolic needs, ineffective
kidney function, or
compromise of the RAAS.
2. Indicators of fluid volume overload. p. 150
A client is brought to the emergency department with complaints
of shortness of breath.
Assessment reveals a full, bounding pulse, severe edema, and
audible crackles in lower
lung fields bilaterally. What is the client's most likely diagnosis?
A) Hyponatremia
B) Fluid volume excess
C) Electrolyte imbalance: hypocalcemia
D) Hyperkalem
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ia Ans: B
Feedback:
Peripheral and pulmonary edema as well as a bounding pulse and
dyspnea
are indicators
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of fluid volume overload.
Etiology of Hyperparathyroidism Ch 8 p.160-161
3. A 52-year-old patient has just passed a kidney stone and has
high levels of calcium in
her urine. Blood tests show high levels of calcium in her blood as
well. What subsequent lab results would be most likely to distinguish
between primary hyperparathyroidism and hypercalcemia of
malignancy?
A) Parathyroid hormone level
B) Bone scan
C) Plasma phosphate levels
D) Serum magnesium
level Ans: A
Feedback:
Hyperparathyroidism, in which parathyroid hormone is secreted
in excess, may be
caused by a parathyroid adenoma. Since parathyroid hormone
mobilizes calcium from
bone and promotes its transfer to the extracellular fluid, excess
calcium is excreted in
the urine (promoting the development of kidney stones) and is
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