Fluid & Electrolyte Balance Questions With Complete Marking Scheme

Fluid & Electrolyte Balance Questions With Complete Marking Scheme Describe the distribution and regulation of body fluids - ANSWER- Hydrostatic pressure balance occurs when the volume of weight in either side of the membrane is equalized. Osmotic pressure balance occurs when the ratio of particles to fluid is equal on either side of the membrane. Discuss the factors that affect fluid balance - ANSWER- Nutrition, hydration, exertion, age, weight, body fat percentage, chronic disease, injury/surgery/wounds Formulate nursing dx related to fluid imbalances - ANSWER- Altered a/o, vs, muscle weakness/spasms, wt loss/gain, I/O, edema, changes in skin turgor and condition Discuss nursing measures & rationale related to altered fluid balance that will assist patients to meet their self-care needs. - ANSWER- ID cause, restore balance, ensure safety, monitor a/o, I/O, vs, skin Identify the rationale for using hypo/hyper/isotonic IV fluids - ANSWER- Hypo/Iso has more fluid to particles which helps to dilute overload of any particle or to rehydrate. Hyper has more particles than solvent to increase particle concentration or to induce excretion of excess fluid. Use critical thinking to compare/contrast the rationale for using hypo/hyper/isotonic fluids - ANSWER- To restore balance. Hypo & Iso for hypovolemic/hypertonic states. Hyper for hypervolemic/hypotonic states Use critical thinking to determine the effect of fluid and electrolyte imbalances on multiple body systems. - ANSWER- Imbalances can cause various body systems to overwork to compensate or, worse, cease to function thereby causing further complications to arise. Sx of Hyponatremia - ANSWER- Irritability, confusion, lethargy, HA, seizure, muscle spasm/weakness, coma Sx of True Hyponatremia - ANSWER- Orthostatic HoTN, tachycardia, wt loss Sx of Dilutional Hyponatremia - ANSWER- Increased BP, edema, wt gain Sx of Hypernatremia - ANSWER- Fever/flush skin, restlessness/irritability, increased fluid retention, increased BP, edema, decreased urine output, dry mouth Sx of Hypokalemia - ANSWER- Fatigue, weakness, leg cramps, resp dysfunction, hyperglycemia , decreased GI motility, weak/irregular pulse, ECG changes Sx of Hyperkalemia - ANSWER- LE muscle cramps, Urine: oliguria (decreased output), anuria (no output), resp distress, dec cardiac contraction, ECG changes, hyper-reflexia Sx of hypocalcemia - ANSWER- Convulsions, arrhythmias, tetany (parathesia, Chvostek, Trosseau), spasms, stridor (harmonica) Sx of Hypercalcemia - ANSWER- Anorexia, nausea, fatigue, constipation, polyuria, dehydration, ECC changes Sx of Hypomagnesmia - ANSWER- Increased neuromuscular ability, LE cramping, tremors, hyperactive DTR, tetany, cardiac dysthymia, dysphagia, paralytic ileus Sx of Hypermagnesmia - ANSWER- Muscle weakness, lethargy, N/V, diaphoresis, HoTN, bradypnea, bradycardia, decreased DTR, decreased LOR The minimum amount of urine per day needed to excrete toxic waste products is ___. This minimum volume is called the obligatory urine output. - ANSWER- 400-600 mL An adult takes in about ___ of fluid daily from food and liquids. - ANSWER- 2300 mL What is the minimum amount of fluid intake per day? - ANSWER- 30-40 mL/kg/d How much fluid does a healthy lose through insensible loss? - ANSWER- 500-1000 mL/day What are the routes of insensible loss - ANSWER- lungs, skin, feces Thirst mechanism - ANSWER- Triggered by the activation of osmoreceptors when ECF volume is decreased and osmolarity is increased (becoming hypertonic). The cells in the thirst center shrink as water moves from the cells into the hypertonic ECF. The shrinking of these cells triggers a person's awareness of thirst and increases the urge to drink. Drinking replaces the amount of water lost through sweating and dilutes the ECF osmolarity, restoring it to normal. The thirst mechanism is less sensitive in older adults, increasing their risk for dehydration. ANP - ANSWER- Released w increased blood volume/pressure in the heart; Inhibits kidney reabsorption of Na and increases GFR causing increased urine output ADH - released from, why & function - ANSWER- Released from anterior pituitary w increased blood mOsm, triggers kidneys to reabsorb H2O Aldosterone - released from & function - ANSWER- released from the adrenal cortex when adrenal cortex is stimulated by Angiotensin II; stimulates kidneys to reabsorb H2O & Na Angiotensin II functions - ANSWER- Vasoconstriction and Aldosterone release Describe the Renin-Angiotensin-Aldosterone System - ANSWER- When low blood pressure/volume/mOsm/O2 are sensed by the kidneys, they release renin into the blood; Renin activates angiotensinogen (secreted by the liver) to convert to Angiotensin I. Ang I is acted on by ACE (secreted from the lungs & blood vessels), and becomes Angiotensin II. Ang II works as a vasoconstrictor, and eventually then also stimulates the adrenal glands to release aldosterone. Aldo