LATEST fluid and electrolyte balance 2024 Exam With 100% Correct Solutions

Compare body water to total weight in infants and adults. - ANSWER- The total body water is about 80% of body weight at birth, gradually decreasing with age to 60-65 % in adults. Identify patients more susceptible to fluid imbalance. - ANSWER- patients with RENAL DISEASE, because these patients kidney's fail to maintain fluid, electrolyte, and acid- base balance. Decreased blood flow to the kidney's due to CARDIOVASCULAR DISEASE stimulates RAAS causing water retention. DM, CANCER, and COPD may affect acid-base imbalance. Discuss the two basic fluid compartments - ANSWER- INTRACELLULAR FLUID: water found within the body's cells (2/3 total body fluid) EXTRACELLULAR FLUID: plasma (within the vasculature) and interstitial fluid (where edema occurs, found in the area surrounding the cells). Define electrolytes. - ANSWER- charged particles capable of conducting electricity. Electrolytes affect the amount of water in your body, the acidity of your blood (pH), your muscle function, and other important processes. You lose electrolytes when you sweat. You must replace them by drinking fluids. Describe cations. - ANSWER- the number of ions carrying a positive charge. NA+, K, CA+, and MG+. Describe anions. - ANSWER- the number of ions carrying a negative charge. CL-, bicarbonate, phosphate, and sulfate. 3. Identify the major electrolytes in ICF and ECF. a. Potassium b. Sodium - ANSWER- POTASSIUM: regulates-renal excretion, aldosterone increases K excretion, mvmt into and out of cells, insulin helps move K into cells; tissue damage and acidosis shift K out of cells into ECF SODIUM: regulates-renal absorption or excretion, aldosterone increases Na+ reabsorption in collecting duct of nephrons Discuss the four major mechanisms of fluid and electrolyte movement. - ANSWER- DIFFUSION: occurs when two solutes of different concentrations are separated by a semipermeable membrane. molecules move from higher to lower concentrations. OSMOSIS: water moves across cell membranes from less con. sol. to more con. sol. (capillary membrane) FILTRATION: fluids and solutes move together across a membrane from high pressure to low pressure areas. ACTIVE TRANSPORT: moves and holds sodium and potassium against their diffusion gradients. Compare hydrostatic and osmotic pressure. - ANSWER- HYDROSTATIC PRESSURE: the pressure exerted by a fluid within a closed system on the walls of the container in which it is contained. OSMOTIC PRESSURE: the power of a solution to pull water across a semipermeable membrane. The solution with a higher concentration exerts a higher osmotic pressure. Define osmolality. - ANSWER- the concentration of solutes in the body fluids. Determined by the total solute concentration within a fluid compartment and is measured as parts of solute/kg of water. 2. Compare the following a. isotonic b. hypertonic c. hypotonic solutions - ANSWER- ISOTONIC- has same osmolality as ECF...(0.9% Na+Cl) HYPERTONIC- has a higher osmolality than ECF...(3% Na+Cl) HYPOTONIC- have a lower osmolality than ECF...(0.45Na+Cl) Discuss the role of the following in the control of fluid and electrolyte balance. Blood pressure - ANSWER- If blood pressure/blood flow to the kidney's decreases, renin is released, which causes the conversion of angiotensin to angiotensin I to angiotensin II which acts directly on the nephrons of the kidney's and promotes sodium and water retention. Also it stimulates the release of aldosterone which promotes sodium retention in the distal nephron. so ultimately BP is increased as well as renal perfusion. Colloids - ANSWER- plasma proteins are colloids and exert a pressure called colloid osmotic pressure. This holds the water in the plasma and when necessary pulls water from the interstitial space into the vascular compartment. This helps to maintain vascular volume. Kidneys - ANSWER- excrete hydrogen ions and retain bicarbonate. kidney's regulate the volume and osmolality of ECF by REGULATING WATER AND ELECTROLYTE EXCRETION. ADH - ANSWER- synthesized in the anterior portion of the hypothalamus and acts on the collecting ducts of the nephrons by making the collecting ducts become more permeable to water ALLOWING MORE WATER TO BE ABSORBED INTO THE BLOOD. blood volume, stress, temperature, pain and opiates affect release of ADH. Aldosterone - ANSWER- promotes SODIUM RETENTION in the distal nephron, INCREASING THE BLOOD VOLUME. Parathyroid hormone [S] - ANSWER- increases reabsorption of phosphate (major anion in ICF), causing more to be excreted through urine and increases the amount of calcium in circulation Discuss electrolyte imbalances. - ANSWER- disrupt fluid balance, and acid-base regulation, disrupt the enzyme reactions and neuromuscular reactions Describe the functions of potassium (K+). - ANSWER- REGULATING INTRACELLULAR FLUID OSMOLALITY, TRANSMITTING NERVE AND OTHER ELECTRICAL IMPULSES, REGULATING CARDIAC IMPULSE TRANSMISSION AND MUSCLE CONTRACTION, SKELETAL AND SMOOTH MUSCLE FUNCTION, REGULATING ACID-BASE BALANCE. the ratio of intracellular to extracellular potassium must be maintained for neuromuscular response to stimuli. Identify the etiology of hypokalemia and hyperkalemia. - ANSWER- HYPER-Renal failure,Hypoaldosteronism, Type 4 renal tubular acidosis, Adrenal insufficiency (Addison disease),Sickle cell anemia, Insulin deficiency, Certain medications, Acidosis, Rhabdomyolysis, Traumatic venipuncture, Severe leukocytosis HYPO-Non-potassium- sparing diuretics, Certain antibiotics, Alcoholism Osmotic diuresis, induced hypertension, Malignant hypertension, Renovascular hypertension, Renin-secreting tumor, Excessive licorice ingestion, Congenital adrenal hyperplasia, acidosis, Catecholamine excess, Leukemia, Beta-adrenergic agonists, Trauma Discuss the clinical assessment findings in the patient experiencing potassium imbalances. - ANSWER- HYPO- MUSCLE WEAKNESS, leg cramps, fatigue and lethargy, anorexia, nausea, vomiting, decreased bowel sounds, cardiac dysrhythmias, depressed tendon reflexes, weak and irregular pulses, HYPER-gastrointestinal hyperactivity, diarrhea, irritability, apathy, confusion, cardiac dysrhythmias or arrest, MUSCLE WEAKNESS, areflexia, decreased heart rate, irregular pulse, paresthesias and numbness in extremities. Identify common lab/diagnostic findings of the patient with a potassium imbalance. - ANSWER- peaked T wave or flattening. serum potassium levels lower than 3.5 or higher than 5.0 mEq/L... widened QRS or ST segment depression on ECG Formulate common nursing diagnoses of patients with a potassium imbalance. - ANSWER- muscle weakness R/T K imbalance, K imbalance R/T diuretics Discuss the treatment and nursing interventions of a patient with a potassium imbalance. - ANSWER- HYPOKALEMIA-monitor heart rate and rhythm,esp. for patients receiving digitalis. administer foods with K, teach patients about K rich foods, and how to prevent excessive K loss (through the abuse of laxatives and diuretics) HYPERKALEMIA-closely monitor cardiac status and ECG, administer diuretics and other medications as ordered, hold K supplements and K conserving diuretics, monitor K levels carefully and watch for a rapid drop that occurs when K shifts into cells.