NURS 1871- UNIT 10 AND 11 EXAM QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS
What are the three important characteristics of fluids in the body?
Volume (amount), degree of concentration (osmolality), and pH.
What are electrolytes?
Electrolytes are substances that are charged particles (ions) when they are placed in
water. Examples of electrolytes are sodium ions (Na+), potassium ions (K+), calcium
ions (Ca2+), and magnesium ions (Mg2+).
All body fluids contain electrolytes; body fluids in different locations normally contain
different concentrations of electrolytes that are necessary for optimal function.
What does extracellular fluid consist of?
The extracellular fluid (ECF) compartment consists of fluid between the cells (interstitial
fluid) and fluid inside blood vessels (vascular fluid)
1/3 of body fluid is ECF. Sodium is most abundant here.
What does intracellular fluid consist of?
Fluid inside the cells.
2/3 of body fluid is ICF. Potassium is most abundant here.
What is tonicty?
,The capability of a solution to modify the volume of cells by altering their water content.
Hypotonic: Osmolality is lower in ECF than ICF. Cells swell and "pop" due to fluid shift.
Isotonic: Osmolality in ECF and ICF match. Cells stay the same.
Hypertonic: Osmolality is higher in ECF than ICF. Cells shrink due to fluid shift.
What is the definition of clinical dehydration?
High sodium + ECF deficit values
What is an anion gap?
A blood test that measures the difference between the amount of positively and
negatively charged electrolytes in your blood. It's a way to check your blood's acid-base
balance, or pH, and to see if your electrolytes are out of balance.
What are the three categories of fluid and electrolyte imbalances?
Extracellular Fluid Volume Imbalances (There are two types of ECV imbalances; ECV
deficit is too little sodium, NaCl, or ECV excess where there is too much sodium.)
Osmolality Imbalances (two types; hypernatremia and hyponatremia)
Electrolyte Imbalances- (two types; deficits and excesses of plasma concentration)
How do you define hypernatremia and hyponatremia?
Hypernatremia (increased serum Na+ concentration) indicates that body fluids are too
concentrated (osmolality is too high).
Hyponatremia (decreased serum Na+ concentration) indicates that body fluids are too
dilute (osmolality is too low).
,Osmolality imbalances can occur alone or with ECV imbalances. The combination of
ECV deficit and hypernatremia is known as clinical dehydration.
What are the three causes of fluid and electrolyte disturbances?
• Fluid and electrolyte output is greater than intake and absorption.
• Fluid and electrolyte output is less than intake and absorption.
• Fluid and electrolyte distribution is altered.
What are some causes of disrupted electrolyte imbalances?
• Lack of access to Na+ and water
• Vomiting
• Acute or chronic diarrhea from any cause, including laxative abuse
• Draining GI fistula, gastric suction, or intestinal decompression
• Hemorrhage or burns
• Overuse of diuretics
• Lack of aldosterone (adrenal insufficiency, Addison disease)
• Acute intestinal obstruction
• Ascites that develops rapidly
• Excessive IV infusion of Na+-containing isotonic solution (0.9% NaCl, Ringer)
• High oral intake of salty foods and water with renal retention of Na+ and water
• Oliguria (e.g., acute kidney injury, acute glomerulonephritis, end-stage kidney disease)
• Aldosterone excess (e.g., cirrhosis, chronic heart failure, primary hyperaldosteronism)
• High levels of glucocorticoids (e.g., corticosteroid therapy, Cushing disease)
and many more...
What are some consequences of disruptions of fluid and electrolyte balance?
, Impaired perfusion and oxygenation, impaired cerebral function, impaired
neuromuscular function.
Who has the right to refuse treatment?
A competent adult, or a person with decision-making capacity.
Patients without decision-making capacity include those younger than 18 years of age
and those without mental competence, either resulting from illness or injury or a
cognitive disability that is present at birth.
In tort law what is the "Standard of Care"?
A set of guidelines based on various types of evidence as to what is reasonable and
prudent for a health care professional in the same or similar circumstance.
Deviation from the standard of care increases the nurse's risk for malpractice and
criminal negligence lawsuits. It is important that nurses are always familiar with the
policies and procedures of their place of employment, in addition to knowing their state's
NPA.
What are some standard of care items that nurses should be doing without fail?
-Remain technically competent and know how to use all equipment properly.
-Recognize immediately when a machine is not working correctly and then remove it
from use.
-Attend educational workshops, and subscribe to nursing journals to keep up to date
with the newest literature and guidelines.
-Stay within the limits of the nurse's own expertise, especially as a newly graduated RN.
ANSWERS WITH COMPLETE SOLUTIONS
What are the three important characteristics of fluids in the body?
Volume (amount), degree of concentration (osmolality), and pH.
What are electrolytes?
Electrolytes are substances that are charged particles (ions) when they are placed in
water. Examples of electrolytes are sodium ions (Na+), potassium ions (K+), calcium
ions (Ca2+), and magnesium ions (Mg2+).
All body fluids contain electrolytes; body fluids in different locations normally contain
different concentrations of electrolytes that are necessary for optimal function.
What does extracellular fluid consist of?
The extracellular fluid (ECF) compartment consists of fluid between the cells (interstitial
fluid) and fluid inside blood vessels (vascular fluid)
1/3 of body fluid is ECF. Sodium is most abundant here.
What does intracellular fluid consist of?
Fluid inside the cells.
2/3 of body fluid is ICF. Potassium is most abundant here.
What is tonicty?
,The capability of a solution to modify the volume of cells by altering their water content.
Hypotonic: Osmolality is lower in ECF than ICF. Cells swell and "pop" due to fluid shift.
Isotonic: Osmolality in ECF and ICF match. Cells stay the same.
Hypertonic: Osmolality is higher in ECF than ICF. Cells shrink due to fluid shift.
What is the definition of clinical dehydration?
High sodium + ECF deficit values
What is an anion gap?
A blood test that measures the difference between the amount of positively and
negatively charged electrolytes in your blood. It's a way to check your blood's acid-base
balance, or pH, and to see if your electrolytes are out of balance.
What are the three categories of fluid and electrolyte imbalances?
Extracellular Fluid Volume Imbalances (There are two types of ECV imbalances; ECV
deficit is too little sodium, NaCl, or ECV excess where there is too much sodium.)
Osmolality Imbalances (two types; hypernatremia and hyponatremia)
Electrolyte Imbalances- (two types; deficits and excesses of plasma concentration)
How do you define hypernatremia and hyponatremia?
Hypernatremia (increased serum Na+ concentration) indicates that body fluids are too
concentrated (osmolality is too high).
Hyponatremia (decreased serum Na+ concentration) indicates that body fluids are too
dilute (osmolality is too low).
,Osmolality imbalances can occur alone or with ECV imbalances. The combination of
ECV deficit and hypernatremia is known as clinical dehydration.
What are the three causes of fluid and electrolyte disturbances?
• Fluid and electrolyte output is greater than intake and absorption.
• Fluid and electrolyte output is less than intake and absorption.
• Fluid and electrolyte distribution is altered.
What are some causes of disrupted electrolyte imbalances?
• Lack of access to Na+ and water
• Vomiting
• Acute or chronic diarrhea from any cause, including laxative abuse
• Draining GI fistula, gastric suction, or intestinal decompression
• Hemorrhage or burns
• Overuse of diuretics
• Lack of aldosterone (adrenal insufficiency, Addison disease)
• Acute intestinal obstruction
• Ascites that develops rapidly
• Excessive IV infusion of Na+-containing isotonic solution (0.9% NaCl, Ringer)
• High oral intake of salty foods and water with renal retention of Na+ and water
• Oliguria (e.g., acute kidney injury, acute glomerulonephritis, end-stage kidney disease)
• Aldosterone excess (e.g., cirrhosis, chronic heart failure, primary hyperaldosteronism)
• High levels of glucocorticoids (e.g., corticosteroid therapy, Cushing disease)
and many more...
What are some consequences of disruptions of fluid and electrolyte balance?
, Impaired perfusion and oxygenation, impaired cerebral function, impaired
neuromuscular function.
Who has the right to refuse treatment?
A competent adult, or a person with decision-making capacity.
Patients without decision-making capacity include those younger than 18 years of age
and those without mental competence, either resulting from illness or injury or a
cognitive disability that is present at birth.
In tort law what is the "Standard of Care"?
A set of guidelines based on various types of evidence as to what is reasonable and
prudent for a health care professional in the same or similar circumstance.
Deviation from the standard of care increases the nurse's risk for malpractice and
criminal negligence lawsuits. It is important that nurses are always familiar with the
policies and procedures of their place of employment, in addition to knowing their state's
NPA.
What are some standard of care items that nurses should be doing without fail?
-Remain technically competent and know how to use all equipment properly.
-Recognize immediately when a machine is not working correctly and then remove it
from use.
-Attend educational workshops, and subscribe to nursing journals to keep up to date
with the newest literature and guidelines.
-Stay within the limits of the nurse's own expertise, especially as a newly graduated RN.
