NURS 3370: QUIZ 2 EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS GRADED A++

NURS 3370: QUIZ 2 EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS GRADED A++ adequate water intake 3.7 L/day (13 cups) for males, 2.7 L/day (9 cups) for females intracellular fluid 70% of fluid; within cell, contains water, K, and P; most stable and resistant to major fluid shifts interstitial fluid fluid between cells; consists of Na and Cl; considered the reserve fluid (can replace fluid in blood vessels or cells) extracellular fluid 35% fluid (50% in children); less stable, interstitial fluid outside of cells and w/in vascular space; major electrolytes are Cl, glucose, Na urine specific gravity 1.003 to 1.035 isotonic dehydration equal loss of water and electrolytes; loss of circulating volume; most common hypertonic dehydration greater loss of ECF than electrolyte loss; fluid moves out of ICC and causes cellular dehydration; fever, diarrhea, AKI hypotonic dehydration electrolyte loss exceeds water loss; fluid moves into ICC and cells swell; brain swellings, chronic renal, malnutrition, severe illness hypertonic fluid causes fluid to be pulled from the cells into the blood stream; draws fluid from the cells into the blood stream; treats hypovolemia, maintains hydration and nutrition, expands volume hypotonic IV fluids causes fluid to move into the cells from the blood stream; causes fluid to be pulled out of the vessels into the cells resulting in decreased vascular volume and increased cell water; CI in brain injury; used for dehydration and promotes waste elimination of kidneys; must monitor LOC, vitals, cerebral edema isotonic IV fluids increases extracellular volume, no movement of existing fluid; same concentration of solutes as plasma and stay in vascular space thus increasing vascular volume; used to replace ECF and electrolyte loss and expand vascular volume quickly; treats hypovolemia, burns, vomiting, diarrhea dextrose in water (D5W) isotonic in bottle but becomes hypotonic in body when metabolized; monitor Na level; several different concentrations (D5, D10, D20); metabolic effects= calories for energy, spares some protein loss; used for dehydration (D2.5, D5, glucose metabolized leaving water which is hypotonic and moves into cells), hypernatremia (as long as pt is not fluid overloaded), and higher concentrations used for nutrition; can cause dehydration if infused too quickly (high sugar content in blood can cause diuresis), hyperinsulinism (too rapid of a rise in blood glucose), water intoxication (as glucose metabolized, free water is left); do not mix with blood transfusions (can cause hemolysis); high concentrations (D20+) should infuse centrally normal saline (0.9%) isotonic, but long term use can cause hypernatremia; used for ECF replacement, metabolic alkalosis with fluid loss, Na depletion, blood transfusion; excessive infusion can cause hypernatremia (especially if there is Na retention); can cause acidosis in large amounts (bc of Cl content), hypokalemia (can increase K excretion), circulatory overload dextrose 5% NS (D5NS) hypertonic solution; prevents catabolism which prevents loss of K and IC water; temporary tx of circulatory insufficiency (tx hypovolemia); early fluid replacer in burns 3% NaCl hypertonic saline; used for severe hyponatremia or water intoxication; use sm volumes, infuse slowly; closely monitor pt (ICU); do not raise serum Na quickly (2mEq/L/hr) hydrating fluids 1/2 NS (0.45% NaCl)= good for hydrating, maintenance fluid; D5 1/2 NS= common initial hydrating fluid; caution with renal, CHF, or edematous pts lactated ringers isotonic fluid (post op); closely resembles electrolyte concentration of ECF; often used to replace fluids from burns or fluid lost as bile and diarrhea; can raise Na levels if too much is used (d/c w/in few hours) colloids