NUR242 MEDSURG UNIT 4 GALEN QUESTIONS WITH CORRECT ANSWERS 2025

NUR242 MEDSURG UNIT 4 GALEN QUESTIONS
WITH CORRECT ANSWERS 2025
RiskZfactors:ZfluidZoverloadZ-ZCORRECTZANSWERZ-•ExcessiveZfluidZreplacement

•KidneyZfailureZ(lateZphase)

•HeartZfailure

•LongZtermZcorticosteroidZtherapy

•SyndromeZofZinappropriateZantidiureticZhormoneZ(SIADH)

•WaterZintoxication

DiabetesZInsipidus

Hypernatremia



S/S:ZfluidZoverloadZ-ZCORRECTZANSWERZ-
tachycardia,ZboundingZpulse,ZHTN,ZdecreaseZpulseZpressure,ZJVD,ZweightZgain

increaseZandZshallowZresp;ZSOB,ZcracklesZlungZsounds

pittingZedema,ZskinZpale/cool

HA,ZvisualZdisturbance,ZmuscleZweakness,Zparesthesia

increaseZmotility,ZenlargedZliver



Assessment:ZfluidZoverloadZ-ZCORRECTZANSWERZ-
•AssessZriskZr/tZageZandZdiagnosis,ZhistoryZ(overhydration,ZCHF,ZkidneyZdisease)

•AssessZvitalZsigns:ZboundingZtachycardia,ZHTN,Zdysrhythmias,Ztachypnea

•AssessZlungZsoundsZ(crackles),Zweight,ZLOC,ZJVD

•electrolytesZimbalanceZandZsignsZandZsymptoms

skin/extremities/abdomen/sacrumZareaZforZedema

•AssessZperfusion:Zedema,Zperipheral/centralZpulses,ZcapillaryZrefill,ZskinZcolor,Ztemp,ZsensoryZandZmotorZf
unction

urineZoutput



Labs:ZfluidZoverloadZ-ZCORRECTZANSWERZ-•SerumZosmolalityZ(285-295ZmOsm/kg)

•DecreaseZfoundZinZoverhydrationZ<Z285;ZandZ<Z265ZisZcriticalZfinding

,•CBC

•DecreaseZhemoglobinZandZhematocrit

•Z<ZBUNZ

•Electrolytes

•Z<ZsodiumZ

•UrineZspecificZgravityZDecreaseZ<Z1.005



Interventions:ZfluidZoverloadZ-ZCORRECTZANSWERZ-
•Goal:ZreduceZexcessZbodyZfluids,ZpromoteZdesiredZelimination

-MonitorZskinZalsoZaroundZmask/nasalZcannula,ZpositionZchanges,

•ManageZunderlyingZcause

•RestrictZdietaryZsodiumZintake

•MonitorZI/OZ-ZdailyZwt.Z>3lbZgain/weekZorZ2lbgain/24hrs:ZcallZCP

•AdministerZdiuretic

-ECGZpatterns

•MonitorZclient'sZs/sZandZelectrolytesZvalues

•RestrictZoralZandZotherZfluidZintakeZasZprescribed



Complications:ZfluidZoverloadZ-ZCORRECTZANSWERZ-•IsotonicZoverhydration

•HFZandZpulmonaryZedema

•Seizure

•Coma



Medications:ZfluidZoverloadZ-ZCORRECTZANSWERZ-Furosemide

Mannitol



S/S:ZdehydrationZ-ZCORRECTZANSWERZ-•VitalZsigns:ZIncreased:ZHR,ZBP,ZRR

hyperthermia,ZST,ZthreadZpulse,Zhypotension,ZdecreaseZCVP

<skinZturgor,Zdry/scaly,ZdryZmucousZmembraines

, •Neuromusculoskeletal:ZDizziness,Zsyncope,Zconfusion,Zweakness,Zfatigue

•GI:Zthirst,ZdryZfurrowedZtongue,ZN/V,Zanorexia,ZweightZloss

<ZurinaryZoutpt

•OtherZsigns:ZDiminishZcapillaryZrefill,ZcoolZclammyZskin,Zdiaphoresis,ZsunkenZeyeballs,ZflatZneckZvein



Assessment:ZdehydrationZ-ZCORRECTZANSWERZ-
•AssessZforZconditionZleadingZtoZdehydration:Zdiarrhea,ZpoorZintake,ZvigorousZexercise,Zvomiting,Zpolyuria,
ZfluidZlossesZ(burns,Ztrauma)ZclientsZwithZdrains/NGZtube,Zburns/fluidZshifts,ZoveruseZofZdiuretic




Labs:ZdehydrationZ-ZCORRECTZANSWERZ-•SerumZelectrolytesZ(hypernatremia)

•IncreasedZserumZosmolalityZnormalZ275-
Z295ZmOsm/kg;ZelevatedZ>Z295ZfoundZinZdehydration;Z>Z320ZisZcriticalZfinding



•CBCZelevatedZH/H

•ElevatedZurineZspecificZgravityZ>Z1.030

•IncreasedZBUN



Interventions:ZdehydrationZ-ZCORRECTZANSWERZ-
•GoalZofZinterventions:ZreplaceZfluidZandZelectrolytesZtoZachieveZhomeostasis

•CloselyZmonitorZstatusZandZrehydration,ZavoidZovercorrection

•MonitorZI/OZandZweight

•IdentifyZandZmanageZcause-Zdiarrhea,Zvomiting,ZbloodZloss,ZpoorZintake

MonitorZfluidZoverloadZJVDZsittingZup,ZdependentZedema,ZassessZIVZsite

•MaintainZatZleastZ1500mL/dayZorZ500mLZmoreZthanZurinaryZoutput-knowZs/sZofZdehydration



RiskZFactors:ZdehydrationZ-ZCORRECTZANSWERZ-•Hypovolemia

•HypovolemiaZshock

•Seizures/coma

•MultiorganZsystemZfailure



Medications:ZdehydrationZ-ZCORRECTZANSWERZ-Loperamide