N262 - CHP 10 (EXAM 1) QUESTIONS WITH COMPLETE
DETAILED SOLUTIONS
What are nursing roles associated with fluid and electrolyte balance?
anticipate, identify, and respond to possible imbalances
What are electrolytes?
active chemicals that carry positive (cations) and negative (anions) electrical charges
What are the major cations?
sodium, potassium, calcium, magnesium, hydrogen ions
What are the major anions?
chloride, bicarbonate, phosphate, sulfate, proteinate ions
What is osmosis?
process of water molecules moving from a less concentrated area to a more
concentrated area
What is diffusion?
solutes move from an area of higher concentration to one of lower concentration
What are routes of gain for fluids?
-drinking and eating
-daily I&O of water are equal
What are routes of losses for fluids?
-kidney: urine output of 1mL/kg/hr
-skin loss: sensible due to sweating and insensible due to fever, exercise, burns
, -lungs: 300mL everyday, greater with increased RR
-GI tract: large losses due to diarrhea and fistulas
What are gerontologic considerations for fluid imbalance?
-clinical manifestations of imbalance may be subtle
-fluid deficit may cause delirium
-decreased cardiac reserve
-reduced renal function
-dehydration is common
-age-related thinning of skin and loss of strength and elasticity
What is fluid volume deficit (hypovolemia?
loss of extracellular fluid exceeds intake ratio of water
-electrolytes lost in same proportion as they exist in normal body fluid
-not the same as dehydration (loss of water alone, with increased serum sodium levels)
What are causes of FVD?
-abnormal fluid loss (vomiting, diarrhea, sweating, GI suctioning)
-decreased intake (nausea, lack of access to fluids)
-third-space fluid shifts (due to burns, ascites)
-additional causes (diabetes insipidus, adrenal insufficiency, hemorrhage)
What are clinical manifestations of FVD?
-can develop rapidly
-severity depends on degree of loss
-dizziness, weakness, drop of blood pressure
-increased BUN (normal 10-20)
DETAILED SOLUTIONS
What are nursing roles associated with fluid and electrolyte balance?
anticipate, identify, and respond to possible imbalances
What are electrolytes?
active chemicals that carry positive (cations) and negative (anions) electrical charges
What are the major cations?
sodium, potassium, calcium, magnesium, hydrogen ions
What are the major anions?
chloride, bicarbonate, phosphate, sulfate, proteinate ions
What is osmosis?
process of water molecules moving from a less concentrated area to a more
concentrated area
What is diffusion?
solutes move from an area of higher concentration to one of lower concentration
What are routes of gain for fluids?
-drinking and eating
-daily I&O of water are equal
What are routes of losses for fluids?
-kidney: urine output of 1mL/kg/hr
-skin loss: sensible due to sweating and insensible due to fever, exercise, burns
, -lungs: 300mL everyday, greater with increased RR
-GI tract: large losses due to diarrhea and fistulas
What are gerontologic considerations for fluid imbalance?
-clinical manifestations of imbalance may be subtle
-fluid deficit may cause delirium
-decreased cardiac reserve
-reduced renal function
-dehydration is common
-age-related thinning of skin and loss of strength and elasticity
What is fluid volume deficit (hypovolemia?
loss of extracellular fluid exceeds intake ratio of water
-electrolytes lost in same proportion as they exist in normal body fluid
-not the same as dehydration (loss of water alone, with increased serum sodium levels)
What are causes of FVD?
-abnormal fluid loss (vomiting, diarrhea, sweating, GI suctioning)
-decreased intake (nausea, lack of access to fluids)
-third-space fluid shifts (due to burns, ascites)
-additional causes (diabetes insipidus, adrenal insufficiency, hemorrhage)
What are clinical manifestations of FVD?
-can develop rapidly
-severity depends on degree of loss
-dizziness, weakness, drop of blood pressure
-increased BUN (normal 10-20)
