N110 EXAM 1 QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS GRADED A++ LATEST UPDATE
Osmolality
the concentration of fluid that affects the movement of water between fluid
compartments by osmosis
Normal serum osmolality value
275 to 290 mOsm/kg water
Normal urine osmolality value
200-800 mOsm/kg water
BUN
blood urea nitrogen.
What determines urine osmolality
urea, creatinine, and uric acid
Osmolarity
the concentration of a solution expressed as the total number of solute particles per
liter.
factors increasing osmolality of serum
severe dehydration. free water loss. diabetes insipidus. hypernatremia. hyperglycemia.
stroke or head injury. renal tubular necrosis. consumption of methanol or ethylene glycol
(antifreeze). high ion gap metabolic acidosis. mannitol therapy. advanced liver disease.
alcoholism. burns.
,factors increasing osmolality of urine
Fluid volume deficit. SIADH. congestive heart failure. acidosis. prerenal failure.
factors decreasing osmolality of serum
fluid volume excess. SIADH. acute kidney injury. diuretic use. adrenal insufficiency.
hyponatremia. overhydration. paraneoplastic syndrom associated with lung cancer.
factors decreasing osmolality of urine
fluid volume excess. diabetes insipidus. hyponatremia. aldosteronism. pyelonephritis.
acute tubular necrosis.
Hypovolemia
(fluid volume deficit). loss of ECF volume exceeds the intake of fluid. water and
electrolytes are lost so not dehydration.
contributing factors for hypovolemia
vomiting, diarrhea, fistulas, fever, excess sweating, burns, blood loss, GI suction, third
space shift, and diabetes insipidus.
signs and symptoms of hypovolemia
weight loss, decreased skin turgor, concentrated urine, cap refill time increase,
decreased blood pressure, flattened neck veins, dizziness, weakness, thirst, confusion,
muscle cramps, increased temp, cool clammy pale skin.
labs findings for hypovolemia
increase hemoglobin and hematocrit, increase in serum and urine osmolality and
specific gravity, increase in BUN and creatinine, increase urine specific gravity and
osmolality, decrease urine sodium
what occurs with GI and renal losses of fluid
, hypokalemia
what occurs with adrenal insufficiency
hyperkalemia
what occurs with increased thirst and ADH release
hyponatremia
what occurs from increaed insensible losses and diabetes insipidus
hypernatremia
nursing management for hypovolemia (FVD)
monitor I&O, vital signs, skin and tongue turgor.
hypervolemia
(fluid volume excess). isotonic expansion of the ECF caused by the abnormal retention
of water and sodium in their normal ratio.
contributing factors for hypervolemia
compromised regulatory mechanisms: kidney injury, heart failure, cirrhosis, fluid shifts,
prolonged corticosteroid therapy, severe stress, and hyperaldosteronism augment fluid
volume excess.
signs and symptoms of hypervolemia
weight gain, peripheral adema, ascites, distended jugular veins, crackles, elevated
CVP, shortness of breath, increase blood pressure, bounding pulse, increase
respiratory rate, increase urine output
lab findings for hypervolemia
decreased hemoglobin and hematocrit. decreased serum and urine osmolality,
decreased urine sodium and specific gravity
COMPLETE SOLUTIONS GRADED A++ LATEST UPDATE
Osmolality
the concentration of fluid that affects the movement of water between fluid
compartments by osmosis
Normal serum osmolality value
275 to 290 mOsm/kg water
Normal urine osmolality value
200-800 mOsm/kg water
BUN
blood urea nitrogen.
What determines urine osmolality
urea, creatinine, and uric acid
Osmolarity
the concentration of a solution expressed as the total number of solute particles per
liter.
factors increasing osmolality of serum
severe dehydration. free water loss. diabetes insipidus. hypernatremia. hyperglycemia.
stroke or head injury. renal tubular necrosis. consumption of methanol or ethylene glycol
(antifreeze). high ion gap metabolic acidosis. mannitol therapy. advanced liver disease.
alcoholism. burns.
,factors increasing osmolality of urine
Fluid volume deficit. SIADH. congestive heart failure. acidosis. prerenal failure.
factors decreasing osmolality of serum
fluid volume excess. SIADH. acute kidney injury. diuretic use. adrenal insufficiency.
hyponatremia. overhydration. paraneoplastic syndrom associated with lung cancer.
factors decreasing osmolality of urine
fluid volume excess. diabetes insipidus. hyponatremia. aldosteronism. pyelonephritis.
acute tubular necrosis.
Hypovolemia
(fluid volume deficit). loss of ECF volume exceeds the intake of fluid. water and
electrolytes are lost so not dehydration.
contributing factors for hypovolemia
vomiting, diarrhea, fistulas, fever, excess sweating, burns, blood loss, GI suction, third
space shift, and diabetes insipidus.
signs and symptoms of hypovolemia
weight loss, decreased skin turgor, concentrated urine, cap refill time increase,
decreased blood pressure, flattened neck veins, dizziness, weakness, thirst, confusion,
muscle cramps, increased temp, cool clammy pale skin.
labs findings for hypovolemia
increase hemoglobin and hematocrit, increase in serum and urine osmolality and
specific gravity, increase in BUN and creatinine, increase urine specific gravity and
osmolality, decrease urine sodium
what occurs with GI and renal losses of fluid
, hypokalemia
what occurs with adrenal insufficiency
hyperkalemia
what occurs with increased thirst and ADH release
hyponatremia
what occurs from increaed insensible losses and diabetes insipidus
hypernatremia
nursing management for hypovolemia (FVD)
monitor I&O, vital signs, skin and tongue turgor.
hypervolemia
(fluid volume excess). isotonic expansion of the ECF caused by the abnormal retention
of water and sodium in their normal ratio.
contributing factors for hypervolemia
compromised regulatory mechanisms: kidney injury, heart failure, cirrhosis, fluid shifts,
prolonged corticosteroid therapy, severe stress, and hyperaldosteronism augment fluid
volume excess.
signs and symptoms of hypervolemia
weight gain, peripheral adema, ascites, distended jugular veins, crackles, elevated
CVP, shortness of breath, increase blood pressure, bounding pulse, increase
respiratory rate, increase urine output
lab findings for hypervolemia
decreased hemoglobin and hematocrit. decreased serum and urine osmolality,
decreased urine sodium and specific gravity
