HURST REVIEW NCLEX RN READINESS EXAM: LATEST A+
QUESTIONS AND ANSWERS EDITION.
How would you treat fluid volume excess?
Give Diuretics (Lasix), fluid restrictions, weigh daily, monitor K+
What can cause a fluid volume deficit
Inadequate fluid intake
hemorrhage
vomiting or diarrhea
massive edema
What are some symptoms of fluid volume deficit
weight loss
oliguria (not enough urine)
postural hypotension
What lab findings may be present with a fluid volume deficit?
Increased BUN
Increased or normal creatinine
Increased H/H
Increased urine specific gravity
How do you treat fluid volume deficits?
Strict I&O
Replace with isotonic fluids
monitor Bp
weight daily
What is most important to remember about intracellular electrolyte balance?
That potassium K+ maintains osmotic pressure and if K+ is not in balance it may be life
threatening.
What is most important to remember about extracellular electrolyte balance?
That sodium Na+ maintains most abundant osmotic pressure. When either the ECF or
the ICF changes in concentration, fluid shifts from the area of lesser concentration to
the area of greater concentration.
, What is Hyponatremia? Symptoms? and How should you treat it
Hyponatremia is a sodium (Na+) level less than 135 mEq/L, it creates Neuro/confusion
and muscle cramps. Check blood pressure often, restrict fluids, and be cautious with IV
fluid replacement.
What is Hypernatremia? What symptoms might you see? How should you treat
it?
Na+ greater than 145 mEq/L
May see:
Pulmonary edema
Neuro: seizures, thirst, fever.
Do Not Use Ivs that contain sodium
Restrict sodium diet
Weigh daily
What is Important to remember about Hypokalemia
Hypokalemia is a K+ level less than 3.5 mEq/L. Affects the cardiac system: The patient
may exhibit a rapid, thready pulse, flat T waves, fatigue, anorexia, and muscle cramps.
Give IV potassium supplements with a max flow rate of 20 meq/hr. Encourage foods
high in K+ (bananas, oranges, spinach, potatoes, milk, strawberries, apricots)
What is Hyperkalemia, what might you see with the patient and how do you treat
it?
Hyperkalemia is a K+ level greater than 5 mEq/L
You may see tall, tented T waves, bradycardia, muscle weakness.
Treatment may include:
- 10%-20% glucose with regular insulin
- Kayexalate
- renal dialysis may be required
What is Hypocalcemia, What might the patient exhibit? How will you treat it?
Hypocalcemia is a Ca2+ level of less than 8.5 meq/L
It affects the muscles: You may see a + Trousseau's sign, + Chvostek's sign, diarrhea,
numbness, and convulsions.
QUESTIONS AND ANSWERS EDITION.
How would you treat fluid volume excess?
Give Diuretics (Lasix), fluid restrictions, weigh daily, monitor K+
What can cause a fluid volume deficit
Inadequate fluid intake
hemorrhage
vomiting or diarrhea
massive edema
What are some symptoms of fluid volume deficit
weight loss
oliguria (not enough urine)
postural hypotension
What lab findings may be present with a fluid volume deficit?
Increased BUN
Increased or normal creatinine
Increased H/H
Increased urine specific gravity
How do you treat fluid volume deficits?
Strict I&O
Replace with isotonic fluids
monitor Bp
weight daily
What is most important to remember about intracellular electrolyte balance?
That potassium K+ maintains osmotic pressure and if K+ is not in balance it may be life
threatening.
What is most important to remember about extracellular electrolyte balance?
That sodium Na+ maintains most abundant osmotic pressure. When either the ECF or
the ICF changes in concentration, fluid shifts from the area of lesser concentration to
the area of greater concentration.
, What is Hyponatremia? Symptoms? and How should you treat it
Hyponatremia is a sodium (Na+) level less than 135 mEq/L, it creates Neuro/confusion
and muscle cramps. Check blood pressure often, restrict fluids, and be cautious with IV
fluid replacement.
What is Hypernatremia? What symptoms might you see? How should you treat
it?
Na+ greater than 145 mEq/L
May see:
Pulmonary edema
Neuro: seizures, thirst, fever.
Do Not Use Ivs that contain sodium
Restrict sodium diet
Weigh daily
What is Important to remember about Hypokalemia
Hypokalemia is a K+ level less than 3.5 mEq/L. Affects the cardiac system: The patient
may exhibit a rapid, thready pulse, flat T waves, fatigue, anorexia, and muscle cramps.
Give IV potassium supplements with a max flow rate of 20 meq/hr. Encourage foods
high in K+ (bananas, oranges, spinach, potatoes, milk, strawberries, apricots)
What is Hyperkalemia, what might you see with the patient and how do you treat
it?
Hyperkalemia is a K+ level greater than 5 mEq/L
You may see tall, tented T waves, bradycardia, muscle weakness.
Treatment may include:
- 10%-20% glucose with regular insulin
- Kayexalate
- renal dialysis may be required
What is Hypocalcemia, What might the patient exhibit? How will you treat it?
Hypocalcemia is a Ca2+ level of less than 8.5 meq/L
It affects the muscles: You may see a + Trousseau's sign, + Chvostek's sign, diarrhea,
numbness, and convulsions.
