QUESTIONS AND CORRECT ANSWERS
EXPERT REVIEW GRADED A+
⩥ Magnesium.
Answer: - Critical for skeletal muscle contraction, carbohydrate
metabolism, ATP formation, vitamin activation, and cell growth
- May regular blood coagulation and skeletal muscle contractility
⩥ Chloride.
Answer: - Imbalances of chloride usually occur as a result of other
electrolyte imbalances
⩥ Fluid Volume Deficit (FVD).
Answer: - BUN: Elevated
- Serum osmolality: May be normal (isotonic) or elevate (hypertonic)
- RBC, H&H: Elevated if FVD develops rapidly
- Urinalysis: Increased urine specific gravity and osmolality
⩥ Fluid Volume Excess (FVE).
Answer: - BUN: Normal
- Serum osmolality: May be normal or low
,- RBC, H&H: Normal (isotonic) or low (hypotonic)
- Urinalysis: Normal or decreased specific gravity and osmolality
⩥ Nursing diagnosis related to fluid volume deficit.
Answer: - Fluid volume deficit related to
- Electrolyte imbalance related to
- Alteration of LOC related to
- Risk for falls related to
- Altered tissue perfusion related to
- Altered oxygenation related to
⩥ Nursing interventions for fluid volume deficit.
Answer: - Monitor symptoms
- Accurate I&Os
- Maintain IV access
- Watch for s/sx of cerebral edema when replacing fluids
- Monitor serum sodium, urine osmolality, and specific gravity
- Provide safe environement
- Daily weights
- Skin and oral care
⩥ Clinical manifestations of hypervolemia (Fluid volume excess).
, Answer: - Rapid, bounding palse
- Increase in BP
- S3 develops
- Distended neck veins
- Edema
- Sudden wt gain
- SOB
- Crackles
- Pink sputum
- Cough
- Cerebral edema
- BP and cardiac will fall with progression
⩥ Nursing interventions for hypervolemia.
Answer: - Assess vital sigsn and response to treatment
- Monitor respiratory status for worsening distress
- Watch for distended neck or hand veins
- Record I&O, foley if needed
- Restrict fluids PRN
- Assess breath sounds to assess for pulmonary edmea
- Elevate head of bed to facilitate breathing
- Maintain IV access