NUR242 EXAM 2 GALEN QUESTIONS WITH CORRECT ANSWERS 2025

NUR242 EXAM 2 GALEN QUESTIONS
WITH CORRECT ANSWERS 2025
CausesZofZfluidZoverloadZ-ZCORRECTZANSWERZ-•ExcessiveZfluidZreplacement

•KidneyZfailureZ(lateZphase)

•HeartZfailure

•LongZtermZcorticosteroidZtherapy

•SyndromeZofZinappropriateZantidiureticZhormoneZ(SIADH)

•PsychiatricZdisordersZwithZpolydipsia

•WaterZintoxication



s/sZfluidZoverloadZ-ZCORRECTZANSWERZ-
•CV:Ztachycardia,ZboundingZpulse,ZHTN,ZdecreaseZpulseZpressure,ZJVD,ZweightZgain

•Resp:ZincreaseZandZshallowZresp;ZSOB,ZcracklesZlungZsounds

•Skin:ZpittingZedema,ZskinZpaleZandZcoolZtoZtouch

•Neuromuscular:ZLOC,ZHA,ZvisualZdisturbance,ZmuscleZweakness,Zparesthesia

•GI:ZincreaseZmotility,ZenlargeZliver



AssessmentZforZfluidZoverloadZ-ZCORRECTZANSWERZ-
•AssessZriskZr/tZageZandZdiagnosis,ZhistoryZ(overhydration,ZCHF,ZkidneyZdisease)

•AssessZvitalZsignsZwhy:ZwatchZforZboundingZtachycardia,ZHTN,Zdysrhythmias,Ztachypnea

•AssessZlungZsoundsZ(crackles)Z,Zweight,ZLOC,ZObserveZJVD

•AssessZlabZvalues:ZelectrolytesZimbalanceZandZsignsZandZsymptoms

•ZFocusZAssessment:Zskin/extremities/ZabdomenZandZsacrumZareaZforZedema

•AssessZperfusion:ZedemaZmayZimpairZperfusionZtoZextremities,ZassessZperipheralZandZcentralZpulses,Zcapil
laryZrefill,ZskinZcolor,Ztemp,ZsensoryZandZmotorZfunction

•ObserveZforZurineZoutput



LabZvaluesZfluidZoverloadZ-ZCORRECTZANSWERZ-•SerumZosmolalityZ(275-295ZmOsm/kg)

•DecreaseZfoundZinZoverhydrationZ<275;ZandZ<Z265ZisZcriticalZfinding

,•CBC

•DecreaseZhemoglobinZandZhematocrit

•BUN

•decreasedZBUN

•Electrolytes

•DecreasedZsodiumZ(shiftsZdueZtoZdilution)

•UrineZspecificZgravityZDecreaseZ<Z1.005



fluidZoverloadZinterventions/goalZ-ZCORRECTZANSWERZ-
•Goal:ZreduceZexcessZbodyZfluids,ZpromoteZdesiredZelimination

•ManageZunderlyingZcause

•RestrictZdietaryZsodiumZintake

•MonitorZI/O

•AdministerZdiuretic

•MonitorZclient'sZs/sZandZelectrolytesZvalues

•RestrictZoralZandZotherZfluidZintakeZasZprescribed



FluidZoverloadZcomplicationsZ-ZCORRECTZANSWERZ-•IsotonicZoverhydration

•HFZandZpulmonaryZedema

•Seizure

•Coma



FluidZoverloadZmedicationsZ-ZCORRECTZANSWERZ-Furosemide

Mannitol



S/SZofZdehydrationZ-ZCORRECTZANSWERZ-
•VitalZsigns:Zhyperthermia,ZST,ZthreadZpulse,Zhypotension,ZdecreaseZCVP

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

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

, •Renal:ZOliguria

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



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




DehydrationZlabsZ-ZCORRECTZANSWERZ-•SerumZelectrolytesZ(hypernatremia)

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



•CBCZelevatedZH/H

•ElevatedZurineZspecificZgravityZ>Z1.030

•IncreasedZBUN



DehydrationZinterventions/goalZ-ZCORRECTZANSWERZ-
•GoalZofZinterventions:ZreplaceZfluidZandZelectrolytesZtoZachieveZhomeostasis

•CloselyZmonitorZstatusZandZrehydration,ZavoidZovercorrection

•MonitorZI/OZandZweight

•IdentifyZandZmanageZcause-Zdiarrhea,Zvomiting,ZbloodZloss,ZpoorZintake

•OralZrehydrationZisZpriorityZifZtoleratingZPOZfluids



DehydrationZpriorityZinterventionsZ-ZCORRECTZANSWERZ-
•IVZfluidZresuscitation/replacement,ZgeneralZguidelines

•HypertonicZdehydration-ZhypotonicZfluids-
ZD5WZonceZdextroseZisZmetabolized;Z0.45%ZNaCLZ(1/2ZnormalZsaline)



•IsotonicZdehydration:ZisotonicZfluidsZ(normalZsaline,ZlactatedZringers)

•HypotonicZdehydration:ZhypertonicZfluidsZ(3%ZorZ5%ZsalineZsolution)

•BloodZproductsZinZincreasedZbloodZloss/trauma

•MedicationsZtoZtreatZcause:Zantidiarrheal,ZantiZemetic,ZAB,Zantipyretics

•IngestionZofZfoodZtoZreplaceZelectrolytes