ULTIMATE CLINICAL TEST BANK (Galen
College of Nursing Verified) | ACTUAL
EXAM with 500+ REAL PATIENT
SCENARIOS & STEP-BY-STEP
RATIONALES | Includes NGN
PRIORITIZATION MODULES + COMPLEX
CARE PLANS + NCLEX®-STYLE CRITICAL
THINKING QUESTIONS + RATIONALES
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NSG 3800 – Med/Surg Adult Health II: Exam 1
Unit 1
Chapter 10
Fluid and Electrolytes
Distribution of body weight (don’t need to know percentages) - pg. 225
How do we tell the fluid status of the person?
- Skin turgor (checked at the clavicle), mucous membranes, over skin
tone
- If dehydrated, lethargic, low BP, tachycardia o BNP labs, metabolic
panel, acid-base, electrolytes o BUN labs (pg. 230) ***
Looking at waste product after we metabolize protein
(BUN is a solute) ***
Normal – 10-20mg/dL o Creatinine (pg. 230)
Muscle metabolism (better indicator of kidney function
than BUN, it’s more stable) Normal – book: 0.7-1.4mg/dL
– if it is higher, indicates kidney failure ?
• M – 0.6-1.2mg/dL
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• F – 0.5-1.1mg/dL
o Hematocrit ***
Normal
• M – 42-52%
• F – 37-47%
Percent of RBC in our floating circulating blood
• Higher level – dehydration ***
• Lower level– overhydrated
o Sodium (Na) (pg. 239, table 10.6) *
Sodium is higher outside, potassium is higher inside
the cell
Normal – 135-145mEq/L *
• High level – dehydrated
• Low level – overhydrated
Signs and symptoms of hyponatremia and
hypernatremia ***
• What is papilledema o Optic nerve swells
o Serum (blood) osmolality (pg. ) Normal 285-295
mOsm/kg H2O **
Measures solutes: sodium, BUN, glucose o Specific
gravity in urine – most likely to be used
Normal 1.005-1.030 ***
Measures solutes: sodium, BUN, glucose o
Potassium (pg. 243) ** Normal 3.5-5mEq/L
High level – higher, tented, peaked T wave
Low level – flattened T waves
- Electrolytes to know ** o Sodium – 135-145mEq/L o Potassium –
3.5-5mEq/L o Calcium – 9.10.5mg/dL
o Creatinine – 0.7-1.4mg/dL (general)
M – 0.6-1.2mg/dL
F – 0.5-1.1mg/dL o Magnesium – 1.5-2.5mEq/L o
Phosphorus (think kidneys)
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- Table 10.7 **** o Signs and symptoms o What can cause it
- Pg. 248
Important to Know
- Paresthesia – nerve related – calcium helps with nerve conduction
- High BP and high pulse, pt. given calcium-channel blockers
Hypocalcemia
- Low BP, weak pulse – w/ hypocalcemia
- Chvostek sign – tap cheek, lip bounces up towards that side (that is a
positive sign)
- Trousseau sign – blood pressure taken and their hand curls up (this is
a positive sign) o Tetany (pg. 248)
- Causes
o Metastatic cancers (moves calcium to bones) o
Phosphorus sponge (chronic kidney disease) o Poor
function parathyroid hormone
- Treatment *** more notes o Consume calcium rich foods (dairy,
leafy greens, broccoli, fish with bones (salmon))
Hypercalcemia (pg. 251)
- Signs and symptoms o Anorexia o Nausea and abd pain o Muscle
weakness o Oliguria
o Confusion o Renal calculi o Pathologic fractures
o Dysrhythmias/cardiac arrest
- Causes
o Too many antacids
o Bone disorders/fractures (moves calcium FROM the
bone)
- Treatment
o Diuretics (excrete calcium) o Fluid intake of 3-4 liters per
day