lewis ch 16 fluid and electrolytes

Question 1

S+S hypervolemia (6)

Answer 1

• weight gain
• headache, confusion, lethargy
• hypertension
• JVD
• peripheral edema
• pulmonary edema, crackles

Question 2

S+S hypovolemia (6)

Answer 2

• weight loss
• increased heart rate
• increased respiratory rate
• decreased skin turgor and delayed cap refill
• decreased urine output
• restless, drowsy, confusion, seizure, coma

Question 3

possible causes of hypovolemia (3)

Answer 3

• diarrhea
• hemorrhage
• inadequate intake

Question 4

labs that would reflect hypovolemia

Answer 4

• increased urine specific gravity
• increased BUN
• increased Hct to Hgb ratio
• increased RBCs

Question 5

most important nursing diagnosis related to hypervolemia

Answer 5

impaired gas exchange

Question 6

most important nursing diagnosis related to hypovolemia

Answer 6

ineffective tissue perfusion

Question 7

skin assessment and care for hypervolemia

Answer 7

• cool skin
• edema
• decreased perfusion
• care: elevate

Question 8

skin assessment and care for hypovolemia

Answer 8

• cool, moist skin
• dry mucous membranes
• care: mouth care

Question 9

S+S hypernatremia (SALT)

Answer 9

Skin flushed, seizure
Agitation
Low-grade fever
Thirst

Question 10

treatment for hypernatremia

Answer 10

replace fluids

diuretic for excess sodium

Question 11

S+S hyponatremia (SALT LOSS)

Answer 11

Stupor/coma
Anorexia, N/V
Lethargy
Tendon reflexes decreased

Limp muscles
Orthostatic hypertension
Seizure
Stomach cramps

Question 12

treatment for hyponatremia

Answer 12

fluid restriction
loop diuretic
seizure precautions

Question 13

S+S hyperkalemia

Answer 13

• peaked T wave
• abdominal cramping, diarrhea
• weak or paralyzed skeletal muscles
• increased irritability

Question 14

treatment for hyperkalemia

Answer 14

diuretics
kayexelate
dialysis
insulin therapy
give calcium gluconate

Question 15

S+S hypokalemia (A SIC WALT)

Answer 15

Alkalosis

Shallow respirations
Irritability
Confusion, drowsiness

Weakness, fatigue
Arrhythmias
Lethargy
Thready Pulse

Question 16

treatment for hypokalemia

Answer 16

KCl supplements
eat potassium rich foods (banana, OJ, beans, milk, yogurt)
limit licorice intake

Question 17

S+S hypercalcemia

Answer 17

• hallucinations
• seizure, coma
• bone pain, fractures
• polyuria, dehydration

Question 18

S+S hypocalcemia

Answer 18

• laryngeal stridor
• chvostek or trousseau sign
• tingling around mouth

Question 19

treatment hypocalcemia

Answer 19

• rebreathe into paper bag

- oral or IV calcium supplements

Question 20

S+S hyperphosphatemia

Answer 20

• calcified deposits in soft tissue

- neuromuscular irritability and tetany

Question 21

treatment hyperphosphatemia

Answer 21

• diuretics
• adequate hydration
• hemodialysis

Question 22

S+S hypophosphatemia

Answer 22

• CNS depression

- rickets

Question 23

treatment hypophosphatemia

Answer 23

• supplements

- eating foods high in phosphorus

Question 24

S+S hypermagnesemia

Answer 24

• lethargy, drowsiness
• N/V
• impaired reflexes
• respiratory and cardiac arrest

Question 25

treatment hypermagnesemia

Answer 25

• IV CaCl or calcium gluconate
• furosemide
• dialysis

Question 26

S+S hypomagnesemia

Answer 26

• hyperactive reflexes
• tremors, seizures
• hypocalcemia and hypokalemia