ATI - Fluid Imbalances - 57

Question 1

Fluid volume _____ includes the both isotonic FVD and dehydration.

Answer 1

deficit (FVD)

Question 2

______ is the loss of water and electrolytes from the ECF.

Answer 2

isotonic FVD

Question 3

Isotonic FVD is often referred to as ______ because intravascular fluid is also lost.

Answer 3

hypovolemia

Question 4

______ is the loss of water from the body without the loss of electrolytes.

Answer 4

dehydration

Question 5

This hemoconcentration results in increases in Hct, serum electrolytes, and _____.

Answer 5

urine specific gravity

Question 6

Compensatory mechanisms of _______ include sympathetic nervous system responses of increased thirst, ADH release, and aldosterone release.

Answer 6

fluid volume deficit (FVD)

Question 7

FVD can lead to ______ shock.

Answer 7

hypovolemic

Question 8

Older adults have an increased risk for ______ due to multiple physiological factors including a decrease in total body mass, which includes total body water content and a decrease in ability to detect thirst.

Answer 8

dehydration

Question 9

Risk Factors (causes of isotonic FVD) Hypovolemia

Answer 9

Excessive GI loss: vomiting, nasogastric suctioning, diarrhea
Excessive skin loss: diaporesis
Excessive renal system losses: diurectic therapy, diabetes insipidus, kidney disease, adrenal insufficiency, osmotic diuresis
Third spacing: peritonitis, intestinal obstruction, ascities, burns
Excessive loss of fluids from a wound
Hemorrhage
Altered intake: anorexia, nausea, impaired swallowing, confusion, nothing by mouth (NPO)

Question 10

Risk Factors (causes of dehydration) Hypovolemia

Answer 10

hyperventilation
prolonged fever
diabetic ketoacidosis (DKA)
enteral feeding without sufficient water intake

Question 11

Fluid Volume Deficit (FVD) vital signs

Answer 11

hypothermia
tachycardia
thready pulse
hypotension
orthostatic hypotension
decreased central venous pressure
tachypnea (increased respirations)
hypoxia

Question 12

Fluid Volume Deficit (FVD) neuromusculoskeletal

Answer 12

dizziness
syncope
confusion
weakness
fatigue

Question 13

Fluid Volume Deficit (FVD) GI

Answer 13

thirst
dry mucous membranes
dry furrowed tongue
nausea
vomiting
anorexia
acute weight loss

Question 14

Fluid Volume Deficit (FVD) renal

Answer 14

oliguria (decreased production of urine)

Question 15

Fluid Volume Deficit (FVD) other findings

Answer 15

Diminished capillary refill
Cool clammy skin
Diaphoresis
Sunken eyeballs
Flattened neck veins
Absence of tears
Decreased skin turgor

Question 16

Assessment of skin turgor in the ________ might not provide reliable findings due to a natural loss of skin elasticity.

Answer 16

older adult

Question 17

Laboratory Tests (4) for FVD

Answer 17

Hct
Serum osmolarity
Urine specific gravity
Serum sodium

Question 18

Hct is _____ in both hypovolemia and dehydration unless the fluid volume deficit is due to hemorrhage.

Answer 18

increased

Question 19

With dehydration how is serum osmolarity effected?

Answer 19

Hemoconcentration osmolarity (greater than 295 mOsm/kg); increased protein, BUN, electrolytes, glucose.

Question 20

With dehydration _____ is increased above 1.030.

Answer 20

urine specific gravity

Question 21

With dehydration, serum sodium lab tests reveal an increased ________ (greater than 145 mEq/L).

Answer 21

hemoconcentration

Question 22

Review pg 344 patient centered care list

Answer 22

-

Question 23

_____ includes fluid volume excess (FVE) and overhydration.

Answer 23

fluid volume excesses (FVE)

Question 24

______ is the isotonic retention of water and sodium in high proportions.

Answer 24

fluid volume excess (FVE)

Question 25

FVE is often referred to as _______ because of the resulting increased blood volume.

Answer 25

hypervolemia

Question 26

Overhydration, or _________, is the retention of more water than electrolytes.

Answer 26

hypoosmolar fluid imbalance

Question 27

With overhydration, hemodilution results in _____ in Hct, serum electrolytes, and protein.

Answer 27

decreases

Question 28

Severe FVE can lead to ______ and heart failure.

Answer 28

pulmonary edema

Question 29

With fluid volume excesses (FVE), compensatory mechanisms include an increased release of natriuretic peptides, resulting in increased excretion of sodium and water by the kidneys, and __________.

Answer 29

a decreased release of aldosterone

Question 30

Risk Factors of Hypervolemia (FVD)

Answer 30

Chronic stimulus to the kidney to conserve sodium and water (heart failure, cirrhosis, increased glucocorticosteroids) Altered kiney function with reduced excretion of sodium and water (kidney failure) Interstitial to plasma fluid shifts (hypertonic fluids, burns) Age-related changes in cardiovascular and kidney function Excessive sodium intake from IV fluids, diet or medications (sodium bicarbonate antacids, hypertonic enema solutions)

Question 31

Risk Factors of Overhydration (FVD)

Answer 31

Water replacement without electrolyte replacement (strenuous exercise with profuse diaphoresis) Syndrome of inappropriate antidiuretic hormone (SIADH), which is the excess secretion of ADH Head injuries Barbiturates Anesthetics

Question 32

Expected findings for Fluid Volume Excesses (FVE) vital signs

Answer 32

``` Tachycardia bounding pulse hypertension tachypnea increased central venous pressure ```

Question 33

Expected findings for Fluid Volume Excesses (FVE) - neuromusculoskeletal

Answer 33

confusion | muscle weakness

Question 34

Expected findings for Fluid Volume Excesses (FVE) - GI

Answer 34

weight gain | ascities

Question 35

Expected findings for Fluid Volume Excesses (FVE) - respiratory

Answer 35

dyspnea orthopnea crackles

Question 36

Expected findings for Fluid Volume Excesses (FVE) - other findings

Answer 36

edema | distended neck veins

Question 37

For FVE: Hypervolemia Hct will ______.

Answer 37

decrease

Question 38

For FVE: Overhydration Hct will ______ = hemodiution.

Answer 38

decrease

Question 39

With overhydration osmolarity will be less than _____ mOsm/kg

Answer 39

280

Question 40

With hypervolemia sodium will be _____.

Answer 40

within expected ranges

Question 41

Overhydration/hypervolemia results in decreased electrolytes, _____, and _____.

Answer 41

BUN | creatinine

Question 42

______ can indicate pulmonary congestion involved with FVE.

Answer 42

Chest x-rays

Question 43

With FVE PaCO2 ______(less than 35 mm Hg).

Answer 43

decreased

Question 44

With FVE there urine specific gravity will be ______ (if not due to SIADH)

Answer 44

less than 1.010

Question 45

The blood pH will be _____with FVE.

Answer 45

increased (greater than 7.45) | respiratory alkalosis?

Question 46

p344 nursing care

Answer 46

?