Chapter 3 - Fluid & Electrolyte Imbalance

Question 1

What is epidemiology?

Answer 1

Study of distribution and determinants of disease, injury and other health related outcomes.

Question 2

Which cancer has the highest incidence in men and women?

Answer 2

Colorectal cancer

Question 3

What is colorectal cancer?

Answer 3

A malignant tumour that starts in the bowel wall.

Question 4

Aetiology of colorectal cancer…

Answer 4

Hereditary and environmental factors.

Question 5

Name a prophylactic anticoagulant

Answer 5

Enoxaparin sodium

Question 6

Name a phrophylactic antibiotic

Answer 6

Metronidazole IV

Cephalothin IV

Question 7

What is a partial colectomy

Answer 7

Removal of a section of the large bowel

Question 8

PCA - stands for

Answer 8

Patient controlled analgesia

Question 9

IVT stands for -

Answer 9

Intravenous therapy

Question 10

Fluid challenge:

Answer 10

Administration of a large amount of IV fluids over a short period of time under close monitoring to evaluate patients response

Question 11

Bellovac:

Answer 11

Vacuum drain

Question 12

IDC stands for:

Answer 12

Indwelling catheter

Question 13

Stoma:

Answer 13

An opening into the body from the outside created by a surgeon

Question 14

BGL:

Answer 14

Blood glucose level

Question 15

When a persons glomerular filtration rate drops:

Answer 15

The juxtaglomerular cells in the kidney respond by secreting renin

Question 16

Antidiuretic hormone is secreted:

Answer 16

By the posterior pituitary gland in response to increased serum osmolality

Question 17

Oliguria:

Answer 17

Is defined as less than 30mL per hour of urine excretion and, left untreated, may lead to AKI

Question 18

When assessing a patients fluid status, which observations are most important?

Answer 18

Urine output, blood pressure, weight

Question 19

Insensible fluid loss occurs through all of the following except:

• Skin
• Lungs
• Kidneys
• Gastrointestinal tract

Answer 19

Kidneys

Question 20

Extracellular fluid loss refers to fluid loss from the interstitial fluid compartment and/or:

Answer 20

Intracellular compartment

Question 21

In assessing a patient with dehydration, you would expect the urine output to be:

Answer 21

Increased with elevated specific gravity

Question 22

A third-space fluid shift may occur as a result of all of the following except:

• Hypoalbuminaemia
• An allergic reaction
• Hypertension
• Hypovolemia

Answer 22

Hypoalbuminaemia

Question 23

Which of the following are considered “normal parameters”?

• Temp 37
• Pulse 112
• RR 22
• BP 90/50

Answer 23

Temp & Resp rate

Question 24

Normal oxygen saturation would be:

Answer 24

95-100%

Question 25

With an IDC insitu, for a grown man (Mr Barrett) normal urine output would be at least:

Answer 25

41mL per hour (35-40mL) adequate

Question 26

A normal BGL would be:

Answer 26

4-8mmol/L

Question 27

Cues most relevant for fluid status...

Answer 27

Blood pressure Pulse Conditions of oral mucosa Urine output

Question 28

Ascertainmemt bias and ageism example:

Answer 28

“Just what we need today, another one with dementia”!

Question 29

Pathophysiology-

Answer 29

Explains the process within the body that results in functional changes in the body from a disease

Question 30

When the inflammatory stage of wound resolves (24-48 hours post-operatively), what are the possible consequences for your patients ‘fluid status’?

Answer 30

1. Plasma from the interstitial compartment typically returns to the circulating blood volume. 2. Significant increases in blood volume add to likelihood of hypervolaemia. 3. The third-space fluid shift resolves, resulting in increased blood volume.

Question 31

Type 2 diabetes can influence fluid balance...

Answer 31

- Diabetes can cause impaired renal function | - hyperglycaemia results in increased serum osmolarity, resulting in excessive diuresis..

Question 32

Confusion in the post-operative person can result from the following.

Answer 32

``` Constipation UTI Pain Delirium Dementia Fluid imbalance Electrolyte imbalance Infection Hypoxia ```

Question 33

Fluid shifts can contribute to tachypnoea because:

Answer 33

Fluid shifts in the alveolar spaces can impact on oxygenation levels.

Question 34

Alternated sodium (Na+) levels...

Answer 34

Decreased sodium concentration can be a consequence of over-hydration.

Question 35

Older people are at risk of fluid imbalance because they have an increased likelihood of all of the following:

Answer 35

Impaired renal function Chronic dehydration Malnutrition Decreased cardiac function

Question 36

What are normal levels of serum sodium?

Answer 36

135-145mmol/L

Question 37

What are normal levels of serum potassium?

Answer 37

3.8-4.9mmol/L

Question 38

Hyponatraemia can cause:

Answer 38

``` Confusion Headaches Nausea and vomiting Abdominal cramps Muscle weakness ```

Question 39

Some signs and symptoms of hyponatraemia:

Answer 39

Confusion Headache Nausea and vomiting

Question 40

Hypokalaemia can cause:

Answer 40

``` Irregular pulse Arrhythmias Cardiac arrest Decreased bowel sounds Cramps Polyuria Muscle weakness ```

Question 41

CKD risk factors

Answer 41

``` Diabetes High BP Age over 60 Smoking Obesity Family hx Aboriginal Established cardiovascular disease ```