Exam 3- Fluid and Electrolytes

Question 1

Phosphate normal value

Answer 1

2.4-4.4 mg/dL

Question 2

Potassium normal value

Answer 2

3.5-5.0 mEq/dL

Question 3

Magnesium normal value

Answer 3

1.5-2.5 mEq/dL

Question 4

Sodium normal value

Answer 4

135-145 mEq/dL

Question 5

Calcium normal value

Answer 5

8.6-10.2 mg/dL

Question 6

Normal urine output

Answer 6

30 mL/hour

Question 7

Serum Osmolality normal

Answer 7

275-295 mOsm/kg

Question 8

Serum osmolality significance

Answer 8

increases in dehydration, decreases with water excess

Question 9

BUN normal

Answer 9

6-20 mg/dL

Question 10

BUN significance

Answer 10

Increases with decreased renal blood flow or decreased urine production, or dehydration
Decreases in pregnancy, overhydration

Question 11

Hematocrit normal (male and female)

Answer 11

male- 39-50%

female- 35-47%

Question 12

Hematocrit significance

Answer 12

Increases in fluid volume deficit

Decreases with normal hemoglobin in the presence of fluid volume excess

Question 13

Creatinine normal

Answer 13

0.6-1.3 mg/100 mL

Question 14

Creatinine significance

Answer 14

Elevated when nephrons are destroyed

Question 15

Serum glucose

Answer 15

70-99 mg/dL

Question 16

Serum glucose significance

Answer 16

High glucose causes osmotic diuresis and fluid volume deficit (encourages increased urine output= losing fluid)

Question 17

Urine osmolality

Answer 17

300-1200 mOsm/L

Question 18

Urine osmolality significance

Answer 18

Shows changes in urine contents but depends on the prior state of hydration
Should be 12x that of serum osmolality. Concentrated urine has osmolality > 1000

Question 19

Urine Specific Gravity normal

Answer 19

1.003-1.030

Question 20

Urine specific gravity significance

Answer 20

Increases with any condition causing hypoperfusion to the kidneys leading to oliguria (dehydration, shock)

Question 21

Hypotonic solutions examples (2)

Answer 21

0.45% Na Cl (1/2 Normal saline), 5% Dextrose in water (D5W),

Question 22

Reason for using hypotonic solutions? Nursing Implications?

Answer 22

• Hypernatremia, good maintenance fluid
• Monitor labs and vitals (may lower BP), monitor I & O, watch for cerebral edema (causes fluid shift from ECF to ICF), dilutes ECF

Question 23

Isotonic solutions examples (4)

Answer 23

0.9% Na Cl (Normal saline), Lactated ringer’s solution, Ringer’s solution, 5% Dextrose in 0.25% Saline

Question 24

Reason for using isotonic solutions? Nursing Implications?

Answer 24

• Normal saline is ideal for fluid and sodium loss
• lactated ringer’s is choice for surgery, burn, GI fluid loss
• Monitor I & O, monitor vitals, lung sounds, edema, monitor labs

Question 25

Hypertonic solutions examples

Answer 25

D5 in 0.45% saline, D5 in 0.9% saline, D10W, 3.0% saline

Question 26

Reason for using hypertonic solutions? Nursing implications?

Answer 26

- Hyponatremia and trauma patients with head injuries | - Monitor for fluid volume overload and sodium levels

Question 27

Colloids examples

Answer 27

Dextran, Albumin 5% or 25%

Question 28

Colloids reasoning

Answer 28

large molecules pull fluid into the blood vessels from interstitial spaces

Question 29

``` ECF deficit: BP? __ RR __ CVP __ Pulse ```

Answer 29

- Postural hypotension - increased RR - Decreased CVP - Increased pulse

Question 30

``` ECF excess: __ pulse __ BP __ CVP Jugular vein? ```

Answer 30

- bounding pulse - increased BP - increased CVP - jugular vein distention

Question 31

HYPOnatremia: __ changes, ___ (older adults) Mucous membranes?

Answer 31

personality changes, confusion | Dry mucous membranes

Question 32

HYPERnatremia: intense ___, mucous membranes? Muscles?

Answer 32

intense thirst, sticky mucous membranes, weakness, muscle cramps