Fluid and Electrolyte Balance (Lecture ?'s)

Question 1

Which of the following are principal electrolytes in ECF?

1. ) Potassium 2.) Bicarbonate
2. ) Sodium 4.) Sulfate
3. ) Magnesium 6.) Chloride
4. ) Phosphate

Answer 1

ECF

Sodium, Chloride, and Bicarbonate

Na⁺, Cl^-, HCO₃^-

Question 2

Which of the following are principal electrolytes in ICF?

1. ) Potassium 2.) Bicarbonate
2. ) Sodium 4.) Sulfate
3. ) Magnesium 6.) Chloride
4. ) Phosphate

Answer 2

ICF

Potassium, Magnesium, Phosphate, Sulfate

K⁺, Mg²⁺, PO₄^3-, SO₄^2-

Question 3

Higher osmolality than body fluids.

Answer 3

Hypertonic

• Higher osmolality than body fluids.
• Draw fluid out of intracellular and interstitial expanding vascular volume.

Question 4

Draw fluid out of intracellular and interstitial expanding vascular volume.

Answer 4

Hypertonic

• Higher osmolality than body fluids.
• Draw fluid out of intracellular and interstitial expanding vascular volume.

Question 5

Lower osmolality than body fluids.

Answer 5

Hypotonic

• Lower osmolality than body fluids.
• Treat cellular dehydration.

Question 6

Treat cellular dehydration.

Answer 6

Hypotonic

• Lower osmolality than body fluids.
• Treat cellular dehydration.

Question 7

Movement from higher concentration to lower concentration.

a. ) Diffusion
b. ) Osmosis
c. ) Active Transport
d. ) Filtration

Answer 7

a.) Diffusion

Question 8

Movement of fluid and solutes together from an area of higher pressure to an area of lower pressure.

a. ) Diffusion
b. ) Osmosis
c. ) Active Transport
d. ) Filtration

Answer 8

d.) Filtration

(osmotic pressure & hydrostatic pressure)

Question 9

From less concentrated to more concentrated.

a. ) Diffusion
b. ) Osmosis
c. ) Active Transport
d. ) Filtration

Answer 9

c.) Active Transport

Question 10

Water moves to a higher concentrated area.

a. ) Diffusion
b. ) Osmosis
c. ) Active Transport
d. ) Filtration

Answer 10

b.) Osmosis

Question 11

0.9% saline solution would be _______.

a. ) isotonic
b. ) hypertonic
c. ) hypotonic

Answer 11

a.) isotonic

Question 12

3% saline solution would be _______.

a. ) isotonic
b. ) hypertonic
c. ) hypotonic

Answer 12

b.) hypertonic

Question 13

0.45% saline solution would be _______.

a. ) isotonic
b. ) hypertonic
c. ) hypotonic

Answer 13

c.) hypotonic

Question 14

Think brain.

a. ) Sodium (Na⁺)
b. ) Potassium (K⁺)
c. ) Calcium (Ca²⁺)
d. ) Magnesium (Mg²⁺)

Answer 14

a.) Sodium (Na⁺)

Normal serum sodium levels = 135 - 145 mEq/L

Question 15

Think heart.

a. ) Sodium (Na⁺)
b. ) Potassium (K⁺)
c. ) Calcium (Ca²⁺)
d. ) Magnesium (Mg²⁺)

Answer 15

b.) Potassium (K⁺)

Normal serum potassium levels = 3.5 - 5 mEq/L

Question 16

Think bones.

a. ) Sodium (Na⁺)
b. ) Potassium (K⁺)
c. ) Calcium (Ca²⁺)
d. ) Magnesium (Mg²⁺)

Answer 16

c.) Calcium (Ca²⁺)

Normal lab values:

8.5 - 10.5 mg/dL total serum bound

4 - 5 mg/dL ionized / unbound

Question 17

Think brain.

a. ) Sodium (Na⁺)
b. ) Potassium (K⁺)
c. ) Calcium (Ca²⁺)
d. ) Magnesium (Mg²⁺)

Question 18

a. ) Sodium (Na⁺)
b. ) Potassium (K⁺)
c. ) Calcium (Ca²⁺)
d. ) Magnesium (Mg²⁺)

Question 19

Which of the following is not one of the roles of water in the human body?

A. Serves as medium for metabolic reactions with cells

B. Is a transporter of waste products

C. Acts as insulator & shock absorber

D. Helps maintain and regulate body temperature

E. Nutrition

Answer 19

E. Nutrition

Question 20

What Percentage of the body is water:

A- 10%

B- 20%

C- 40%

D- 60%

Answer 20

D- 60%

Question 21

Giving a hypertonic IV solution to a client may cause too much fluid to be:

A. Pulled from the cells into the bloodstream, which may cause the cells to shrink

B. Pulled out of the bloodstream into the cells

C. Pushed out of the bloodstream into the extravascular spaces

D. Pulled from the cells into the bloodstream which may cause the cells to increase in size

Answer 21

A. Pulled from the cells into the bloodstream, which may cause the cells to shrink

Question 22

Which foods would you include when giving a client a list of foods to avoid on a low sodium diet?

A. bananas, peaches and broccoli

B. red meat, chicken and pork

C. milk, nuts and liver

D. canned soups, ketchup and cheese

Answer 22

D. canned soups, ketchup and cheese

Question 23

When administering IV potassium via IV push for severe hypokalemia you should

A. NEVER administer potassium IV push

B. add potassium to whichever fluids are hanging

C. Push at a rate of 2ml/minute

D. Use gravity flow and calculate appropriate drip rate rather than using a pump

Answer 23

A. NEVER administer potassium IV push

Question 24

An older man is admitted to the medical unit with a diagnosis of dehydration. Which sign or symptom is most representative of a sodium imbalance

A. Hyperreflexia

B. Mental Confusion

C. Irregular Pulse

D. Muscle Weakness

Answer 24

B. Mental Confusion

Question 25

An older nursing home resident has refused to eat or drink for several days and is admitted to the hospital. The nurse should expect which assessment finding. A. Increased blood pressure B. Weak, rapid pulse C. Moist mucous membranes D. Jugular Vein distention

Answer 25

B. Weak, rapid pulse

Question 26

Which individual would least likely suffer from a disturbance in fluid volume, electrolyte, or acid-base balance A. A Client suffering from type 1 decubitus B. An infant suffering from gastroenteritis C. Adults with impaired cardiac function D. Clients who are confused

Answer 26

A. A Client suffering from type 1 decubitus

Question 27

Measurements related to fluid balance of clients that a nurse can initiate without a physician's order include: A. Daily weights, diuretics, waist measurement B. Daily weights, vital signs, and fluid intake and output C. Temperature, fluid intake and output, calorie count D. Auscultating lung sounds, monitoring color of urine, inserting a foley catheter.

Answer 27

B. Daily weights, vital signs, and fluid intake and output

Question 28

Occurs when water is lost from the body leaving sodium behind. Leads to an increase in serum osmolality and serum sodium. ## Footnote a. ) Fluid volume deficit (FVD) b. ) Fluid volume excess (FVE) c. ) Dehydration d. ) Overhydration

Answer 28

c.) Dehydration

Question 29

Loss of both water and electrolytes from the ECF in similar proportions. ## Footnote a. ) Fluid volume deficit (FVD) b. ) Fluid volume excess (FVE) c. ) Dehydration d. ) Overhydration

Answer 29

a.) Fluid volume deficit (FVD) ## Footnote *AKA hypovolemia*

Question 30

Occurs when the body retains both water and sodium in similar proportions to normal ECF. ## Footnote a. ) Fluid volume deficit (FVD) b. ) Fluid volume excess (FVE) c. ) Dehydration d. ) Overhydration

Answer 30

b.) Fluid volume excess (FVE) ## Footnote *Always secondary to an increase in total body sodium*

Question 31

The nurse is admitting a new client, 80 years old, with congestive heart failure into your home health agency. The following assessment findings have been determined after meeting the client: overweight but no gain since the client left the hospital two days ago; VS: T 99.0, HR 100, R 22, BP 130/86. Foods eaten include canned soup at each meal, ham, and cheese. When completing the care plan for this client, the nurse should include which of the following nursing diagnosis: A. Improved gas exchange B. Risk for fluid volume deficit C. Impaired skin integrity D. Risk for Fluid Volume Imbalance

Answer 31

D. Risk for Fluid Volume Imbalance

Question 32

Occurs when water is gained in excess of electrolytes. Water is drawn into the cells causing them to swell. ## Footnote a. ) Fluid volume deficit (FVD) b. ) Fluid volume excess (FVE) c. ) Dehydration d. ) Overhydration

Answer 32

d.) Overhydration