Fluid & Electrolytes 2

Question 1

Hypertonic solution would be used for….

Answer 1

Increased ICP

Question 2

Hypertonic is usually given with..

Answer 2

Diuretic so we do not stress out the heart (b/c hypertonic increases intravascular fluid volume)

Question 3

Hypotonic can cause…

Answer 3

Edema or increased ICP

Question 4

Straight D5W is…

Answer 4

Hypotonic

Question 5

Arterial end of capillaries has a _____ hydrostatic pressure

Answer 5

High

Question 6

Venous end of capillaries has a _____ hydrostatic pressure

Answer 6

Low

Question 7

Oncotic pressure at arterial end

Answer 7

So much fluid that colloids have less of a pull

Question 8

Fluid shift from the plasma to the interstitial space is due to…

Answer 8

High venous hydrostatic pressure
Low plasma oncotic pressure
High interstitial oncotic pressure

Question 9

Fluid shift from the interstitial space to the plasma could be due to…

Answer 9

Low venous hydrostatic pressure (dehydrated)
High plasma oncotic pressure (diabetes, too much salt, urea)
Low interstitial oncotic pressure

Question 10

Reasons for increased plasma oncotic pressure

Answer 10

Therapeutically administered (Mannitol, albumin, hypertonic solutions), hyperglycemia

Question 11

Therapeutic reasons for increased interstitial hydrostatic pressure

Answer 11

Elastic stockings, ted hose

Question 12

Reasons for high venous hydrostatic pressure (plasma –> interstitial space)

Answer 12

Fluid overload
CHF
Liver failure
Obstruction of venous return to the heart 
Varicose veins

Question 13

Reasons for decreased plasma oncotic pressure (plasma –> interstitial space)

Answer 13

Insufficient protein intake
Excessive protein loss (nephrotic syndrome)
Deficient protein synthesis (liver disease)

Question 14

Increased interstitial oncotic pressure could be due to…

Answer 14

Trauma
Burns
?

Question 15

Local effects of plasma –> interstitial space

Answer 15

Rubor (redness) 
Tumor (swelling)
Calor (heat) 
Dolor (pain) 
Functiolaesa (function loss)

Question 16

Systemic effects of plasma –> interstitial space

Answer 16

Malaise / fatigue
Nausea / vomiting
Tachycardia / tachypnea
Fever

Question 17

When the nurse if evaluating the fluid balance for a patient admitted for hypovolemia associated with multiple draining wounds, the most accurate assessment to include is

Answer 17

Daily weight

Question 18

When caring for an alert and oriented elderly patient with a history of dehydration, the home health nurse will teach the patient to increase fluid intake

Answer 18

If the oral mucosa feels dry

Question 19

The home health nurse notes that an elderly patient has a low serum protein level. The nurse will plan to assess for

Answer 19

Edema

Question 20

A patient is receiving 3% NaCl solution for correction of hyponatremia. During administration of the solution, the most important assessment for the nurse to monitor is

Answer 20

Lung sounds 9water retention, fluid volume excess)

Question 21

ADH is released from the..

Answer 21

Posterior pituitary

Question 22

ADH is triggered by..

Answer 22

Decreased H2O
Increased Na
(also stress, narcotics, anesthetics, heat, nicotine, etc)

Question 23

ADH causes..

Answer 23

Kidney reabsorption of H2O

Question 24

Diabetes Insidipus involves..

Answer 24

Too little ADH

Question 25

Diabetes insipidus would be caused by…

Answer 25

A tumor or damage to the pituitary

Question 26

Patients with diabetes insidious will be..

Answer 26

Very thirsty because they urinate frequently

Question 27

SIADH

Answer 27

Too much ADH

Question 28

Major cause of SIADH

Answer 28

Secretion by an oat-cell or small-cell lung cancer

Question 29

Symptoms of SIADH

Answer 29

Hypervolemia symptoms and hyponatremia symptoms

Question 30

Focus of nursing care for diabetes insipidus

Answer 30

Replacing fluids

Monitoring for circulatory collapse

Question 31

Focus of nursing care for SIADH

Answer 31

Skin care, treat underlying cause