NUR 112 Exam 1

Question 1

Furosemide (Lasix) Direct IV
dilute? With what?
Rate in mg/min

Answer 1

administer UNdiluted

20mg/min

Question 2

Lorazepam (Ativan) Direct IV
dilute? With what?
Rate in mg/min

Answer 2

Dilute 
with equivalent amount of:
1. sterile H2O for injection
2. D5W
3. 0.9% NS for injection
2 mg/min

Question 3

Morphine Direct IV
dilute? With what? (Davis differs from hospital protocols)
Rate in mg/min

Answer 3

Davis: Dilute with at least 5 mL of:
1. 0.9% NS for injection
2. Sterile H2O for injection
 Hospital Protocol:administer UNdiluted
2.5 - 15 mg over 5 min

Question 4

What does ANP do with regard to Na+, H2O?

Answer 4

promotes excretion of Na+

H2O follows Na+ so H2O removed from body

Question 5

What is effect of ANP on Blood Volume and BP?

Answer 5

decrease BV

decrease BP

Question 6

Functions of aldosterone
1. Na+
2.K+
Produced in response to 1. 2. 3. 4.

Answer 6

1. Na+ retained
2. K+ excreted
3. decreased renal perfusion (BV) sensed by kidney
4. dec Na+ sensed by kidney
5. inc. plasma K+
6. Dec plasma Na+

Question 7

ADH

1. made in the _____________?
2. stored in the _______________?
3. Released in response to (2 bio) (2 drugs)?
4. Function______________

Answer 7

1. hypothalamus
2. Post. pituitary
   3 low plasma osmolality, stress, nicotine, morphine.
3. causes kidneys to reabsorb H2O

Question 8

1. What is SIADH?
2. state 2 causes
3. what happens in body?
4. Result of SIADH on: plasma osmolality?
5. Urine production?
6. Urine osmolality?

Answer 8

1. syndrome of inappropriate anti-diuretic hormone release.
2. Brain injury, small cell lung cancer
3. too much ADH = H2O RETENTION
4. Decrease
5. Decrease
6. Increase

Question 9

Reduction in ADH leads to which metabolic disorder?

list 2 main s/s

Answer 9

Diabetes insipidus
polyuria
polydipsia (thirst)

Question 10

What is: 1. first spacing?

2. second spacing?
3. third spacing?
4. eg of 3rd spacing

Answer 10

1. normal distribution of ECF/ICF
2. abnormal accumulation of IF (edema)
3. fluid is trapped and unavailable for functional use. Fluid accumulates in part of body where it is not easily exchanged with ECF.
4. ascites (many others…)

Question 11

Main cation in ECF?

Main anion in ECF?

Answer 11

Na+

Cl-

Question 12

Main cation in ICF?

Main anion in ICF?

Answer 12

K+

PO4 3-

Question 13

Other cations found in ECF & ICF in small amounts

Answer 13

Ca2+, Mg2+

Question 14

Other anions found in ICF (2)

Answer 14

Protein, HCO3-

Question 15

Other anions found in ECF (4)

Answer 15

protein, HCO3-, SO4-, PO4 3-

Question 16

Define simple diffusion

Answer 16

movement of solute from area of high concentration to area of low concentration until equilibrium.

Question 17

define facilitated diffusion

give example of substance moving this way

Answer 17

uses carrier molecule to achieve movement of solute from area of high concentration to area of low concentration until equilibrium.
e.g. glucose into cell

Question 18

define active transport

Answer 18

movement of solute against concentration gradient, requires energy.

Question 19

osmosis

Answer 19

movement of water molecules from area of high concentration of water to area of low concentration of water across a selectively permeable membrane until equilibrium of water.

Question 20

1. osmo__________ refers to fluids inside the body

2. osmo__________ refers to fluids outside the body

Answer 20

1. osmolality

2. osmolarity

Question 21

normal plasma osmolality per pagana

Answer 21

285 - 295 mOsm/kg

Question 22

2 substances that determine plasma osmolality

Answer 22

Na+

glucose

Question 23

What % (fraction) of total body fluid is:

1. ICF
2. ECF

Answer 23

1. 2/3

2. 1/3

Question 24

What % of ECF is:

1. transcellular
2. interstitial
3. intravascular

Answer 24

1. negligible
2. 2/3 (includes lymph)
3. 1/3 (plasma)

Question 25

List 2 examples of transcellular fluids

Answer 25

cerebrospinal fluid GI fluid pleural synovial + others.... see Lewis chp 17

Question 26

1. What is hydrostatic pressure (in the body) and what does it do? 2. Is hydrostatic pressure greater at arterial or venous end of capillary?

Answer 26

1. pressure in blood vessels generated by contraction of heart. forces fluid from ECF vascular system out of capillary to interstitium to allow exchange with intracellular fluid. 2. 40 mmHg at arterial end 10 mmHg at venous end.

Question 27

1. What is oncotic (colloidal osmotic pressure)? | 2. What is its function in capillaries?

Answer 27

1. osmotic pressure exerted by colloids in solution (proteins) 2. Protein found in ECF pulls fluid from interstitium back into capillaries at venous end (v. little protein in interstitium relative to intravascular)

Question 28

Fluid shifts: 1. Plasma to interstitium results in ______? 2. Caused by ____________ in hydrostatic pressure at venous end.

Answer 28

1. edema | 2. increase (reduces amount of fluid moving from interstitium to capillary)

Question 29

Causes of edema due to increase in hydrostatic pressure (5)

Answer 29

1. fluid overload 2. heart failure 3. liver failure 4. thrombosis, tourniquets, restrictive clothing (obstruction of venous return to heart) 5. varicose veins (venous insufficiency)

Question 30

2 other causes of edema related to shift of fluid from plasma to interstitium.

Answer 30

1. dec in plasma oncotic pressure (P is too low to pull fluid back into capillary) low plasma proteins caused by renal disorders, liver disease, malnutrition 2. inc in interstitial oncotic pressure due to accumulation of plasma protein in IF as result of trauma, burns.

Question 31

Shift of interstitial fluid to plasma caused by______ (2)

Answer 31

admin of colloids | admin hypertonic IV

Question 32

Hypertonic solution effects on brain cells?

Answer 32

pulls H2O out of cells - crenate, brain cells shrink - altered CNS responses

Question 33

Hypotonic solution effects on brain cells?

Answer 33

pushes H2O into cells - swell brain cells - altered CNS response

Question 34

Values per pagana: 1. Na+ 2. Cl- 3. PO4 3- 4. K+ 5. HCO3-

Answer 34

1. 135- 146 2. 98-106 3. 3- 4.5 4. 3.5- 5 5. 21- 28

Question 35

Values per pagana: 1. Mg2+ 2. Ca2+

Answer 35

1. 1.3 - 2.1 | 2. 9 - 10.5