QUIZ 2: FLUID VOLUME DEFICIT

Question 1

There are different fluid volume disturbances that may affect an individual.

Answer 1

Fluid volume disturbances

Question 2

occurs when loss of ECF volume exceeds the intake of fluid.

Answer 2

Fluid volume deficit

Question 3

refers to an isotonic volume expansion of the ECF caused by the abnormal retention of water and sodium in approximately the same proportions in which they normally exist in the ECF.

Answer 3

Fluid volume excess

Question 4

refers to a serum sodium level that is less than 135 mEq/L

Answer 4

Hyponatremia

Question 5

is a serum sodium level higher than 145 mEq/L.

Answer 5

Hypernatremia

Question 6

usually indicates a deficit in total potassium stores.

Answer 6

Hypokalemia

Question 7

refers to a potassium level greater than 5.0 mEq/L.

Answer 7

Hyperkalemia

Question 8

CALCIUM levels below 8.6 mg/di.

Answer 8

Hypocalcemia

Question 9

is a calcium level greater than 10.2 mg/dl.

Answer 9

Hypercalcemia

Question 10

refers to a below-normal serum magnesium concentration.

Answer 10

Hypomagnesemia

Question 11

is a serum phosphorus level that exceeds 4.5 mg/di in adults.

Answer 11

Hyperphosphatemia

Question 12

Disturbances in electrolyte balances

Answer 12

Hyponatremia
Hypernatremia
Hypokalemia
Hyperkalemia
Hypocalcemia
Hypercalcemia
Hypomagnesemia
Hypermagnesemia
Hypophosphatemia
Hyperphosphatemia

Question 13

Complications of fluid and electrolyte imbalances

DCSC

Answer 13

Dehydration
Cardiac overload
Siadh / syndrome of inappropriate secretion of antidiuretic hormone
Cardiac arrest

Question 14

Fluid volume deficit would result in dehydration of the body tissues.

Answer 14

Dehydration

Question 15

Fluid volume excess could result in cardiac overload if left untreated.

Answer 15

Cardiac overload

Question 16

Siadh MEANING

Answer 16

syndrome of inappropriate secretion of antidiuretic hormone- is a disorder of impaired water excretion caused by the inability to suppress the secretion of antidiuretic hormone (adh).

Question 17

Assessment and diagnostic findings

Answer 17

BUN .
Hematocrit
Physical examination
Serum electrolyte levels.
ECG.
ABG

Question 18

Medical Management

Answer 18

Isotonic electrolyte solutions.
Accurate I&O.
Dialysis
Nutritional Therapy

Question 19

Pharmacologic therapy

Answer 19

AVP receptor agonists.
Diuretics.
IV calcium gluconate.
Calcitonin.

Question 20

is also a potent vasoconstrictor and exerts a direct constrictive action on specific smooth muscle receptors

Answer 20

Vasopressin

Question 21

Nursing management

Answer 21

Close monitoring
I&O.
Daily weight. Assess the patient’s weight daily to measure any gains or losses.
Vital signs.
Physical exam. Physical exam is needed to reinforce other data about a fluid or electrolyte imbalance.

Question 22

Nursing diagnosis

Answer 22

• Excess fluid volume related to excess fluid intake and sodium intake.
• Deficient fluid volume related to active fluid loss or failure of regulatory mechanisms.
• Imbalanced nutrition: less than body requirements related to inability to ingest food or absorb nutrients.
• Imbalanced nutrition: more than body requirements related to excessive intake.

Question 23

Nursing interventions for fluid & electrolyte imbalances

Answer 23

Monitor turgor.
Urine concentration.
Oral and parenteral fluids.
Oral rehydration solutions.
Central nervous system changes.
Diet.

Question 24

occurs when loss of extracellular fluid exceeds the intake of fluid.

Answer 24

Hypovolemia

Question 25

It is a state or condition where the fluid output exceeds the fluid intake. It occurs when the body loses both water and electrolytes from the ECF in similar proportions.

Answer 25

Hypovolemia

Question 26

Predisposing factors: Hypovolemia DAOHCT

Answer 26

Diabetes Insipidus Adrenal insufficiency Osmotic diuresis Hemorrhage Coma Third-space fluid shifts

Question 27

Signs and symptoms: hypovolemia LTDOCIADC

Answer 27

Low BP (Postural hypotension) Tachycardia: rapid weak & thready pulse Decreased skin turgor Oliguria Concentrated urine Flattened neck veins Increased temperature Acute weight loss Decreased central venous pressure Cool, clammy skin (due to peripheral vasoconstriction

Question 28

Signs and symptoms (Infant and young children) CNBIS

Answer 28

Crying without tears No wet diapers for three hours or more Being unusually sleepy or drowsy Irritability Eyes that look sunken Sunken fontanel

Question 29

Causes: hypovolemia

Answer 29

Abnormal fluid losses - Vomiting - Diarrhea - Gastric suctioning - Sweating - Bleeding Decrease intake - Nausea - Lack of access to fluids - Osmotic diuresis 3rd-space fluid shifts - Edema formation in Burns - Ascites in liver dysfunction Diabetes Insipidus

Question 30

Diagnosis: Blood test:

Answer 30

CBC - increase Hematocrit level Elevated BUN - Out of proportion with creatinine Imbalance serum K+, Na+

Question 31

Diagnosis: Urine Test

Answer 31

Increase BUN, Creatinine Na+ concentration Urine pH Xray/ MRI - Hypovolemic shock with subtle imaging signs

Question 32

possibly evidenced by:

Answer 32

Abdominal distention. Confusion, restlessness. Dark concentrated urine. Decreased urine volume. Decreased central venous pressure. Hypotension. Pale, moist, clammy skin. Tachycardia. Tachypnea. Weak pulses

Question 33

Nursing assessment

Answer 33

Complete a thorough head-to-toe assessment. Assess intake and output. Assess vital signs. Assess laboratory values. Assess skin turgor. Assess urine color and concentration. Auscultate cardiac sounds. Assess cardiac rhythm. Assess mental status.

Question 34

Treatment

Answer 34

Oral hydration and diet IV Fluids Isotonic electrolyte crystalloid solutions ( LR, 0.9% NSS) then hypotonic electrolyte Blood transfusion

Question 35

Management

Answer 35

Monitor I & O, weight, vital signs, LOC, breath sounds, skin color to prevent fluid overload. Fluid volume replacement accordingly. CVP Monitoring Fluid challenge test (due to prolonged FVD / to check renal blood flow.

Question 36

Level of consciousness ALOSC

Answer 36

Alert (conscious) Lethargy Obtundation Stupor Coma (unconscious)

Question 37

Appearance of wakefulness, awareness of the self and environment

Answer 37

Alert (conscious)

Question 38

mild reduction in alertness

Answer 38

Lethargy

Question 39

moderate reduction in alertness. Increased response time to stimuli

Answer 39

Obtundation

Question 40

Deep sleep, patient can be aroused only by vigorous and repetitive stimulation. Returns to deep sleep when not continually stimulated.

Answer 40

Stupor

Question 41

Sleep lice appearance and behaviorally unresponsive to all external stimuli (Unarousable unresponsiveness, eyes closed)

Answer 41

Coma (unconscious)

Question 42

CVP mean?

Answer 42

Central Venous Pressure-often used as an assessment of hemodynamic status.

Question 43

3 stages of hypovolemic shock

Answer 43

Stage 1: 15% blood loss (750 mL or about 25 ounces). Stage 2: 15% to 30% (750 mL to 1,500 mL or up to almost 51 ounces) Stage 3: 30% to 40% of your blood (1,500 to 2,000 mL or up to 68 oz.)