Fluid & Electrolytes

Question 1

Match the Solution term with its definition:

Isotonic, Hypertonic, Hypotonic
- Solution is more concentrated inside; fluid moves inward
- Solution is more concentrated outside; fluid moves outward
- Solutions are equal; no fluid shift

Answer 1

Hypotonic - Solution is more concentrated inside; fluid moves inward

Hypertonic - Solution is more concentrated outside; fluid moves outward (SHRINKS)

Isotonic - Solutions are equal; no fluid shift

Question 2

True or false: Capillary membranes are semi-permeable

Answer 2

True

Question 3

Define Osmotic Pressure

Answer 3

Force that moves fluids towards equal concentrations

Question 4

What is Serum Electrolyte Testing? (3)

Answer 4

• Na, K, Cl blood concentrations
• Routine screen test OR
• Suspected electrolyte embalance

Question 5

What is Serum Osmolarity Testing? (2)

Answer 5

• Measures water/electrolyte balance in blood
• Increases with dehydration, decreases with overload

Question 6

What is Urine Osmolarity Testing? (2)

Answer 6

• Measures water/electrolyte balance in urine
• Can detect renal dysfunction

Question 7

What is Urine Specific Gravity (SG) Testing?

Answer 7

Measures kidney’s ability to concentrate urine

Question 8

What are 2 Fluid Imbalance Disorders?

Answer 8

• Edema (Hypervolemia)
• Dehydration (Hypovolemia)

Question 9

What is NOT true of Edema?

a. Excess fluid in interstitial spaces
b. Can be local or systemic
c. Always visible
d. Interferes with arterial circulation and venous return

Answer 9

c. Always visible

Question 10

True or False: Na+ is the primary cation

Answer 10

True

Question 11

What is NOT true of Hypernatremia?

a. >142mEq/L Serum Sodium Concentration
b. Loss of water is slower than the loss of sodium due to diarrhea, rapid respiration
c. Restlessness, weakness, twitching, agitation, low grade fever, confusion
d. Treatments: IV fluid replacement, Na+ intake restriction

Answer 11

b. Loss of water is slower than the loss of sodium

Question 12

What are 4 Nursing Interventions for Hypernatremia?

Answer 12

• Monitor vitals (BP, pulse)
• Monitor intake/outake
• Daily weight
• Monitor IV

Question 13

What is NOT true of Hyponatremia?

a. >135mEq/L Serum Sodium Concentration
b. Significant Na+ loss due to excessive perspiration, vomiting, diarrhea, diuretics, excess ADH secretion
c. Symptoms: ab/muscle cramps, fatigue, nausea, hypotension, confusion, headaches
d. Treatment: restrict fluid intake, admin NaCl, identify and correct underlying problem

Answer 13

a. >135mEq/L Serum Sodium Concentration

Question 14

What are 4 Nursing Interventions for Hyponatremia?

Answer 14

• Monitor vitals (BP, pulse)
• Monitor decrease LOC
• Monitor intake/ouput
• Daily weight

Question 15

True or false: Both severe Hyper- and Hyponatremia can result in seizures

Answer 15

True

Question 16

What is NOT true of Calcium?

a. Ingested in food, stored in bone
b. Controlled by Parathyroid hormone
c. Required for muscle contractions, nerve conduction, and metabolic reactions
d. Intracellular cation

Answer 16

d. Intracellular cation

Extracellular cation

Question 17

What is NOT true of Hypocalcemia?

a. <2.2mmol/L Serum Calcium Concentration
b. Etiology: poor VitD intake, poor Ca+ absorption, hypoparathyroidism
c. Symptoms: lethargy, anorexia, constipation, thirst, polyuria, STRONG contractions
d. Should watch for signs and symptoms post thyroid or parathyroid surgery

Answer 17

c. Symptoms: lethargy, anorexia, constipation, thirst, polyuria, STRONG contractions

These are symptoms of Hypercalcemia

Question 18

What is NOT true of Hypercalcemia?

a. >2.5mmol/L Serum Calcium Concentration
b. Etiology: Neoplasms, hyperparathyroidism, immobility, increased calcium intake
c. Symptoms: lethargy, anorexia, constipation, thirst, polyuria, STRONG contractions
d. Treatment: IV solution to dilute extracellular Ca+, diuretics, NaHCO3, hemodialysis

Answer 18

All are true

Question 19

What are 4 Nursing Interventions for Hypercalcemia?

Answer 19

• Monitor for arrhythmia, paralytic ileus, coma
• Monitor intake/output
• Encourage fluid intake of 3-4 L/day
• Encourage movement

Question 20

What is the difference between Edema and Hypervolemia?

Answer 20

Excess fluid in interstitial spaces (Edema) vs extracellular compartment (Hypervolemia)

Question 21

What is NOT true of Hypervolemia?

a. Excess fluid in interstitial spaces
b. Etiology: renal failure, congestive heart failure, increased salt intake, overhydration
c. Symptoms: tachypnea, dyspnea, puffy eyes, hypertension, edema
d. Treatment: Na+ and fluid restriction, diuretics

Answer 21

a. Excess fluid in interstitial spaces

** extracellular spaces

Question 22

What are 4 Nursing Interventions for Hypervolemia?

Answer 22

• Monitor vitals (respirations)
• Monitor venous distension
• Monitor intake/output
• Skin care for edema

Question 23

What is NOT true of Dehydration?

a. Insufficient fluids due to inadequate intake, excessive loss, or both
b. Serious problem for adults due to lack of fluid reserves
c. Symptoms: dry mucous membrane, increased weak HR, decreased HP, confusion
d. Often accompanied by loss of electrolytes

Answer 23

b. Serious problem for adults due to lack of fluid reserves

** children and older adults

Question 24

Match the Dehydration type with its definition:

Isotonic D, Hypotonic D, Hypertonic D
- equal loss of fluid and electrolytes
- greater loss of fluid than electrolytes
- greater loss of electrolytes than fluid

Answer 24

Isotonic D
- equal loss of fluid and electrolytes

Hypertonic D
- greater loss of fluid than electrolytes

Hypotonic D
- greater loss of electrolytes than fluid

Question 25

What is NOT true of Hypovolemia? a. Due to insufficient fluid intake b. Symptoms are the similar to Dehydration but more significant c. Lab results show increased hematocrit, high specific gravity, change in serum electrolytes d. Treatment: replacing lost fluids with isotonic fluids, vasoconstrictors, oxygen therapy

Answer 25

a. Due to insufficient fluid intake Due to Third Shift, trauma, hemorrhage

Question 25

What is NOT true of Potassium? a. Intracellular cation b. Excreted in urine c. Regulates intracellular fluid volume d. Abnormal levels have serious effects on heart contractions

Answer 25

All are true

Question 25

Define Third Space Shift (2)

Answer 25

- Fluid shift out of blood into body cavity - Results in fluid deficit in vascular (hypovolemia) compartments and excess in interstitial spaces

Question 26

What are 4 Nursing Interventions for Hypokalemia?

Answer 26

- Monitor vitals (pulse, BP) - Assess HR and rhythm - Assess RR - Monitor intake/output

Question 26

What is NOT true of Hypokalemia? a. <3.5mEq/L Serum Potassium Concentration b. Etiology: Poor dietary intake, excessive output, medication, diabetic ketoacidosis treatment c. Symptoms: muscle weakness, leg cramping, decreased tendon reflexes, cardiac dysrhythmias d. Treatment: IV solution to dilute extracellular K+, diuretics

Answer 26

d. Treatment: IV solution to dilute extracellular K+, diuretics Treatment includes high K+ diet, oral or IV K+ supplements

Question 27

What is NOT true of Hyperkalemia? a. >5.0mEq/L Serum Potassium Concentration b. Etiology: Kidney dysfunction, K+ sparing diuretics, severe acidosis c. Symptoms: muscle weakness in legs to trunk, nausea, diarrhea, decreased HR, cardiac dysrhythmias d. Treatment: diuretics, reduced K+ intake, cardiac interventions **

Answer 27

All are true

Question 28

What are 4 Nursing Interventions for Hyperkalemia?

Answer 28

- Monitor K+ levels closely - Monitor vitals (HR, BP) - Monitor intake/output (<20ml/h out is dangerous) - Assess K+ related medications

Question 29

Imbalance (hypo- or hyper-) of which Electrolyte causes severe or fatal cardiac arrythmias?

Answer 29

Potassium

Question 30

What are Trousseau's and Chvostek's signs? (2)

Answer 30

- Involuntary muscle contractions (wrist and face) - Sign of Hypocalcemia

Question 31

What is NOT true of Magnesium? a. Intracellular ion b. Stored in adipose c. Functions in enzyme reactions and protein/DNA synthesis d. Imbalances are rare

Answer 31

b. Stored in adipose Magnesium is stored in bone (50%)