CNUR 203 MIDTERM EXAM STUDY GUIDE
WITH ANSWERS
◉ First Spacing
Answer: the normal distribution between ICF and ECF
◉ Second Spacing
Answer: abnormal accumulation of interstitial fluid (Edema)
◉ Third Spacing
Answer: when fluid is accumulated, trapped, and unavailable for
functional use (peritonitis, edema associated with burns, trauma,
or sepsis
◉ If fluid moves from the interstitial space to the blood, what
would you expect to find when assessing the skin?
Answer: Dry skin with poor turgor
◉ If a person loses a large quantity of blood, where is the biggest
loss of fluid coming from?
Answer: Vascular
,◉ Hypovolemia
Answer: loss of water and electrolytes (especially sodium)
Can lose volume through vomiting, diarrhea, burns, hemorrhage,
excessive wound drainage
◉ Fluid volume deficit findings
Answer: altered mental status, anxiety, restless, dry skin, swollen
tongue, pale/cool, ppor skin turgor, flat neck veins, weak pulse,
reduced cap refill, tachycardia, hypotension, reduced cardiac
output, thirst, weight loss, fatigue
◉ Why are older adults at increased risk for dehydration?
Answer: Do not drink enough water, might have renal failure,
altered sensation of thirst, do not want to get up to go to the
bathroom, confusion and cognitive impairment, mobility issues
◉ Hypervolemia
Answer: fluid volume excess
Caused by: high sodium levels, kidney failure, overhydration with
too much IV therapy, corticosteroids
◉ Hypervolemia findings
Answer: mental status changes, edema, distended neck veins,
polyuria, pitting, crackles, SOB, dyspnea, weight gain,
hypertension, increased cardiac output
,◉ What is the easiest measurement of volume status?
Answer: Weight
◉ Crystalloids
Answer: contain small molecules that are easily dissolved in a
solution
◉ Colloids
Answer: contain large molecules, can't pass through semi-
permeable membranes
◉ Hypotonic
Answer: pulls fluid into the cell
◉ Isotonic
Answer: Stay where I put it, maintains equilibrium
◉ Hypertonic
Answer: pulls fluid out of the cell
◉ Potassium
Answer: many cellular and metabolic functions
Transmission and conduction of nerve impulses
Maintenance of normal cardiac rhythms
, Skeletal and smooth muscle contraction
Regulates intracellular osmolality and promotes cellular growth
Alterations in potassium are largely seen in skeletal systems and
cardiac functions
Kidneys are the primary route in which potassium is lost
◉ Hyperkalemia
Answer: Renal disease, K+ sparing diuretics, adrenal insufficiency,
ACE inhibitors
Assessment findings: irregular pulse, cardiac standstill if its
sudden or severe, ECG changes, abdominal cramping, diarrhea,
anxiety, irritability, weakness of lower extremities, paresthesia
◉ Hypokalemia
Answer: deficient dietary intake, diarrhea, vomiting, NG suction,
diuretics, diaphoreses
Assessment findings: weak irregular pulse, ECG changes, skeletal
muscle weakness, fatigue, shallow respirations, leg cramps, limp
muscles
◉ Hypomagnesemia
Answer: Causes: Diarrhea, vomiting, chronic alcoholism, impaired
GI absorption, prolonged malnutrition, large urine output, NG
suction,
Assessment: when taking blood pressure the face will
involuntarily contract
WITH ANSWERS
◉ First Spacing
Answer: the normal distribution between ICF and ECF
◉ Second Spacing
Answer: abnormal accumulation of interstitial fluid (Edema)
◉ Third Spacing
Answer: when fluid is accumulated, trapped, and unavailable for
functional use (peritonitis, edema associated with burns, trauma,
or sepsis
◉ If fluid moves from the interstitial space to the blood, what
would you expect to find when assessing the skin?
Answer: Dry skin with poor turgor
◉ If a person loses a large quantity of blood, where is the biggest
loss of fluid coming from?
Answer: Vascular
,◉ Hypovolemia
Answer: loss of water and electrolytes (especially sodium)
Can lose volume through vomiting, diarrhea, burns, hemorrhage,
excessive wound drainage
◉ Fluid volume deficit findings
Answer: altered mental status, anxiety, restless, dry skin, swollen
tongue, pale/cool, ppor skin turgor, flat neck veins, weak pulse,
reduced cap refill, tachycardia, hypotension, reduced cardiac
output, thirst, weight loss, fatigue
◉ Why are older adults at increased risk for dehydration?
Answer: Do not drink enough water, might have renal failure,
altered sensation of thirst, do not want to get up to go to the
bathroom, confusion and cognitive impairment, mobility issues
◉ Hypervolemia
Answer: fluid volume excess
Caused by: high sodium levels, kidney failure, overhydration with
too much IV therapy, corticosteroids
◉ Hypervolemia findings
Answer: mental status changes, edema, distended neck veins,
polyuria, pitting, crackles, SOB, dyspnea, weight gain,
hypertension, increased cardiac output
,◉ What is the easiest measurement of volume status?
Answer: Weight
◉ Crystalloids
Answer: contain small molecules that are easily dissolved in a
solution
◉ Colloids
Answer: contain large molecules, can't pass through semi-
permeable membranes
◉ Hypotonic
Answer: pulls fluid into the cell
◉ Isotonic
Answer: Stay where I put it, maintains equilibrium
◉ Hypertonic
Answer: pulls fluid out of the cell
◉ Potassium
Answer: many cellular and metabolic functions
Transmission and conduction of nerve impulses
Maintenance of normal cardiac rhythms
, Skeletal and smooth muscle contraction
Regulates intracellular osmolality and promotes cellular growth
Alterations in potassium are largely seen in skeletal systems and
cardiac functions
Kidneys are the primary route in which potassium is lost
◉ Hyperkalemia
Answer: Renal disease, K+ sparing diuretics, adrenal insufficiency,
ACE inhibitors
Assessment findings: irregular pulse, cardiac standstill if its
sudden or severe, ECG changes, abdominal cramping, diarrhea,
anxiety, irritability, weakness of lower extremities, paresthesia
◉ Hypokalemia
Answer: deficient dietary intake, diarrhea, vomiting, NG suction,
diuretics, diaphoreses
Assessment findings: weak irregular pulse, ECG changes, skeletal
muscle weakness, fatigue, shallow respirations, leg cramps, limp
muscles
◉ Hypomagnesemia
Answer: Causes: Diarrhea, vomiting, chronic alcoholism, impaired
GI absorption, prolonged malnutrition, large urine output, NG
suction,
Assessment: when taking blood pressure the face will
involuntarily contract
