CMSRN Exam Prep 2021-2022: A Medical
Surgical Nursing Study Guide with Test Bank
what type of hyponatremia is most common, results from excessive fluid intake and
leads to decreased serum sodium concentration? - dilutional hypotnatremia
symptoms of diltuional hyponatremia - edema, confusion, weight gain
treatment of dilutional hyponatremia - fluid restriction
what type of hyponatremia results from fluid and sodium loss? - true hyponatremia
symptoms of true hyponatremia - dry tissue, weight loss, hypotension, tachycardia
treatment of true hyponatremia - replace sodium AND water (NS or LR)
causes of true hyponatremia - burns, hemorrhage, adrenal insufficiency
what type of sodium imbalance is caused by decreased fluid intake or water loss without
loss of sodium? - hypernatremia
causes of hypernatremia - fever, IVF with sodium, DI, high protein TF
symptoms of hypernatremia - dry tissues, weight gain, thirst, tachycardia, oliguria
treatment of hypernatremia - decrease sodium, replace fluids
which electrolyte does sodium work with? - chloride - works to maintain acid/base
balance
which labs are most important to watch with potassium abnormalities? - renal
what does potassium have an inverse relationship with? - PH, insulin, calcium
causes of hyperkalemia - cell wall destruction, increased intake, potassium sparing
diuretics, renal failure, acidosis
symptoms of hyperkalemia - irritable muscles, cardiac arrhythmias, hyperactive bowels,
bladder
treatment of hyperkalemia - limit intake, kaexylate, calcium gluconate, IV glucose and
insulin, dialysis
,what electrolyte imbalance should you avoid green leafy vegetables and citrus fruits? -
hyperkalemia
what electrolyte are avocado, dried fruits, and potato skins high in? - potassium
causes of hypokalemia - vomiting, diarrhea, DKA, prolonged NG suction, burns,
potassium wasting diuretics
symptoms of hypokalemia - muscle flaccidity and weakness, constipation, alkalosis,
shallow respirations, cardiac arrest
treatment for hypokalemia - potassium supplements, monitor magnesium levels
normal calcium level - 9-10.5
where is calcium stored? - bones
what vitamin is important for calcium absorption - Vitamin D
what does calcium have an inverse relationship with? - phosphorous
which electrolyte imbalance increases bleeding risk? - hypocalcemia
causes for hypercalcemia - cancer, bone mets, hyperparathyroidism, excessive vitamin
D, thiazide diuretics, parathyroid tumor
symptoms of hypercalcemia - sedation, lethargy, hypoactive reflexes, slurred speech,
impaired memory (decreased LOC/CNS sympstoms), renal stones
treatment for hypercalcemia - decrease intake, encourage fluids, loop diuretics,
phosphate administration
causes of hypocalcemia - decreased intake, decreased vitamin D, increased phosphate
levels, renal disease, pacreatitis, alcoholism, pregnancy
symptoms of hypocalcemia - chvosteks, trousseaus, laryngospasm, tingling in
fingers/toes/lips, coagulopathy
treatment of hypocalcemia - increased intake, vitamin D, IV calcium gluconate,
phosphate binding antacids
sign of hypocalcemia that causes twitching of face if you tap the front of the ear? -
chvosteks sign
sign of hypocalcemia that causes carpal tunnel/turning in of hands? - trousseaus sign
, normal level of phosphate - 3-4.5
symptoms of this electrolyte imbalance are opposite of calcium since it has an inverse
relationship - phosphate
Normal level of magnesium - 1.3-2.1
Normal level of sodium - 135-145
normal level of potassium - 3.5-5.0 mEq/L
symptoms of hypermagnesemia - poor renal excretion, muscular depression
symptoms of hypomagnesemia - Hyperactive deep tissue reflexes, tremors, seizures,
cardiac arrhythmia, confusion (resembles hypocalcemia)
treatment for hypermagnesemia - calcium gluconate
what is serum osmolality? - how thick solution is
what does it mean if serum osmolality is high? - the patient is dry
what type of solution is NS, LR? - isotonic
what does an isotonic solution do? - expands blood volume
increases blood pressure if dehydrated
has same osmolarity as our cells
can cause electrolyte increase
what type of solution is D5LR, D5NS? - hypertonic
what does a hypertonic solution do? - Pulls fluid into the intravascular space from
tissue, do NOT give if dehydrated
what type of solution is 1/2 NS, 1/4 NS? - hypotonic
what does a hypotonic solution do? - contain less solute than our cells
used for cellular hydration
has more water than electrolytes
given after surgery due to dehydration
What organ metabolizes most nutrients? - liver
gallbladder location - RUQ
appendix location - RLQ
Surgical Nursing Study Guide with Test Bank
what type of hyponatremia is most common, results from excessive fluid intake and
leads to decreased serum sodium concentration? - dilutional hypotnatremia
symptoms of diltuional hyponatremia - edema, confusion, weight gain
treatment of dilutional hyponatremia - fluid restriction
what type of hyponatremia results from fluid and sodium loss? - true hyponatremia
symptoms of true hyponatremia - dry tissue, weight loss, hypotension, tachycardia
treatment of true hyponatremia - replace sodium AND water (NS or LR)
causes of true hyponatremia - burns, hemorrhage, adrenal insufficiency
what type of sodium imbalance is caused by decreased fluid intake or water loss without
loss of sodium? - hypernatremia
causes of hypernatremia - fever, IVF with sodium, DI, high protein TF
symptoms of hypernatremia - dry tissues, weight gain, thirst, tachycardia, oliguria
treatment of hypernatremia - decrease sodium, replace fluids
which electrolyte does sodium work with? - chloride - works to maintain acid/base
balance
which labs are most important to watch with potassium abnormalities? - renal
what does potassium have an inverse relationship with? - PH, insulin, calcium
causes of hyperkalemia - cell wall destruction, increased intake, potassium sparing
diuretics, renal failure, acidosis
symptoms of hyperkalemia - irritable muscles, cardiac arrhythmias, hyperactive bowels,
bladder
treatment of hyperkalemia - limit intake, kaexylate, calcium gluconate, IV glucose and
insulin, dialysis
,what electrolyte imbalance should you avoid green leafy vegetables and citrus fruits? -
hyperkalemia
what electrolyte are avocado, dried fruits, and potato skins high in? - potassium
causes of hypokalemia - vomiting, diarrhea, DKA, prolonged NG suction, burns,
potassium wasting diuretics
symptoms of hypokalemia - muscle flaccidity and weakness, constipation, alkalosis,
shallow respirations, cardiac arrest
treatment for hypokalemia - potassium supplements, monitor magnesium levels
normal calcium level - 9-10.5
where is calcium stored? - bones
what vitamin is important for calcium absorption - Vitamin D
what does calcium have an inverse relationship with? - phosphorous
which electrolyte imbalance increases bleeding risk? - hypocalcemia
causes for hypercalcemia - cancer, bone mets, hyperparathyroidism, excessive vitamin
D, thiazide diuretics, parathyroid tumor
symptoms of hypercalcemia - sedation, lethargy, hypoactive reflexes, slurred speech,
impaired memory (decreased LOC/CNS sympstoms), renal stones
treatment for hypercalcemia - decrease intake, encourage fluids, loop diuretics,
phosphate administration
causes of hypocalcemia - decreased intake, decreased vitamin D, increased phosphate
levels, renal disease, pacreatitis, alcoholism, pregnancy
symptoms of hypocalcemia - chvosteks, trousseaus, laryngospasm, tingling in
fingers/toes/lips, coagulopathy
treatment of hypocalcemia - increased intake, vitamin D, IV calcium gluconate,
phosphate binding antacids
sign of hypocalcemia that causes twitching of face if you tap the front of the ear? -
chvosteks sign
sign of hypocalcemia that causes carpal tunnel/turning in of hands? - trousseaus sign
, normal level of phosphate - 3-4.5
symptoms of this electrolyte imbalance are opposite of calcium since it has an inverse
relationship - phosphate
Normal level of magnesium - 1.3-2.1
Normal level of sodium - 135-145
normal level of potassium - 3.5-5.0 mEq/L
symptoms of hypermagnesemia - poor renal excretion, muscular depression
symptoms of hypomagnesemia - Hyperactive deep tissue reflexes, tremors, seizures,
cardiac arrhythmia, confusion (resembles hypocalcemia)
treatment for hypermagnesemia - calcium gluconate
what is serum osmolality? - how thick solution is
what does it mean if serum osmolality is high? - the patient is dry
what type of solution is NS, LR? - isotonic
what does an isotonic solution do? - expands blood volume
increases blood pressure if dehydrated
has same osmolarity as our cells
can cause electrolyte increase
what type of solution is D5LR, D5NS? - hypertonic
what does a hypertonic solution do? - Pulls fluid into the intravascular space from
tissue, do NOT give if dehydrated
what type of solution is 1/2 NS, 1/4 NS? - hypotonic
what does a hypotonic solution do? - contain less solute than our cells
used for cellular hydration
has more water than electrolytes
given after surgery due to dehydration
What organ metabolizes most nutrients? - liver
gallbladder location - RUQ
appendix location - RLQ
