ATI chapter 57 Fluid and Electrolyte Imbalances Exam Questions With 100% Correct Answers

ATI chapter 57 Fluid and Electrolyte Imbalances Exam Questions With 100% Correct Answers ◯ Fluid can move between compartments (through selectively permeable membranes) by a variety of methods - answer(diffusion, active transport, ltration, osmosis) in order to maintain homeostasis. ◯ Fluid imbalances that the nurse should be familiar with are: - answer■ Fluid volume deficits ■ Fluid volume excess electrolytes - answerElectrolytes are minerals (sometimes called salts) that are present in all body fuids. They regulate fuid balance and hormone production, strengthen skeletal structures, and act as catalysts in nerve response, muscle contraction, and the metabolism of nutrients. When dissolved in water or another solvent, electrolytes separate into ions and then conduct either a - answerpositive ions: (cations - magnesium, potassium, sodium, calcium) or negative ions: (anions - phosphate, sulfate, chloride, bicarbonate) electrical current. Fluid volume de cits (FVDs) include - answer◯Isotonic FVD is the loss of water and electrolytes from the ECF. ■ Isotonic FVD is often referred to as hypovolemia because intravascular uid is also lost. ◯ Dehydration is the loss of water from the body without the loss of electrolytes. ■ This hemoconcentration results in increases in Hct, serum electrolytes, and urine speci c gravity. Older adults have an increased risk for dehydration due to multiple physiological factors including a decrease in total body mass, which includes total body water content. Causes of isotonic FVD (hypovolemia) - answer■ Abnormal gastrointestinal (GI) losses - vomiting, nasogastric suctioning, diarrhea ■ Abnormal skin losses - diaphoresis ■ Abnormal renal losses - diuretic therapy, diabetes insipidus, kidney disease, adrenal insuf ciency, osmotic diuresis ■ Third spacing - peritonitis, intestinal obstruction, ascites, burns ■ Hemorrhage ■ Altered intake - impaired swallowing, confusion, nothing by mouth (NPO) Causes of dehydration - answer■ Hyperventilation ■ Prolonged fever ■ Diabetic ketoacidosis ■ Enteral feeding without suf cient water intake ● Subjective and Objective Data for FVD - answer◯ Vital signs - hypothermia, tachycardia, thready pulse, hypotension, orthostatic hypotension, decreased central venous pressure, tachypnea (increased respirations), hypoxia ◯ Neuromusculoskeletal - dizziness, syncope, confusion, weakness, fatigue ◯ GI - thirst, dry mucous membranes, dry furrowed tongue, nausea/vomiting, anorexia, acute weight loss ◯ Renal - oliguria (decreased production of urine) ◯ Other clinical ndings - diminished capillary re ll, cool clammy skin, diaphoresis, sunken eyeballs, attened neck veins, absence of tears, decreased skin turgor - answer◯ Hct - Increased in both hypovolemia and dehydration unless the fluid volume deficit is due to hemorrhage. ◯ Serum osmolarity ■ Dehydration - increased hemoconcentration osmolarity (greater than 300 mOsm/kg) - increased protein, BUN, electrolytes, glucose ◯ Urine specific gravity and osmolarity ■ Dehydration - increased concentration (urine speci c gravity greater than 1.030) ◯ Serum sodium ■ Dehydration - increased hemoconcentration Compensatory mechanisms for FVD include sympathetic nervous system responses of increased thirst - answerantidiuretic hormone (ADH) release, and aldosterone release.