NURS 143 Final Exam Guide With
Complete Solution
osmolality
_____ is the particle concentration of a solution, expressed as the total number
of solute particles per kilogram. 275-290 WNL for serum. For hypertonic
solutions this is higher compared to body fluids.
oncotic
_____ pressure refers to the osmotic pressure exerted by proteins (like
albumin).
D5W (Dextrose 5% in water)
This is an IV fluid that should NOT be given to infants or patients with head
injuries. It is injected into a vein through an IV to replace deficits of total
body water and provide carbohydrates to the body. ____ (acronym only) is
commonly given for treatment of hypoglycemia. It is never given alone to
expand ECF volume due to the risk of dilution of electrolytes.
isotonic
NS 0.9% NaCl and lactated ringers are IV fluids that are considered _____, i.e.
they have the same osmolarity as body fluid.
lactated ringer (LR)
The administration of ____ (two words) is indicated for burns, cases of acute
blood loss from serious injury, intravascular dehydration or dehydration from
,loss of bile or diarrhea.
FVD
Increased Na+, increased specific gravity of urine, and increased Hct are
strong indicators that a patient is in a state of ____ (acronym only).
FVE
Decreased Na+, decreased specific gravity of urine, and decreased Hct are
strong indicators that a patient is in a state of ____ (acronym only).
hyponatremia
The nurse reviewing lab results finds that the patient's serum Na+ level is
107 mEq/L and a urine specific gravity of 1.003. The patient is confused, has
generalized skeletal muscle weakness and diminished DTR. The nurse
suspects this patient may have ____.
hypernatremia
A patient's lab results have come back with serum Na+ level of 165 mEq/L
and a urine specific gravity of 1.045. The patient has altered LOC, is lethargic
and polydipsia (very thirsty). The nurse suspects this patient has ____.
Furosemide (Lasix)
_____ is a loop diuretic that causes the kidneys to excrete more water, Na+
and K+. "Loop" refers to the drugs effects on the ascending limb of the loop
of Henle in the kidneys. It can also be given to increase Ca2+ excretion in the
urine in patients with hypercalcemia.
replacement
The best treatment for hyponatremia (Na+ < 135mEq/L) is sodium ____,
,which can occur via oral, NG or parenteral routes. IV, isotonic, NS 0.9% NaCl
can be administered for those with FVD or who cannot tolerate other routes.
Osmotic Diuretics (e.g. mannitol)
If hyponatremia is accompanied by FVE, ____ (two words) may be prescribed
to promote the excretion of water rather than Na+.
pitting
The most common symptoms of hypernatremia (Na+ > 145mEq/L) are:
F: Fever
R: Restless (irritable)
I: Increased fluid retention and increased BP
E: Edema (peripheral and ______ )
D: Decreased urine output and dry mouth
thirst
Cognitively intact (conscious) individuals have intact ____ mechanisms, which
makes hypernatremia less likely among this population.
Alka-Seltzer
You suspect your patient's complaint could be due to FVE. As part of your
assessment, obtain a previous medication history. In particular ask about
regular use of ____ (two-words), an antacid and pain reliever which can induce
Na+ and water retention and lead to hypernatremia and hypokalemia.
salt substitutes
, Certain food products and condiments are made with K+. If a patient has K+
retention, specifically the patient should be instructed to avoid ____ (two
words).
weakness
Serum K+ (3.5-5.0 mEq/L) is important in the use of ALL our muscles. As a
result muscle [ weakness / tetany ] will likely be the INITIAL sign the nurse
observes in a patient with hyperkalemia.
K+
Anytime we have diarrhea, void, sweat, have NG suctioning or vomit our
body loses this cation. Kidneys conserve [ Na+ / K+ ] less efficiently, so it is
more likely to be lost in the urine.
Hypokalemia
Increased secretion of aldosterone, such as occurs in Cushing's syndrome in
addition to excessive use of diuretics or corticosteroids, NG suctioning,
vomiting and diarrhea are potential causes of hypernatremia and
concomitant _____.
Magnesium (Mg2+)
_____ depletion MUST BE corrected before K+ replenishment occurs, or renal
loss of K+ will continue.
too little
A SIC WALT are all S / Sx of [ too much / too little ] K+:
A: Alkalosis (metabolic)
S: Shallow respirations
Complete Solution
osmolality
_____ is the particle concentration of a solution, expressed as the total number
of solute particles per kilogram. 275-290 WNL for serum. For hypertonic
solutions this is higher compared to body fluids.
oncotic
_____ pressure refers to the osmotic pressure exerted by proteins (like
albumin).
D5W (Dextrose 5% in water)
This is an IV fluid that should NOT be given to infants or patients with head
injuries. It is injected into a vein through an IV to replace deficits of total
body water and provide carbohydrates to the body. ____ (acronym only) is
commonly given for treatment of hypoglycemia. It is never given alone to
expand ECF volume due to the risk of dilution of electrolytes.
isotonic
NS 0.9% NaCl and lactated ringers are IV fluids that are considered _____, i.e.
they have the same osmolarity as body fluid.
lactated ringer (LR)
The administration of ____ (two words) is indicated for burns, cases of acute
blood loss from serious injury, intravascular dehydration or dehydration from
,loss of bile or diarrhea.
FVD
Increased Na+, increased specific gravity of urine, and increased Hct are
strong indicators that a patient is in a state of ____ (acronym only).
FVE
Decreased Na+, decreased specific gravity of urine, and decreased Hct are
strong indicators that a patient is in a state of ____ (acronym only).
hyponatremia
The nurse reviewing lab results finds that the patient's serum Na+ level is
107 mEq/L and a urine specific gravity of 1.003. The patient is confused, has
generalized skeletal muscle weakness and diminished DTR. The nurse
suspects this patient may have ____.
hypernatremia
A patient's lab results have come back with serum Na+ level of 165 mEq/L
and a urine specific gravity of 1.045. The patient has altered LOC, is lethargic
and polydipsia (very thirsty). The nurse suspects this patient has ____.
Furosemide (Lasix)
_____ is a loop diuretic that causes the kidneys to excrete more water, Na+
and K+. "Loop" refers to the drugs effects on the ascending limb of the loop
of Henle in the kidneys. It can also be given to increase Ca2+ excretion in the
urine in patients with hypercalcemia.
replacement
The best treatment for hyponatremia (Na+ < 135mEq/L) is sodium ____,
,which can occur via oral, NG or parenteral routes. IV, isotonic, NS 0.9% NaCl
can be administered for those with FVD or who cannot tolerate other routes.
Osmotic Diuretics (e.g. mannitol)
If hyponatremia is accompanied by FVE, ____ (two words) may be prescribed
to promote the excretion of water rather than Na+.
pitting
The most common symptoms of hypernatremia (Na+ > 145mEq/L) are:
F: Fever
R: Restless (irritable)
I: Increased fluid retention and increased BP
E: Edema (peripheral and ______ )
D: Decreased urine output and dry mouth
thirst
Cognitively intact (conscious) individuals have intact ____ mechanisms, which
makes hypernatremia less likely among this population.
Alka-Seltzer
You suspect your patient's complaint could be due to FVE. As part of your
assessment, obtain a previous medication history. In particular ask about
regular use of ____ (two-words), an antacid and pain reliever which can induce
Na+ and water retention and lead to hypernatremia and hypokalemia.
salt substitutes
, Certain food products and condiments are made with K+. If a patient has K+
retention, specifically the patient should be instructed to avoid ____ (two
words).
weakness
Serum K+ (3.5-5.0 mEq/L) is important in the use of ALL our muscles. As a
result muscle [ weakness / tetany ] will likely be the INITIAL sign the nurse
observes in a patient with hyperkalemia.
K+
Anytime we have diarrhea, void, sweat, have NG suctioning or vomit our
body loses this cation. Kidneys conserve [ Na+ / K+ ] less efficiently, so it is
more likely to be lost in the urine.
Hypokalemia
Increased secretion of aldosterone, such as occurs in Cushing's syndrome in
addition to excessive use of diuretics or corticosteroids, NG suctioning,
vomiting and diarrhea are potential causes of hypernatremia and
concomitant _____.
Magnesium (Mg2+)
_____ depletion MUST BE corrected before K+ replenishment occurs, or renal
loss of K+ will continue.
too little
A SIC WALT are all S / Sx of [ too much / too little ] K+:
A: Alkalosis (metabolic)
S: Shallow respirations
