NS 119 FINAL EXAM REVIEW QUESTIONS &
ANSWERS VERIFIED 100% CORRECT
ADH - ANSWER produced in hypothalamus, released by the post pituitary gland in
response to low blood vol, pain, stress, high serum osmolality, rise in temp, and some
opioids
- causes collectors in nephrons to reabsorb more water for inc blood volume& lower
osmolality--the kidneys retain fluid
Thyroid hormone - ANSWER affects fluid volume by influencing cardiac output
--an increase causes an inc in CO, thereby increasing glomerular filtration rate and urine
output
Sodium function & normal serum level - ANSWER major cation in the ECF
-regulates fluid volume*, helps maintain blood vol, interacts w/ Ca to maintain muscle
contraction, stimulates conduction of nerve impulses
-regulated by aldosterone & ADH levels
-adults should limit the intake to 2,300 mg/day
135-145 mEq/L
Potassium function & normal serum level - ANSWER major cation in the ICF
-key electrolyte in cellular metabolism*, maintains ICF osmolality, regulates conduction
of cardiac rhythm, transmits electrical impulses in multiple body systems, assists w/
acid-base balance
-adults should consume at least 4,700 mg/day
-regulated by aldosterone
3.5-5.0 mEq/L
,Calcium function & normal serum level - ANSWER most abundant electrolyte in the
body
-responsible for bone health & neuromuscular & cardiac function*, essential factor in
blood clotting*, promotes transmission of nerve impulses, regulates muscle
contractions, maintains cardiac automaticity, catalyst for many cellular activities
-PTH stimulates release from the bones & reabsorption from kidneys & intestines;
Calcitonin blocks bone breakdown & lowers Ca levels; absorption stimulated by vitamin
D
8.5-10.5 mg/dL
Magnesium function & normal serum level - ANSWER in skeleton and ICF
-mineral used in more than 300 biochemical reactions in the body*, involved in protein
& carb metabolism; necessary for protein & DNA synthesis w/in the cell; maintains
normal IC levels of K; involved in electrical activity in nerve & muscle membranes,
including the heart; may have a role in regulating BP & may influence the release &
activity of insulin
-green leafy vegetables, whole grains, fish, nuts
-ingested in the diet and absorbed through the small intestines
1.6-2.6 mEq/L
Hyponatremia - ANSWER Na+ <135 mEq/L
S/S- HA, confusion, anorexia, nausea, vomiting, weakness, lethargy, muscle cramps or
twitching, seizures, tachycardia
CAUSES- diuretics, GI fluid loss, adrenal insufficiency, excessive intake of hypotonic
solutions(water, D5W IV fluids, etc), syndrome of inappropriate ADH
INTERVENTIONS- monitor I&O, Na level, LOC, safety; inc oral Na intake; provide mouth
care; admin IV saline infusion & take seizure precautions, if severe
Hypernatremia - ANSWER Na+ >145 mEq/L
,S/S- thirst, elevated temp, dry mouth & sticky MMs, tachycardia, skin flushed, restless; if
severe: hallucinations, irritability, lethargy, seizures
CAUSES- dehydration; excessive Na intake; inc water loss through profuse sweating,
heat stroke, diabetes insipidus; admin of hypertonic tube feeding
INTERVENTIONS- monitor I&O, Na level, VS & LOC; restrict Na in diet; inc water intake;
admin IV solutions that don't contain Na; give oral hygiene hourly; daily weights; safety;
seizure precautions if severe
Hypokalemia - ANSWER K+ <3.5 mEq/L
S/S- fatigue, anorexia, nausea, vomiting, muscle weakness, dec GI motility (hypo or
absent bowel sounds), polyuria, shallow respirations, tachycardia, disorientation,
paresthesia, flat T wake on ECG, inc sensitivity to digitalis, risk of kidney stones, risk of
bone turnover, inc risk of stroke
CAUSES- diuretics, GI fluid loss (vomiting, gastric suction, diarrhea), steroid admin,
hyperaldosteronism, anorexia or bulimia or malnutrition, trauma, burns
INTERVENTIONS- monitor I&O, K level, VS esp HR and RR; daily weights, safety,
encourage foods rich in K, admin K supplements (IV K must be diluted & admin into a
central vein slowly! NEVER IV PUSH)
Hyperkalemia - ANSWER K+ >5.0 mEq/L
S/S- muscle weakness, adb & muscle cramps, no reflexes, nausea, diarrhea, irritability,
oliguria, bradycardia
CAUSES- K-sparing diuretics, renal failure, hypoaldosteronism, high K intake coupled w/
renal insufficiency, acidosis, major trauma
INTERVENTIONS- monitor I&O, K level, pain, VS, heart monitor hourly
Hypocalcemia - ANSWER Ca <8.5 mg/dL
S/S- diarrhea, numbness & tingling of extremities, muscle cramps, tetany, convulsions,
laryngeal spasms, cardiac irritability, anxiety, thready pulse, positive Trousseau's &
Chvostek's signs
, CAUSES- hypoparathyroidism, malabsorption, pancreatitis, alkalosis, vit D deficiency,
inadequate intake of Ca rich food (e.g. during pregnancy and lactation)
INTERVENTIONS- monitor I&O, serum Ca, LOC; cardiac monitor; encourage inc Ca
intake; admin Ca supplements; observe Ca solutions IV sites for infiltration; watch for
stridor; if severe: monitor patency of airway, institute seizure & safety precautions, &
admin parenteral Ca
Chvostek's Sign - ANSWER Tap the face in front of the ear and below the zygomatic
bone.
-Facial twitching constitutes a positive sign
-Positive sign is a sign of hypocalcemia, respiratory alkalosis, hypokalemia, and/or
hypomagnesemia
Trousseau's Sign - ANSWER Inflate a blood pressure cuff above systolic pressure and
leave it inflated 2 min
-Flexion of the wrist and hand constitutes a positive sign
-Positive sign is a sign of hypocalcemia, respiratory alkalosis, and/or hypomagnesemia
Hypercalcemia - ANSWER Ca >10.5 mq/dL
S/S- muscle weakness, constipation, anorexia, nausea, vomiting, polyuria, polydipsia
(excessive thirst), kidney stones, bizarre behavior, bradycardia, osteoporosis, fractures,
bone pain, dec deep tendon reflexes
CAUSES- hyperparathyroidism, malignant bone disease, prolonged immobilization,
excess Ca supplementation, thiazide diuretics, multiple fractures, renal impairment,
steroid therapy, smoking
INTERVENTIONS- monitor I&O, LOC, safety, cardiac, teach exercise; encourage fluid
intake to prevent stone formation; encourage fiber to prevent constipation; eliminate
Ca supplements & limit Ca-rich foods; avoid Ca-based antacids; renal dialysis may be
required
ANSWERS VERIFIED 100% CORRECT
ADH - ANSWER produced in hypothalamus, released by the post pituitary gland in
response to low blood vol, pain, stress, high serum osmolality, rise in temp, and some
opioids
- causes collectors in nephrons to reabsorb more water for inc blood volume& lower
osmolality--the kidneys retain fluid
Thyroid hormone - ANSWER affects fluid volume by influencing cardiac output
--an increase causes an inc in CO, thereby increasing glomerular filtration rate and urine
output
Sodium function & normal serum level - ANSWER major cation in the ECF
-regulates fluid volume*, helps maintain blood vol, interacts w/ Ca to maintain muscle
contraction, stimulates conduction of nerve impulses
-regulated by aldosterone & ADH levels
-adults should limit the intake to 2,300 mg/day
135-145 mEq/L
Potassium function & normal serum level - ANSWER major cation in the ICF
-key electrolyte in cellular metabolism*, maintains ICF osmolality, regulates conduction
of cardiac rhythm, transmits electrical impulses in multiple body systems, assists w/
acid-base balance
-adults should consume at least 4,700 mg/day
-regulated by aldosterone
3.5-5.0 mEq/L
,Calcium function & normal serum level - ANSWER most abundant electrolyte in the
body
-responsible for bone health & neuromuscular & cardiac function*, essential factor in
blood clotting*, promotes transmission of nerve impulses, regulates muscle
contractions, maintains cardiac automaticity, catalyst for many cellular activities
-PTH stimulates release from the bones & reabsorption from kidneys & intestines;
Calcitonin blocks bone breakdown & lowers Ca levels; absorption stimulated by vitamin
D
8.5-10.5 mg/dL
Magnesium function & normal serum level - ANSWER in skeleton and ICF
-mineral used in more than 300 biochemical reactions in the body*, involved in protein
& carb metabolism; necessary for protein & DNA synthesis w/in the cell; maintains
normal IC levels of K; involved in electrical activity in nerve & muscle membranes,
including the heart; may have a role in regulating BP & may influence the release &
activity of insulin
-green leafy vegetables, whole grains, fish, nuts
-ingested in the diet and absorbed through the small intestines
1.6-2.6 mEq/L
Hyponatremia - ANSWER Na+ <135 mEq/L
S/S- HA, confusion, anorexia, nausea, vomiting, weakness, lethargy, muscle cramps or
twitching, seizures, tachycardia
CAUSES- diuretics, GI fluid loss, adrenal insufficiency, excessive intake of hypotonic
solutions(water, D5W IV fluids, etc), syndrome of inappropriate ADH
INTERVENTIONS- monitor I&O, Na level, LOC, safety; inc oral Na intake; provide mouth
care; admin IV saline infusion & take seizure precautions, if severe
Hypernatremia - ANSWER Na+ >145 mEq/L
,S/S- thirst, elevated temp, dry mouth & sticky MMs, tachycardia, skin flushed, restless; if
severe: hallucinations, irritability, lethargy, seizures
CAUSES- dehydration; excessive Na intake; inc water loss through profuse sweating,
heat stroke, diabetes insipidus; admin of hypertonic tube feeding
INTERVENTIONS- monitor I&O, Na level, VS & LOC; restrict Na in diet; inc water intake;
admin IV solutions that don't contain Na; give oral hygiene hourly; daily weights; safety;
seizure precautions if severe
Hypokalemia - ANSWER K+ <3.5 mEq/L
S/S- fatigue, anorexia, nausea, vomiting, muscle weakness, dec GI motility (hypo or
absent bowel sounds), polyuria, shallow respirations, tachycardia, disorientation,
paresthesia, flat T wake on ECG, inc sensitivity to digitalis, risk of kidney stones, risk of
bone turnover, inc risk of stroke
CAUSES- diuretics, GI fluid loss (vomiting, gastric suction, diarrhea), steroid admin,
hyperaldosteronism, anorexia or bulimia or malnutrition, trauma, burns
INTERVENTIONS- monitor I&O, K level, VS esp HR and RR; daily weights, safety,
encourage foods rich in K, admin K supplements (IV K must be diluted & admin into a
central vein slowly! NEVER IV PUSH)
Hyperkalemia - ANSWER K+ >5.0 mEq/L
S/S- muscle weakness, adb & muscle cramps, no reflexes, nausea, diarrhea, irritability,
oliguria, bradycardia
CAUSES- K-sparing diuretics, renal failure, hypoaldosteronism, high K intake coupled w/
renal insufficiency, acidosis, major trauma
INTERVENTIONS- monitor I&O, K level, pain, VS, heart monitor hourly
Hypocalcemia - ANSWER Ca <8.5 mg/dL
S/S- diarrhea, numbness & tingling of extremities, muscle cramps, tetany, convulsions,
laryngeal spasms, cardiac irritability, anxiety, thready pulse, positive Trousseau's &
Chvostek's signs
, CAUSES- hypoparathyroidism, malabsorption, pancreatitis, alkalosis, vit D deficiency,
inadequate intake of Ca rich food (e.g. during pregnancy and lactation)
INTERVENTIONS- monitor I&O, serum Ca, LOC; cardiac monitor; encourage inc Ca
intake; admin Ca supplements; observe Ca solutions IV sites for infiltration; watch for
stridor; if severe: monitor patency of airway, institute seizure & safety precautions, &
admin parenteral Ca
Chvostek's Sign - ANSWER Tap the face in front of the ear and below the zygomatic
bone.
-Facial twitching constitutes a positive sign
-Positive sign is a sign of hypocalcemia, respiratory alkalosis, hypokalemia, and/or
hypomagnesemia
Trousseau's Sign - ANSWER Inflate a blood pressure cuff above systolic pressure and
leave it inflated 2 min
-Flexion of the wrist and hand constitutes a positive sign
-Positive sign is a sign of hypocalcemia, respiratory alkalosis, and/or hypomagnesemia
Hypercalcemia - ANSWER Ca >10.5 mq/dL
S/S- muscle weakness, constipation, anorexia, nausea, vomiting, polyuria, polydipsia
(excessive thirst), kidney stones, bizarre behavior, bradycardia, osteoporosis, fractures,
bone pain, dec deep tendon reflexes
CAUSES- hyperparathyroidism, malignant bone disease, prolonged immobilization,
excess Ca supplementation, thiazide diuretics, multiple fractures, renal impairment,
steroid therapy, smoking
INTERVENTIONS- monitor I&O, LOC, safety, cardiac, teach exercise; encourage fluid
intake to prevent stone formation; encourage fiber to prevent constipation; eliminate
Ca supplements & limit Ca-rich foods; avoid Ca-based antacids; renal dialysis may be
required
