EXAM 2 FUNDAMENTALS NR 226 EXAM QUESTIONS
WITH COMPLETE SOLUTION
What are the main causes of electrolytes imbalances?
Changes in diet
GI malfunction
Renal problems
Medications
Procedures
Disease process
What is considered an isotonic solution?
Fluid with the same tonicity as normal blood
What is considered a hypotonic solution?
More dilute than blood
--cell swells
What is considered a hypertonic solution?
More concentrated than normal blood
--cell shrinks
Extracellular fluid volume deficit
Body Fluids Have Decreased Volume but Normal Osmolality
-decreased intake of H20 and salt
-Increased GI output
-Increased renal output
-Loss of blood or plasma
-Massive sweating without water and salt intake
Extracellular fluid volume excess
Body Fluids Have Increased Volume but Normal Osmolality
-Excessive administration of Na+ containing isotonic IV fluids or oral intake of salty
foods and water
-Renal retention of Na+
Signs of mild Extracellular fluid volume excess
Swollen ankles and fingers (rings feel tight) and a gain of 2lbs or more
Bananas are rich in what type of electrolyte
Potassium
Foods high in potassium K+
Fruits, potatoes, instant coffee, molasses, brazil nuts,
True or false: Cancer can cause major electrolyte imbalances
True
Calcium-rich foods include
dairy products, lentils, fish w/ fine bones, broccoli, oranges, dried fruits, nuts, chocolate,
cocoa, Ovaltine
Best absorption of calcium rich fluids happens with
Vitamin D
Undigested fat can prevent ____ and _____ from absorption
,Calcium and Magnesium
Magnesium-rich foods include
dark green leafy vegetables, whole grains, magnesium-containing laxatives and
antacids
Phosphate-rich foods include
milk, processed food
What can prevent phosphate absorption?
Aluminum antacids
Hypernatremia
Abnormally high sodium concentration in the blood
-water deficit
What types of patients should you monitor for hypernatremia?
Diabetes insipidus
Osmotic diuresis
-Large amount of perspiration and respiratory water output
-Tube feedings, hypertonic parenteral fluids, or salt tablets
-Dysfunction of osmoreceptor driven thirst drive
Causes of hypernatremia
Excessive / rapid IV administration of normal saline, inadequate water intake and kidney
disease
Normal range for sodium
135-145 mEq/L
Signs and symptoms of hypernatremia
Confusion, dry mucous membranes, seizures flat neck veins, dry skin, intense thirst,
dark urine, skin tenting
True or false: a patient with hypernatermia will show very similar signs of
dehydration
True
What blood work is done to look at sodium?
Chem 7, cmp
Confusion is present in both hypo and hyper_____________
Hyponatermia and hypernatremia
Treatment for hypernatremia
Weigh patient daily, monitor I/O, check vital signs, check skin turgor, place patient on
sodium restricted diet
Clinical dehydration
ECV deficit and hypernatremia combined
What IV drugs do you want to administer for a patient experiencing
hypernatremia
Hypotonic IV fluids or Isotonic IV fluids
Hyponatremia
Abnormally low sodium ion concentration in the blood
Causes of hyponatremia
Decreased sodium intake, increased sodium excretion due to suctioning
Signs and symptoms of hyponatremia
, Confusion, N/V, abdominal cramping, weigh gain, cold clammy skin, SOB, crackles,
periorbital edema,
Treatment for hyponatremia
Provide high sodium foods, auscultate lungs (crackles), monitor body weight and vital
signs
What IV solutions should be hung to help with hyponatremia?
Administer hypertonic IV fluids or Hypotonic IV fluids,
Hyperkalemia
abnormally high potassium ion in concentration in the blood
Whenever potassium is off, what should the nurse be worried about?
The heart; dysrhythmias occur in both hypo and hyperkalemia
What should you use to help determine if a patient is experiencing a potassium
imbalance?
Lab: CNP, BMP
Test: 12 lead ECG or EKG
Causes of hyperkalemia
Excessive potassium intake, shift of potassium from cells into the ECF
-Renal issues (oliguria)
Signs and symptoms of hyperkalemia
muscle weakness, cardiac dysrhythmias, numbness, tinging, irritability, flaccid paralysis,
N/V/D
Treatment for hyperkalemia includes
sodium polystyrene and keyaxalate enemas, diet changes, no use of salt supplements
Keyaxalate enema
Removes excess potassium via the stool
Sodium polystyrene
Removes excess potassium via bowel
Why do you want to monitor acid base balance with hyperkalemia?
Too much potassium in the body can cause the blood to become acidic
With hyper and hypokalemia what test should be ran?
ECG or EKG
Hypokalemia
Low potassium concentration in the blood
Causes of hypokalemia
NG tube suctioning, diuretics such as furosemide
Signs and symptoms of hypokalemia
Cardiac dysrhythmias, thready, rapid, weak pulse, decreased blood pressure, muscle
weakness, shallow respiration, weight loss
Treatment for hypokalemia
Increase potassium-rich foods, administer potassium supplements, monitor ECG, EKG
and vital signs
Hypercalcemia
Abnormally high calcium concentration in the blood
Normal calcium levels
8.4-10.5 mg/dL
Causes of hypercalcemia
WITH COMPLETE SOLUTION
What are the main causes of electrolytes imbalances?
Changes in diet
GI malfunction
Renal problems
Medications
Procedures
Disease process
What is considered an isotonic solution?
Fluid with the same tonicity as normal blood
What is considered a hypotonic solution?
More dilute than blood
--cell swells
What is considered a hypertonic solution?
More concentrated than normal blood
--cell shrinks
Extracellular fluid volume deficit
Body Fluids Have Decreased Volume but Normal Osmolality
-decreased intake of H20 and salt
-Increased GI output
-Increased renal output
-Loss of blood or plasma
-Massive sweating without water and salt intake
Extracellular fluid volume excess
Body Fluids Have Increased Volume but Normal Osmolality
-Excessive administration of Na+ containing isotonic IV fluids or oral intake of salty
foods and water
-Renal retention of Na+
Signs of mild Extracellular fluid volume excess
Swollen ankles and fingers (rings feel tight) and a gain of 2lbs or more
Bananas are rich in what type of electrolyte
Potassium
Foods high in potassium K+
Fruits, potatoes, instant coffee, molasses, brazil nuts,
True or false: Cancer can cause major electrolyte imbalances
True
Calcium-rich foods include
dairy products, lentils, fish w/ fine bones, broccoli, oranges, dried fruits, nuts, chocolate,
cocoa, Ovaltine
Best absorption of calcium rich fluids happens with
Vitamin D
Undigested fat can prevent ____ and _____ from absorption
,Calcium and Magnesium
Magnesium-rich foods include
dark green leafy vegetables, whole grains, magnesium-containing laxatives and
antacids
Phosphate-rich foods include
milk, processed food
What can prevent phosphate absorption?
Aluminum antacids
Hypernatremia
Abnormally high sodium concentration in the blood
-water deficit
What types of patients should you monitor for hypernatremia?
Diabetes insipidus
Osmotic diuresis
-Large amount of perspiration and respiratory water output
-Tube feedings, hypertonic parenteral fluids, or salt tablets
-Dysfunction of osmoreceptor driven thirst drive
Causes of hypernatremia
Excessive / rapid IV administration of normal saline, inadequate water intake and kidney
disease
Normal range for sodium
135-145 mEq/L
Signs and symptoms of hypernatremia
Confusion, dry mucous membranes, seizures flat neck veins, dry skin, intense thirst,
dark urine, skin tenting
True or false: a patient with hypernatermia will show very similar signs of
dehydration
True
What blood work is done to look at sodium?
Chem 7, cmp
Confusion is present in both hypo and hyper_____________
Hyponatermia and hypernatremia
Treatment for hypernatremia
Weigh patient daily, monitor I/O, check vital signs, check skin turgor, place patient on
sodium restricted diet
Clinical dehydration
ECV deficit and hypernatremia combined
What IV drugs do you want to administer for a patient experiencing
hypernatremia
Hypotonic IV fluids or Isotonic IV fluids
Hyponatremia
Abnormally low sodium ion concentration in the blood
Causes of hyponatremia
Decreased sodium intake, increased sodium excretion due to suctioning
Signs and symptoms of hyponatremia
, Confusion, N/V, abdominal cramping, weigh gain, cold clammy skin, SOB, crackles,
periorbital edema,
Treatment for hyponatremia
Provide high sodium foods, auscultate lungs (crackles), monitor body weight and vital
signs
What IV solutions should be hung to help with hyponatremia?
Administer hypertonic IV fluids or Hypotonic IV fluids,
Hyperkalemia
abnormally high potassium ion in concentration in the blood
Whenever potassium is off, what should the nurse be worried about?
The heart; dysrhythmias occur in both hypo and hyperkalemia
What should you use to help determine if a patient is experiencing a potassium
imbalance?
Lab: CNP, BMP
Test: 12 lead ECG or EKG
Causes of hyperkalemia
Excessive potassium intake, shift of potassium from cells into the ECF
-Renal issues (oliguria)
Signs and symptoms of hyperkalemia
muscle weakness, cardiac dysrhythmias, numbness, tinging, irritability, flaccid paralysis,
N/V/D
Treatment for hyperkalemia includes
sodium polystyrene and keyaxalate enemas, diet changes, no use of salt supplements
Keyaxalate enema
Removes excess potassium via the stool
Sodium polystyrene
Removes excess potassium via bowel
Why do you want to monitor acid base balance with hyperkalemia?
Too much potassium in the body can cause the blood to become acidic
With hyper and hypokalemia what test should be ran?
ECG or EKG
Hypokalemia
Low potassium concentration in the blood
Causes of hypokalemia
NG tube suctioning, diuretics such as furosemide
Signs and symptoms of hypokalemia
Cardiac dysrhythmias, thready, rapid, weak pulse, decreased blood pressure, muscle
weakness, shallow respiration, weight loss
Treatment for hypokalemia
Increase potassium-rich foods, administer potassium supplements, monitor ECG, EKG
and vital signs
Hypercalcemia
Abnormally high calcium concentration in the blood
Normal calcium levels
8.4-10.5 mg/dL
Causes of hypercalcemia
