NSG 533 - Advanced Pathophysiology Exam 1 - Module 2 Questions with Correct Answers

hemorrhage, severe wound drainage, excessive sweating. - ANSWERSEtiology of fluid volume deficit (hypovolemia) may remain the same - ANSWERSnormal serum level of hypovolemia weight loss, dryness of skin and mucous membranes, decreased urine output, increased hematocrit value, weak pulse tachycardia, normal or decreased BP, flattened neck veins - ANSWERSclinical manifestations of hypovolemia increased BUN and hematocrit - ANSWERSdiagnostic findings of hypovolemia isotonic fluid excess. Excessive admin of hypotonic IV fluids, hypersecretion of aldosterone, the effects of drugs such as cortisones, or kidney failure, psychogenic polydipsia, tap water enema, SIADH - ANSWERSetiology of hypervolemia weight gain, edema (caused by increased capillary hydrostatic pressure), pulmonary edema, heart failure, distended neck veins, confusion, extra cellular volume contraction excess plasma volume leads to decreased hematocrit and decreased plasma protein concentration, blood pressure increases - ANSWERSclinical manifestations of hypervolemia increased BUN and hematocrit - ANSWERSdiagnostic finding of hypervolemia sodium 145 excessive hypertonic salt solutions IV hypertonic sodium saline-induced abortions select infant formulas hyperaldosteronism cushing syndrome advanced age, impaired mental state fever diarrhea vomiting uncontrolled diabetes tube feedings use of diuretics - ANSWERSetiology of hypernatremia body loses Na+ AND H20 but loses more H20 than Na+ non renal: sweating, diarrhea, poor PO intake (urine NA 10) renal: loop diuretics, diuretic stage of kidney disease (urine NA 20) - ANSWERSCauses of hypovolemic hypernatremia most common Body loses free H20 with near normal Na+ insufficient water intake, excessive sweating, fever with hyperventilation, burns, vomiting, diarrhea or nephrogenic diabetes insipidus - ANSWERSCauses of isovolemic hypernatremia rare Body retains NA+ and H20 but retains more NA infusing hypertonic saline solutions ACTH excess consuming lots of soy sauce or concentrated salt water - ANSWERSCauses of hypervolemic hypernatremia loss of sodium, inadequate intake of sodium, or dilution of sodium by water excess, hyperaldosteronism, excessive Loss of body fluid: vomiting, diarrhea, inadequate secretion of aldosterone, excessive use of diuretics SIADH, excessive water drinking, SSRIs, liver cirrhosis, hyperglycemia, hyperlipidemia, - ANSWERSetiology of hyponatremia exceed level of 145 mEq/L (normal 135-145) - ANSWERSnormal serum level hypernatremia sodium serum level decreases to less than 135 mEq/L (normal 135-145) - ANSWERSnormal serum level hyponatremia happens when there's a loss of overall body fluid, loss of body sodium is greatest than loss of body water prolonged vomiting, prolonged diarrhea, inadequate secretion of aldosterone, renal loss from diuretics hypotension, tachycardia, decreased urine output - ANSWERSHypovolemic hyponatremia causes and CM happens when there's a loss of sodium without significant loss of H20 water retention d/t SIADH, hypothyroidism, PNA, glucose deficiency - ANSWERSIsotonic hyponatremia causes low levels of sodium (dilutional hyponatremia) and excess extracellular fluid CHF, cirrhosis, nephrotic syndrome, excessive infusion CM; N/C, HA, confusion, lethargy, coma. Weight gain, ascites, edema, and JVD - ANSWERShypovolemic hyponatremia causes and CM (pseudohyponatremia) when water moves from inside cells to surrounding fluid. Shift dilutes sodium concentration in the ECF causes: hyperglycemia, hyperlipidemia, hyperproteinemia - ANSWERShypertonic hyponatremia causes bounding pulse central nervous system signs weakness weight gain lethargy muscle twitching and hyperreflexia, Confusion, coma, and seizures can occur - ANSWERSclinical manifestations of hypernatremia usually asymptomatic. Mild (120-130): N/V Less than 120 mEq/l: neurologic symptoms: lethargy, headache, confusion, apprehension, seizures, and coma. - ANSWERSclinical manifestations of hyponatremia sodium serum levels of 145 mEq/L Urine specific gravity 1.030 High BUN and Creatinine Hematocrit and plasma protein levels will be elevated with water loss - ANSWERSdiagnostic findings of hypernatremia serum less than 135 mEq/l. hematocrit and plasma protein levels may be elevated urine specific gravity 1.010 Urine sodium level may be high or low High (cerebral salt wasting syndrome, adrenal insufficiency) Low (extra renal loss, v/d, severe burns, HF, or cirrhosis - ANSWERSdiagnostic findings of hyponatremia an elevation of ECF K+ 5.0 mEq/l excessive intake, a shift of K from ICF to ECF, decreased renal excretion/renal failure. Tissue breakdown, adrenal failure, K+ sparing diuretics, metabolic acidosis, hyperglycemia, transfusions, pseudohyperkalemia Other causes: hypoxia, changes in cell membrane permeability, acidosis - ANSWERSetiology of hyperkalemia hemolysis during blood draw, platelets 1,000,000 WBC 20,000 mononeucleosis familial pseudohyperkalemia - ANSWERSWhat causes pseudohyperkalemia?