NUR 242 Exam 2 Med-Surg
Medical-Surgical Nursing Galen
2026/2027 – Questions and
Answers | 100% Verified | Detailed
Rationales – Pass Guaranteed – A+
Graded |Instant Download
Causes of fluid overload - answer•Excessive fluid replacement
•Kidney failure (late phase)
•Heart failure
•Long term corticosteroid therapy
•Syndrome of inappropriate antidiuretic hormone (SIADH)
•Psychiatric disorders with polydipsia
•Water intoxication
s/s fluid overload - answer•CV: tachycardia, bounding pulse,
HTN, decrease pulse pressure, JVD, weight gain
•Resp: increase and shallow resp; SOB, crackles lung sounds
•Skin: pitting edema, skin pale and cool to touch
•Neuromuscular: LOC, HA, visual disturbance, muscle weakness,
paresthesia
•GI: increase motility, enlarge liver
Assessment for fluid overload - answer•Assess risk r/t age and
diagnosis, history (overhydration, CHF, kidney disease)
•Assess vital signs why: watch for bounding tachycardia, HTN,
dysrhythmias, tachypnea
•Assess lung sounds (crackles) , weight, LOC, Observe JVD
,•Assess lab values: electrolytes imbalance and signs and
symptoms
• Focus Assessment: skin/extremities/ abdomen and sacrum area
for edema
•Assess perfusion: edema may impair perfusion to extremities,
assess peripheral and central pulses, capillary refill, skin color,
temp, sensory and motor function
•Observe for urine output
Lab values fluid overload - answer•Serum osmolality (275-295
mOsm/kg)
•Decrease found in overhydration <275; and < 265 is critical
finding
•CBC
•Decrease hemoglobin and hematocrit
•BUN
•decreased BUN
•Electrolytes
•Decreased sodium (shifts due to dilution)
•Urine specific gravity Decrease < 1.005
fluid overload interventions/goal - answer•Goal: reduce excess
body fluids, promote desired elimination
•Manage underlying cause
•Restrict dietary sodium intake
•Monitor I/O
•Administer diuretic
•Monitor client's s/s and electrolytes values
•Restrict oral and other fluid intake as prescribed
Fluid overload complications - answer•Isotonic overhydration
•HF and pulmonary edema
•Seizure
•Coma
, Fluid overload medications - answerFurosemide
Mannitol
S/S of dehydration - answer•Vital signs: hyperthermia, ST, thread
pulse, hypotension, decrease CVP
•Neuromusculoskeletal: Dizziness, syncope, confusion,
weakness, fatigue
•GI: thirst, dry furrowed tongue, N/V, anorexia, weight loss
•Renal: Oliguria
•Other signs: Diminish capillary refill, cool clammy skin,
diaphoresis, sunken eyeballs, flat neck vein
Dehydration assessment - answer•Assess for condition leading to
dehydration: diarrhea, poor intake, vigorous exercise, vomiting,
polyuria, fluid losses (burns, trauma) clients with drains/NG tube,
burns/fluid shifts, overuse of diuretic
Dehydration labs - answer•Serum electrolytes (hypernatremia)
•Increased serum osmolality normal 275- 295 mOsm/kg; elevated
> 295 found in dehydration; > 320 is critical finding
•CBC elevated H/H
•Elevated urine specific gravity > 1.030
•Increased BUN
Dehydration interventions/goal - answer•Goal of interventions:
replace fluid and electrolytes to achieve homeostasis
•Closely monitor status and rehydration, avoid overcorrection
•Monitor I/O and weight
•Identify and manage cause- diarrhea, vomiting, blood loss, poor
intake
•Oral rehydration is priority if tolerating PO fluids
Dehydration priority interventions - answer•IV fluid
resuscitation/replacement, general guidelines
Medical-Surgical Nursing Galen
2026/2027 – Questions and
Answers | 100% Verified | Detailed
Rationales – Pass Guaranteed – A+
Graded |Instant Download
Causes of fluid overload - answer•Excessive fluid replacement
•Kidney failure (late phase)
•Heart failure
•Long term corticosteroid therapy
•Syndrome of inappropriate antidiuretic hormone (SIADH)
•Psychiatric disorders with polydipsia
•Water intoxication
s/s fluid overload - answer•CV: tachycardia, bounding pulse,
HTN, decrease pulse pressure, JVD, weight gain
•Resp: increase and shallow resp; SOB, crackles lung sounds
•Skin: pitting edema, skin pale and cool to touch
•Neuromuscular: LOC, HA, visual disturbance, muscle weakness,
paresthesia
•GI: increase motility, enlarge liver
Assessment for fluid overload - answer•Assess risk r/t age and
diagnosis, history (overhydration, CHF, kidney disease)
•Assess vital signs why: watch for bounding tachycardia, HTN,
dysrhythmias, tachypnea
•Assess lung sounds (crackles) , weight, LOC, Observe JVD
,•Assess lab values: electrolytes imbalance and signs and
symptoms
• Focus Assessment: skin/extremities/ abdomen and sacrum area
for edema
•Assess perfusion: edema may impair perfusion to extremities,
assess peripheral and central pulses, capillary refill, skin color,
temp, sensory and motor function
•Observe for urine output
Lab values fluid overload - answer•Serum osmolality (275-295
mOsm/kg)
•Decrease found in overhydration <275; and < 265 is critical
finding
•CBC
•Decrease hemoglobin and hematocrit
•BUN
•decreased BUN
•Electrolytes
•Decreased sodium (shifts due to dilution)
•Urine specific gravity Decrease < 1.005
fluid overload interventions/goal - answer•Goal: reduce excess
body fluids, promote desired elimination
•Manage underlying cause
•Restrict dietary sodium intake
•Monitor I/O
•Administer diuretic
•Monitor client's s/s and electrolytes values
•Restrict oral and other fluid intake as prescribed
Fluid overload complications - answer•Isotonic overhydration
•HF and pulmonary edema
•Seizure
•Coma
, Fluid overload medications - answerFurosemide
Mannitol
S/S of dehydration - answer•Vital signs: hyperthermia, ST, thread
pulse, hypotension, decrease CVP
•Neuromusculoskeletal: Dizziness, syncope, confusion,
weakness, fatigue
•GI: thirst, dry furrowed tongue, N/V, anorexia, weight loss
•Renal: Oliguria
•Other signs: Diminish capillary refill, cool clammy skin,
diaphoresis, sunken eyeballs, flat neck vein
Dehydration assessment - answer•Assess for condition leading to
dehydration: diarrhea, poor intake, vigorous exercise, vomiting,
polyuria, fluid losses (burns, trauma) clients with drains/NG tube,
burns/fluid shifts, overuse of diuretic
Dehydration labs - answer•Serum electrolytes (hypernatremia)
•Increased serum osmolality normal 275- 295 mOsm/kg; elevated
> 295 found in dehydration; > 320 is critical finding
•CBC elevated H/H
•Elevated urine specific gravity > 1.030
•Increased BUN
Dehydration interventions/goal - answer•Goal of interventions:
replace fluid and electrolytes to achieve homeostasis
•Closely monitor status and rehydration, avoid overcorrection
•Monitor I/O and weight
•Identify and manage cause- diarrhea, vomiting, blood loss, poor
intake
•Oral rehydration is priority if tolerating PO fluids
Dehydration priority interventions - answer•IV fluid
resuscitation/replacement, general guidelines
