NUR 623 (Adult_Gero Acute) MOD #2, electrolyte imbalances, quiz Questions with CORRECT
Answers (Grade A+)
Question 1:
normal 135-145
-regulates water, body volume, BP -generates action potentials for nerve signaling -muscle
contractions/relaxations
Answer:
Na
Question 2:
loss of water
-N/V/D
-impaired thirst (elderly, neuro damage like DI) -sweating, fever -burns, surgical losses
Answer:
hypernatremia
Question 3:
s/s hypernatremia
Answer:
confusion/irritability -N/V, weakness -thirst, polyuria -hypotension, tachycardia
Question 4:
labs in hypernatremia
Answer:
-NA > 145 -serum osmo > 300 -urine osmo < 500 - dilute urine (normal is 500-850) *if urine osmo is
<300, consider DI
Question 5:
tool to know how much fluid to restore in a patient with hypernatremia per hour of 24 hours (on
MD CALC)
Answer:
,calculate free water deficit, divide that by 24 and give that amount hourly for 24 hours
Question 6:
hypernatremia treatment
Answer:
-stop excess saline, encourage water PO intake -determine free water deficit to know how much
fluid to restore **aim for a correction of 1-2 meq/hr to avoid cerebral edema in acute cases
Question 7:
if they can't tolerate PO water, treat
Answer:
mild depletion: D5W moderate depletion: 1/2 NS severe depletion: NS or LR run NA every 4-6
hours
Question 8:
why does hypotonic fluid help with hypernatremia?
Answer:
reduces extracellular NA concentration - fluid and sodium will then move into cells via osmosis
-decreases serum NA
Question 9:
A 70IyearIold hospitalized patient is noted to have a serum sodium of 162 mEq/L. The patient is
awake, hemodynamically stable, and has had poor oral intake for several days. Hypernatremia is
believed to be chronic. Which of the following is the most appropriate management approach
Answer:
administer hypotonic fluids (free water, D5W) and correct sodium gradually by 1-2 meq/hr
Question 10:
Na < 135
-acute less than 48 hours, chronic longer than 48 hours -excess water, low serum osmo -increased
risk for cerebral edema and brain herniation
Answer:
hyponatremia
, Question 11:
severe vs non severe s/s of hyponatremia
Answer:
non-severe: N/V, HA, lethargy/confusion, dizziness, muscle cramps, hyperreflexia severe: seizures,
delirium, neurogenic pulm. edema, coma, brain herniation
Question 12:
causes hyponatremia
Answer:
-thiazides, SSRI's -renal failure -polydipsia, rapid water intake -elderly diet low in salt
Question 13:
-GI losses, bleeding, sweating -thiazides, adrenal insufficiency -hypoaldosteronism can all cause
Answer:
hypovolemic hyponatremia
Question 14:
-severe hypothyroidism -SIADH -lung CA -neuro psych disorders can all cause
Answer:
euvolemic hyponatremia
Question 15:
HF, cirrhosis, nephrotic syndrome, severe renal failure can all cause
Answer:
hypervolemic hyponatremia
Question 16:
treatment for acute and symptomatic hyponatremia (coma)
Answer:
3% saline 100ML over ten minutes, may repeat X3
Question 17:
why does hypertonic saline help with hyponatremia?
Answers (Grade A+)
Question 1:
normal 135-145
-regulates water, body volume, BP -generates action potentials for nerve signaling -muscle
contractions/relaxations
Answer:
Na
Question 2:
loss of water
-N/V/D
-impaired thirst (elderly, neuro damage like DI) -sweating, fever -burns, surgical losses
Answer:
hypernatremia
Question 3:
s/s hypernatremia
Answer:
confusion/irritability -N/V, weakness -thirst, polyuria -hypotension, tachycardia
Question 4:
labs in hypernatremia
Answer:
-NA > 145 -serum osmo > 300 -urine osmo < 500 - dilute urine (normal is 500-850) *if urine osmo is
<300, consider DI
Question 5:
tool to know how much fluid to restore in a patient with hypernatremia per hour of 24 hours (on
MD CALC)
Answer:
,calculate free water deficit, divide that by 24 and give that amount hourly for 24 hours
Question 6:
hypernatremia treatment
Answer:
-stop excess saline, encourage water PO intake -determine free water deficit to know how much
fluid to restore **aim for a correction of 1-2 meq/hr to avoid cerebral edema in acute cases
Question 7:
if they can't tolerate PO water, treat
Answer:
mild depletion: D5W moderate depletion: 1/2 NS severe depletion: NS or LR run NA every 4-6
hours
Question 8:
why does hypotonic fluid help with hypernatremia?
Answer:
reduces extracellular NA concentration - fluid and sodium will then move into cells via osmosis
-decreases serum NA
Question 9:
A 70IyearIold hospitalized patient is noted to have a serum sodium of 162 mEq/L. The patient is
awake, hemodynamically stable, and has had poor oral intake for several days. Hypernatremia is
believed to be chronic. Which of the following is the most appropriate management approach
Answer:
administer hypotonic fluids (free water, D5W) and correct sodium gradually by 1-2 meq/hr
Question 10:
Na < 135
-acute less than 48 hours, chronic longer than 48 hours -excess water, low serum osmo -increased
risk for cerebral edema and brain herniation
Answer:
hyponatremia
, Question 11:
severe vs non severe s/s of hyponatremia
Answer:
non-severe: N/V, HA, lethargy/confusion, dizziness, muscle cramps, hyperreflexia severe: seizures,
delirium, neurogenic pulm. edema, coma, brain herniation
Question 12:
causes hyponatremia
Answer:
-thiazides, SSRI's -renal failure -polydipsia, rapid water intake -elderly diet low in salt
Question 13:
-GI losses, bleeding, sweating -thiazides, adrenal insufficiency -hypoaldosteronism can all cause
Answer:
hypovolemic hyponatremia
Question 14:
-severe hypothyroidism -SIADH -lung CA -neuro psych disorders can all cause
Answer:
euvolemic hyponatremia
Question 15:
HF, cirrhosis, nephrotic syndrome, severe renal failure can all cause
Answer:
hypervolemic hyponatremia
Question 16:
treatment for acute and symptomatic hyponatremia (coma)
Answer:
3% saline 100ML over ten minutes, may repeat X3
Question 17:
why does hypertonic saline help with hyponatremia?
