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NURS 1141 - Exam 2 Study Questions and Correct Answers

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Hypotonic Will push fluid to extravascular space Isotonic No change in fluid shift Hypertonic Will draw fluid into the vascular system Lactated Ringers Sodium Chloride Normal saline contains 154 mEq Na per liter Contraindicated in hypernatremia or hyperchloremia Albumin Colloid Natural protein produced in the liver - 70% of colloid oncotic pressure Human donor Contraindicated in severe heart failure Concentrations 5-25% Onset - 1 minute, Half Life - 16 hour, Duration - 24 hour Dextran Colloid Solution of glucose Concentration 40, 70, 75, mixed in D5w or 0.9ns Contraindications - heart failure, renal insufficiency, severe dehydration Onset - 5 min, Half Life - 2-6 hr, Duration 4-6 hr Crystalloids Lactated Ringers, Normal Saline Substances in a solution that diffuse through a semi-permeable membrane Can leak out of the vessels Colloids Albumin, Dextran Protein substances that increase the colloid oncotic pressure Hypertonic! "Plasma expander" More expensive - more likely to induce bleeding Potassium Chloride "most abundant electrolyte inside sells" (95% intracell) Normal concentration 3.5-5 mEq/L (150 intracell) Indicated in K+ deficiency Chloride works on hypochloremia which typically accompanies hypoK+ Contraindications - hyperkalemia, renal disease, dehydration, untreated addisons disease, hemolytic disease, tissue breakdown

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NURS 1141 - Exam 2 Study Questions
and Correct Answers
Hypotonic ✅Will push fluid to extravascular space

Isotonic ✅No change in fluid shift

Hypertonic ✅Will draw fluid into the vascular system

Lactated Ringers ✅

Sodium Chloride ✅Normal saline contains 154 mEq Na per liter
Contraindicated in hypernatremia or hyperchloremia

Albumin ✅Colloid
Natural protein produced in the liver - 70% of colloid oncotic pressure
Human donor
Contraindicated in severe heart failure
Concentrations 5-25%
Onset - 1 minute, Half Life - 16 hour, Duration - 24 hour

Dextran ✅Colloid
Solution of glucose
Concentration 40, 70, 75, mixed in D5w or 0.9ns
Contraindications - heart failure, renal insufficiency, severe dehydration
Onset - 5 min, Half Life - 2-6 hr, Duration 4-6 hr

Crystalloids ✅Lactated Ringers, Normal Saline
Substances in a solution that diffuse through a semi-permeable membrane
Can leak out of the vessels

Colloids ✅Albumin, Dextran
Protein substances that increase the colloid oncotic pressure
Hypertonic!
"Plasma expander"
More expensive - more likely to induce bleeding

Potassium Chloride ✅"most abundant electrolyte inside sells" (95% intracell)
Normal concentration 3.5-5 mEq/L (150 intracell)
Indicated in K+ deficiency
Chloride works on hypochloremia which typically accompanies hypoK+
Contraindications - hyperkalemia, renal disease, dehydration, untreated addisons
disease, hemolytic disease, tissue breakdown

, SE - n/v/d, GI ulcers/bleeding
Dose 20-40mEq/L peripheral, 60mEq/L central - 10mEq/hr no tele, 20mEq/hr tele
Toxicity - weakness, paresthesia, paralysis, dysrhythmia
**hyperK+ fixed by dextrose/insulin, bicarb, Ca gluc/chloride
Interactions - K+ sparing diuretics, ACE inhibitors = + K+, non-paring
diuretic,/amphotrecin B, mineral alocorticiods = - K+

Renal role in fluid/electrolyte balance ✅Filtering, excreting, or retaining water and
electroylytes in the kidneys

Glomerular Filtration Rate ✅amount of filtrate formed in all the renal corpuscles of both
kidneys each minute

Creatinine Clearance ✅measurement of the rate at which creatinine is cleared from
the blood by the kidney

Acetazolamide (Diamox) ✅Carbonic Anhydrase Inhibitor
Actions: Weak Diuretic, inhibits CA in kidney, brain, eye, pee out bicarb, making them
acidotic, increase rate
Uses: Reduces intraocular pressure (glaucoma) reduces seizure activity, also used in
ICU as respiratory stimulant with metabolic alkalosis for weaning off vent

Furosemide ✅Sulfonamide-type loop
Dose 20, 40, 80mg
IV 10mg/mL (IV is half oral dose)
*Use peroxide for oral irritation
Dumps K+, can cause dehydration/ortho changes
May inhibit uric acid excretion -> gout
Interactions - alchohol/narcs/sedatives -> ortho change
Dig - may increase K+ excretion
*Watch for doses > 200mg

Hydrochlorothiazide ✅Thiazide-type
Dose - 12.5/25/50 oral tablets/capsules (12.5-200mg)
Administer with food/milk
Plasma uric acid issues
May induce hyperglycemia in DM (adjust DM meds)

Metolazone (zaroxolyn) ✅Thiazide-type diuretic
Dose 2.5/5/10mg (2.5-20mg)
Administer with food/milk
Plasma uric acid issues
May induce hyperglycemia in DM (adjust DM meds)

Spironolactone ✅Potassium-sparing diuretic

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