Fluid and Electrolyte Management RNC NIC
UPDATED ACTUAL Exam Questions and
CORRECT Answers
Magnesium Homeostasis - CORRECT ANSWER - 1.5-2.5 mg/dl; important for muscle
contractions and enzymatic function
For greatest possible accuracy; when should urine output be measured? - CORRECT
ANSWER - right after it occurs; infants on radiant warmer may loose volume due to
evaporation before diaper is weighed
Sodium - CORRECT ANSWER - major extra cellular cation; plays pivotal role in fluid
homeostasis
What major change of fluid occurs for the neonate at birth? - CORRECT ANSWER -
decrease in extracellular volume as diuresis is established within first week of life; this results in
weight loss approximately 10-15% up to 20% in preterm infants
Fetal neprhons are immature up until what week of gestation? - CORRECT ANSWER - 34
weeks
Antidiuretic Hormone ADH - CORRECT ANSWER - produced by the posterior pituitary
and is created in response to hypotension (low fluid volume) and hyperosmolality (want to retain
fluid to balance hyperosmolality)
What is the normal urine output in a neonate? - CORRECT ANSWER - 1-4 ml/kg/hr
Insensible Water Loss IWL - CORRECT ANSWER - Unmeasurable loss of fluid that
typically occurs through the skin and pulmonary system in the neonate
, TEWL is a type of __________ - CORRECT ANSWER - insensible water loss; stands for
transepidermal water loss TEWL
What is the major source of IWL in premature infants? - CORRECT ANSWER - TEWL
TEWL ____________ with gestational age - CORRECT ANSWER - decreases
When is TEWL the highest? - CORRECT ANSWER - The first day after birth; improves
as skin barrier matures
What is the typical fluid maintenance (ml/kg/day) for the first 3 to 5 days of life? - CORRECT
ANSWER - 60-100 ml/kg/day
What weight is used to calculate fluid maintenance? - CORRECT ANSWER - usually
birth weight not current weight until birth weight is reestablished
For infants less than 1 kg what percentage of dextrose is recommended and why? - CORRECT
ANSWER - 5%; to prevent hyperglycemia
Describe the clinical presentation of fluid depletion in a neonate? - CORRECT ANSWER -
decreased urine output <1 or even <0.5 ml/kg/hr, increased urine specific gravity, weight loss,
poor skin turgor (a late sign) dry mucous membranes
What hemodynamic changes are accompanied by fluid depletion in the neonate? - CORRECT
ANSWER - low blood pressure; weak pulses; slow cap refill pale cool mottle skin
tachycardia; increased core vs peripheral temperature differential
What would a blood gas look like for the hypovolemic infant? - CORRECT ANSWER -
metabolic acidosis secondary to tissue/cellular hypoxia (less blood getting to tissue due to less
volume)
UPDATED ACTUAL Exam Questions and
CORRECT Answers
Magnesium Homeostasis - CORRECT ANSWER - 1.5-2.5 mg/dl; important for muscle
contractions and enzymatic function
For greatest possible accuracy; when should urine output be measured? - CORRECT
ANSWER - right after it occurs; infants on radiant warmer may loose volume due to
evaporation before diaper is weighed
Sodium - CORRECT ANSWER - major extra cellular cation; plays pivotal role in fluid
homeostasis
What major change of fluid occurs for the neonate at birth? - CORRECT ANSWER -
decrease in extracellular volume as diuresis is established within first week of life; this results in
weight loss approximately 10-15% up to 20% in preterm infants
Fetal neprhons are immature up until what week of gestation? - CORRECT ANSWER - 34
weeks
Antidiuretic Hormone ADH - CORRECT ANSWER - produced by the posterior pituitary
and is created in response to hypotension (low fluid volume) and hyperosmolality (want to retain
fluid to balance hyperosmolality)
What is the normal urine output in a neonate? - CORRECT ANSWER - 1-4 ml/kg/hr
Insensible Water Loss IWL - CORRECT ANSWER - Unmeasurable loss of fluid that
typically occurs through the skin and pulmonary system in the neonate
, TEWL is a type of __________ - CORRECT ANSWER - insensible water loss; stands for
transepidermal water loss TEWL
What is the major source of IWL in premature infants? - CORRECT ANSWER - TEWL
TEWL ____________ with gestational age - CORRECT ANSWER - decreases
When is TEWL the highest? - CORRECT ANSWER - The first day after birth; improves
as skin barrier matures
What is the typical fluid maintenance (ml/kg/day) for the first 3 to 5 days of life? - CORRECT
ANSWER - 60-100 ml/kg/day
What weight is used to calculate fluid maintenance? - CORRECT ANSWER - usually
birth weight not current weight until birth weight is reestablished
For infants less than 1 kg what percentage of dextrose is recommended and why? - CORRECT
ANSWER - 5%; to prevent hyperglycemia
Describe the clinical presentation of fluid depletion in a neonate? - CORRECT ANSWER -
decreased urine output <1 or even <0.5 ml/kg/hr, increased urine specific gravity, weight loss,
poor skin turgor (a late sign) dry mucous membranes
What hemodynamic changes are accompanied by fluid depletion in the neonate? - CORRECT
ANSWER - low blood pressure; weak pulses; slow cap refill pale cool mottle skin
tachycardia; increased core vs peripheral temperature differential
What would a blood gas look like for the hypovolemic infant? - CORRECT ANSWER -
metabolic acidosis secondary to tissue/cellular hypoxia (less blood getting to tissue due to less
volume)
