NURSING 105 FINAL EXAM STUDY
GUIDE COMPLETELY SOLVED!!
Clinical Manifestations for Dehydration - ANSWER *Increased thirst
*Dry mouth and swollen tongue
*Weakness
*Dizziness
*Palpitations (feeling that the heart is jumping or pounding
*Confusion
*Sluggishness fainting
*Decreased urine output
*Changes in mental status
*Kidney
*Endocrine (poor regulation of sodium and potassium
*Nausea
*Vomiting
Assesssment findings for Dehydration - ANSWER *Pulmonary edema
*Poor skin turgor (check for skin turgor on the chest and the forehead)
*Weight loss
*Reduced urine output
*Cardiovascular changes (heart rate increases)
*Respiratory changes (increased rate)
*Peripheral pulses weak
*Hypotension while standing
*Kidney changes
*Neurologic changes (confusion)
*Neck Vein Distention
Risk factors for dehydration - ANSWER *Older adults are unable to obtain fluids without
help
*Older patients have less total body water than younger adults
*Decreased thirst sensation
*Diuretics
*Antihypertensives
*Laxatives
Nursing Interventions for Dehydration - ANSWER Patient Safety
Fluid Replacement
Drug Therapy (Oral or IV fluid replacement)
Best Indicator for fluid volume loss - ANSWER Daily Weight (same time every day)
,Patient Teaching for Dehydration - ANSWER Drink more fluids, mainly water, matching
fluid intake with fluid output
Clinical Manifestations of Hypokalemia - ANSWER Diuretics
Digitalis
Corticosteroids
Diarrhea
Vomiting
Prolonged nasogastric suction
NPO
Assessment Findings for Hypokalemia - ANSWER Respiratory
Musculoskeletal
Cardiovascular
Neurologic
Intestinal
*All of these conditions are weakened
Interventions for Hypokalemia - ANSWER Drug Therapy:
*Potassium via IV is given for more severe
*Oral potassium is given as a liquid or solid
*Drugs given are Aldactone, Novospiroton, Dyrenium,Midamor
Nutrition Therapy:
*Teach patient how to increase potassium intake
*Eat foods that are naturally rich in potassium to prevent further loss
Safety Measures:
*Fall precautions
Respiratory Monitoring:
Pulse oximetry (O2 Sat)
Hypocalcemia - ANSWER Low calcium levels (below 9.0 mg/dl)
Clinical Manifestations of Hypocalcemia - ANSWER Inadequate oral intake of calcium
Lactose intolerance
Inadequate intake of Vitamin D
End Stage Kidney Disease
Diarrhea
Wound Drainage
Assesssment Findings of Hypocalcemia - ANSWER *Neuromuscular changes -
Paresthesias occur with sensations of tingling and numbness
*Cardivascular changes - Heart rate increase or decrease with weak threading pulse
*Intestinal changes - Abdominal cramping or diarrhea
, *Skeletal changes - Osteoporosis
Nursing Priority for Hypocalcemia - ANSWER *Drug Therapy: Calcium replacement
oral and IV
*Nutrition Therapy: High Calcium Diet
*Reducing environmental stimuli
*Preventing Injury
Nursing Interventions of Metabolic Acidosis - ANSWER *Hydration
*Bicarbonate administered if serum bicarbonate levels are low
*Monitor patient Continously
Clinical Manifestations of Fluid Volume Overload - ANSWER Pulmonary edema
Bounding pulse
Increasing neck distention
Crackles in lungs
Increasing peripheral edema
Reduced urine output
Drug Prescribed for Fluid Overload - ANSWER Diuretic (Lasix, Foroside)
Nutrition Therapy for Fluid Overload - ANSWER Restrictions of both fluid and sodium
intake
Foods High in Sodium - ANSWER Dairy products
Processed or preserved foods
Snack foods
Many condiments
Foods Low in Sodium - ANSWER Fish
Most fresh fruits and vegetables
Buffers - ANSWER *Can act either as an acid (releasing hydrogen ion) or as a base
(binding hydrogen ions)
*If the fluid is basic (with few free hydrogen ions), the buffer binds some of the excess
hydrogen ions>
Metabolic Acidosis - ANSWER *A condition that occurs when the body produces
excessive quantities of acid or when the kidneys are not removing enough acid from the
body
*pH is less than 7.359
Metabolic Alkalosis - ANSWER *pH is high, beyond the normal range of 7.35-7.45
*Result of decreased hydrogen ion concentration, leading to increased bicarbonate, or
alternatively a direct result of increased bicarbonate concentrations
GUIDE COMPLETELY SOLVED!!
Clinical Manifestations for Dehydration - ANSWER *Increased thirst
*Dry mouth and swollen tongue
*Weakness
*Dizziness
*Palpitations (feeling that the heart is jumping or pounding
*Confusion
*Sluggishness fainting
*Decreased urine output
*Changes in mental status
*Kidney
*Endocrine (poor regulation of sodium and potassium
*Nausea
*Vomiting
Assesssment findings for Dehydration - ANSWER *Pulmonary edema
*Poor skin turgor (check for skin turgor on the chest and the forehead)
*Weight loss
*Reduced urine output
*Cardiovascular changes (heart rate increases)
*Respiratory changes (increased rate)
*Peripheral pulses weak
*Hypotension while standing
*Kidney changes
*Neurologic changes (confusion)
*Neck Vein Distention
Risk factors for dehydration - ANSWER *Older adults are unable to obtain fluids without
help
*Older patients have less total body water than younger adults
*Decreased thirst sensation
*Diuretics
*Antihypertensives
*Laxatives
Nursing Interventions for Dehydration - ANSWER Patient Safety
Fluid Replacement
Drug Therapy (Oral or IV fluid replacement)
Best Indicator for fluid volume loss - ANSWER Daily Weight (same time every day)
,Patient Teaching for Dehydration - ANSWER Drink more fluids, mainly water, matching
fluid intake with fluid output
Clinical Manifestations of Hypokalemia - ANSWER Diuretics
Digitalis
Corticosteroids
Diarrhea
Vomiting
Prolonged nasogastric suction
NPO
Assessment Findings for Hypokalemia - ANSWER Respiratory
Musculoskeletal
Cardiovascular
Neurologic
Intestinal
*All of these conditions are weakened
Interventions for Hypokalemia - ANSWER Drug Therapy:
*Potassium via IV is given for more severe
*Oral potassium is given as a liquid or solid
*Drugs given are Aldactone, Novospiroton, Dyrenium,Midamor
Nutrition Therapy:
*Teach patient how to increase potassium intake
*Eat foods that are naturally rich in potassium to prevent further loss
Safety Measures:
*Fall precautions
Respiratory Monitoring:
Pulse oximetry (O2 Sat)
Hypocalcemia - ANSWER Low calcium levels (below 9.0 mg/dl)
Clinical Manifestations of Hypocalcemia - ANSWER Inadequate oral intake of calcium
Lactose intolerance
Inadequate intake of Vitamin D
End Stage Kidney Disease
Diarrhea
Wound Drainage
Assesssment Findings of Hypocalcemia - ANSWER *Neuromuscular changes -
Paresthesias occur with sensations of tingling and numbness
*Cardivascular changes - Heart rate increase or decrease with weak threading pulse
*Intestinal changes - Abdominal cramping or diarrhea
, *Skeletal changes - Osteoporosis
Nursing Priority for Hypocalcemia - ANSWER *Drug Therapy: Calcium replacement
oral and IV
*Nutrition Therapy: High Calcium Diet
*Reducing environmental stimuli
*Preventing Injury
Nursing Interventions of Metabolic Acidosis - ANSWER *Hydration
*Bicarbonate administered if serum bicarbonate levels are low
*Monitor patient Continously
Clinical Manifestations of Fluid Volume Overload - ANSWER Pulmonary edema
Bounding pulse
Increasing neck distention
Crackles in lungs
Increasing peripheral edema
Reduced urine output
Drug Prescribed for Fluid Overload - ANSWER Diuretic (Lasix, Foroside)
Nutrition Therapy for Fluid Overload - ANSWER Restrictions of both fluid and sodium
intake
Foods High in Sodium - ANSWER Dairy products
Processed or preserved foods
Snack foods
Many condiments
Foods Low in Sodium - ANSWER Fish
Most fresh fruits and vegetables
Buffers - ANSWER *Can act either as an acid (releasing hydrogen ion) or as a base
(binding hydrogen ions)
*If the fluid is basic (with few free hydrogen ions), the buffer binds some of the excess
hydrogen ions>
Metabolic Acidosis - ANSWER *A condition that occurs when the body produces
excessive quantities of acid or when the kidneys are not removing enough acid from the
body
*pH is less than 7.359
Metabolic Alkalosis - ANSWER *pH is high, beyond the normal range of 7.35-7.45
*Result of decreased hydrogen ion concentration, leading to increased bicarbonate, or
alternatively a direct result of increased bicarbonate concentrations
