NSG 212 - Exam 3 Questions With Complete Solutions
Hypovolemia: fluid volume deficit
Causes: loss, poor intake, fluid shift
Labs: increased sodium, serum osmolality, BUN, urine specific
gravity, urine osmolality, hematocrit (falsely elevated);
decreased potassium
Clinical manifestations: weight loss, loss of skin turgor,
concentrated urine, low urine output, dry mucous membranes,
hypotension, weak and rapid peripheral pulse
Hypovolemia nursing management
Identify and correct cause
Oral fluids if not severe
IV isotonic fluids
Assess urine output, VS, neuro and resp status
Hypovolemic shock
Significant loss of body fluids
Blood flow and perfusion are slowed and the cells are no longer
able to carry O2 to the blood
Hypervolemia: Fluid Volume Excess
Causes: retention of sodium and water
Labs: decreased H&H, albumin, sodium, serum osmolality
Clinical manifestations: weight gain, ascites, edema,
hypertension, tachycardia, JVD, increase urine output, decreased
O2 saturation
, Hypervolemia Nursing Management
Prevent, correct, manage underlying cause
Limit fluid and sodium intake
Monitor daily weight
Early recognition
Diuretics, may need dialysis if renal compromise
Serum sodium
Levels controlled by thirst, ADH and RAAS
Sodium potassium pump = action potential = cardiac and
skeletal muscle contraction
Sodium ions are positive
Hyponatremia
treat with 3% sodium chloride
neurological symptoms because of fluid shift into brain cells
seizure, confusion
people losing lots of fluid are at risk, since sodium follows water
muscle weakness
Hypernatremia
treat with hypotonic fluids; have to correct slowly to prevent
cerebral edema (24-48hrs)
Thirst
elevated body temp
restlessness, disorientation, lethargy, stupor or coma
muscle irritability
Serum potassium
Hypovolemia: fluid volume deficit
Causes: loss, poor intake, fluid shift
Labs: increased sodium, serum osmolality, BUN, urine specific
gravity, urine osmolality, hematocrit (falsely elevated);
decreased potassium
Clinical manifestations: weight loss, loss of skin turgor,
concentrated urine, low urine output, dry mucous membranes,
hypotension, weak and rapid peripheral pulse
Hypovolemia nursing management
Identify and correct cause
Oral fluids if not severe
IV isotonic fluids
Assess urine output, VS, neuro and resp status
Hypovolemic shock
Significant loss of body fluids
Blood flow and perfusion are slowed and the cells are no longer
able to carry O2 to the blood
Hypervolemia: Fluid Volume Excess
Causes: retention of sodium and water
Labs: decreased H&H, albumin, sodium, serum osmolality
Clinical manifestations: weight gain, ascites, edema,
hypertension, tachycardia, JVD, increase urine output, decreased
O2 saturation
, Hypervolemia Nursing Management
Prevent, correct, manage underlying cause
Limit fluid and sodium intake
Monitor daily weight
Early recognition
Diuretics, may need dialysis if renal compromise
Serum sodium
Levels controlled by thirst, ADH and RAAS
Sodium potassium pump = action potential = cardiac and
skeletal muscle contraction
Sodium ions are positive
Hyponatremia
treat with 3% sodium chloride
neurological symptoms because of fluid shift into brain cells
seizure, confusion
people losing lots of fluid are at risk, since sodium follows water
muscle weakness
Hypernatremia
treat with hypotonic fluids; have to correct slowly to prevent
cerebral edema (24-48hrs)
Thirst
elevated body temp
restlessness, disorientation, lethargy, stupor or coma
muscle irritability
Serum potassium
