NFDN 2003 Final exam with correct
| | | | | |
answers
Fluid |& |Electrolyte |Needs |- |correct |answers |- |Homeostasis
- |Affected |by |digestion, |absorption, |metabolism |of |nutrients |and |excretion |of |waste
Functions |of |Body |Fluids |- |correct |answers |- |Need |1.5 |L |- |2.5L |per |day
- |60-70% |body |weight |is |fluid |[70% |intracellular, |30% |extracellular]
- |Transport |nutrients |and |wastes |to |and |from |cells
- |Maintain |body |temp., |acid-base |balance, |aids |in |digestion |and |elimination
Assessment |of |Fluid |Balance |- |correct |answers |- |Health |history |[age, |acute |illness, |
environmental |factors, |diet, |medications]
- |Physical |exam |[head |to |toe, |weight |[1kg |gain |= |1L |fluid |gain], |intake/output, |assess |edema, |
diagnostic |tests]
Problems |of |Fluid |Imbalances |- |correct |answers |- |Electrolyte |imbalance
- |Acid-Base |imbalance
- |Deficient |fluid |volume
- |Excess |fluid |volume |[edema]
Common |Fluid |Imbalances |- |correct |answers |- |Dehydration |{hypovolemia}: |burn |victims |[3rd |
degree] |are |most |at |risk
Hypovolemia |- |correct |answers |- |Acute |weight |loss
- |Rapid |& |weak |pulse
- |Hypotension |[bp]
- |Dry, |sticky |mucous |membrane
,- |U/O |<30ml/h |and |constipation
- |Thirst |and |weakness
- |Increase |Hgb, |Hct, |urine |osmol
Hypervolemia |- |correct |answers |- |Acute |weight |gain
- |Bounding |full |pulse |
- |Hypertension |[bp]
- |Moist |mucous |membrane
- |U/O |increased, |specific |gravity |<1
- |Cough/Dyspnea
- |Decreased |Hgb, |Hct, |urine |osmol
Electrolytes |- |correct |answers |- |Sodium |[135-145 |mEq/L]
- |Potassium |[3.5-5 |mEq/L]
- |Calcium |[4.5-5.5 |mEq/L]
- |Magnesium |[1.5-2.5 |mEq/L]
- |Chloride |[98-106 |mEq/L]
- |Phosphorus |[1.2-3 |mEq/L]
Hyponatremia |- |correct |answers |- |Na |maintains |extracellular |osmolality, |controls |body |fluids, |
influences |acid-base |balance
- |Cause: |Excess |sweating |and |increased |water |intake, |GI |suction, |excess |IV, |use |of |diuretics
Hypernatremia |- |correct |answers |- |Causes: |Decreased |water |intake, |excess |saline/salt, |profuse |
diarrhea, |diabetes |insipidus, |heatstroke, |hyperventilation
Fluid |Diagnostic |Tests |- |correct |answers |- |Plasma |sodium, |potassium, |chloride, |calcium, |
magnesium
- |Hematocrit
,- |BUN
- |Osmolality
- |Urine |specific |gravity |
- |ECG
- |ABG
Acid-Base |Imbalances |- |correct |answers |- |ABG
- |Based |on |the |carbonic-acid |buffer |system
- |Measures |6 |components
- |pH, |PaCO2, |PaO2, |oxygen |saturation, |base |excess, |bicarbonate
- |Deviation |from |a |normal |level |is |indicated |by |acid-base |imbalance
Acid-Base |Balance |- |correct |answers |- |Normal |pH |7.35 |- |7.45 |
- |< |7.30-7.35 |acidotic |state
- |> |7.45 |alkalotic |state
PaCO2 |- |correct |answers |- |Partial |pressure |of |carbon |dioxide |in |ARTERIAL |blood
- |Normal |range |35-45mmHg
- |Less |than |35mmHg |= |hyperventilation |
- |Greater |then |45mmHg |= |hypoventilation |[rate |and |depth |of |reps. |decreases, |less |carbon |
dioxide |is |exhaled, |more |is |retained |increasing |the |concentration
PaO2 |- |correct |answers |- |Partial |pressure |of |oxygen |in |ARTERIAL |blood
- |Normal |range |80-100mmHg |
- |No |real |role |in |acid |base |imbalance
- |Less |than |60mmHg |can |lead |to |anaerobic |metabolism, |leading |to |lactic |acid |production |and |
metabolic |acidosis
- |Reduction |in |vital |capacity |can |lead |to |reduction
, Oxygen |Saturation |- |correct |answers |- |Normal |range |95-99%
- |Hemoglobin |saturation
- |Clients |become |hypoxic |getting |the |reserve |O2 |stored |in |the |Hgb, |to |provide |tissue |w/ |O2
- |O2 |can |be |affected |by |pH |and |PaCO2
- |When |PaO2 |falls |below |60mmHg |a |large |saturation |results
Base |Excess |- |correct |answers |- |Normal |range |of |+2 |/ |-2 |
- |Base |excess |reflects |deviations |of |pH |[7.4 |neutral]
- |Higher |values |of |base |excess |indicate |alkalosis
- |Negative |values |of |base |excess |indicates |acidosis |which |may |result |in |elimination |of |too |
many |bicarbonate |ion
Bicarbonates |- |correct |answers |- |Normal |range |22-26 |mmol/L
- |Excreted/retained |by |the |kidneys |to |maintain |normal |acid |base |environment
- |Also |the |principle |buffer |of |the |ECF's |of |body
- |A |normal |pH |is |maintained |w/ |a |bicarbonate |ratio |20 |times |that |of |the |fluid |concentration |of
|carbonic |acid
Buffering |System |- |correct |answers |- |Plasma
- |Respiratory |system
- |Renal |system
Respiratory |Acidosis |- |correct |answers |- |Results |from |retention |of |CO2 |and |decrease |in |pH
- |Pulmonary |insufficiency |because |of |respiratory |depression |causing |CO2 |build |up
- |S&S: |Increased |Pulse, |resp, |& |BP, |Mental |cloudiness, |Fullness |in |the |head, |Ventrical |
Arrythmias
- |Treatment: |improve |ventilation, |bronchodilators |to |reduce |bronco |spasm
- |Thrombolytics |or |anticoagulants |for |PE
- |Antibiotics |for |pneumonia
| | | | | |
answers
Fluid |& |Electrolyte |Needs |- |correct |answers |- |Homeostasis
- |Affected |by |digestion, |absorption, |metabolism |of |nutrients |and |excretion |of |waste
Functions |of |Body |Fluids |- |correct |answers |- |Need |1.5 |L |- |2.5L |per |day
- |60-70% |body |weight |is |fluid |[70% |intracellular, |30% |extracellular]
- |Transport |nutrients |and |wastes |to |and |from |cells
- |Maintain |body |temp., |acid-base |balance, |aids |in |digestion |and |elimination
Assessment |of |Fluid |Balance |- |correct |answers |- |Health |history |[age, |acute |illness, |
environmental |factors, |diet, |medications]
- |Physical |exam |[head |to |toe, |weight |[1kg |gain |= |1L |fluid |gain], |intake/output, |assess |edema, |
diagnostic |tests]
Problems |of |Fluid |Imbalances |- |correct |answers |- |Electrolyte |imbalance
- |Acid-Base |imbalance
- |Deficient |fluid |volume
- |Excess |fluid |volume |[edema]
Common |Fluid |Imbalances |- |correct |answers |- |Dehydration |{hypovolemia}: |burn |victims |[3rd |
degree] |are |most |at |risk
Hypovolemia |- |correct |answers |- |Acute |weight |loss
- |Rapid |& |weak |pulse
- |Hypotension |[bp]
- |Dry, |sticky |mucous |membrane
,- |U/O |<30ml/h |and |constipation
- |Thirst |and |weakness
- |Increase |Hgb, |Hct, |urine |osmol
Hypervolemia |- |correct |answers |- |Acute |weight |gain
- |Bounding |full |pulse |
- |Hypertension |[bp]
- |Moist |mucous |membrane
- |U/O |increased, |specific |gravity |<1
- |Cough/Dyspnea
- |Decreased |Hgb, |Hct, |urine |osmol
Electrolytes |- |correct |answers |- |Sodium |[135-145 |mEq/L]
- |Potassium |[3.5-5 |mEq/L]
- |Calcium |[4.5-5.5 |mEq/L]
- |Magnesium |[1.5-2.5 |mEq/L]
- |Chloride |[98-106 |mEq/L]
- |Phosphorus |[1.2-3 |mEq/L]
Hyponatremia |- |correct |answers |- |Na |maintains |extracellular |osmolality, |controls |body |fluids, |
influences |acid-base |balance
- |Cause: |Excess |sweating |and |increased |water |intake, |GI |suction, |excess |IV, |use |of |diuretics
Hypernatremia |- |correct |answers |- |Causes: |Decreased |water |intake, |excess |saline/salt, |profuse |
diarrhea, |diabetes |insipidus, |heatstroke, |hyperventilation
Fluid |Diagnostic |Tests |- |correct |answers |- |Plasma |sodium, |potassium, |chloride, |calcium, |
magnesium
- |Hematocrit
,- |BUN
- |Osmolality
- |Urine |specific |gravity |
- |ECG
- |ABG
Acid-Base |Imbalances |- |correct |answers |- |ABG
- |Based |on |the |carbonic-acid |buffer |system
- |Measures |6 |components
- |pH, |PaCO2, |PaO2, |oxygen |saturation, |base |excess, |bicarbonate
- |Deviation |from |a |normal |level |is |indicated |by |acid-base |imbalance
Acid-Base |Balance |- |correct |answers |- |Normal |pH |7.35 |- |7.45 |
- |< |7.30-7.35 |acidotic |state
- |> |7.45 |alkalotic |state
PaCO2 |- |correct |answers |- |Partial |pressure |of |carbon |dioxide |in |ARTERIAL |blood
- |Normal |range |35-45mmHg
- |Less |than |35mmHg |= |hyperventilation |
- |Greater |then |45mmHg |= |hypoventilation |[rate |and |depth |of |reps. |decreases, |less |carbon |
dioxide |is |exhaled, |more |is |retained |increasing |the |concentration
PaO2 |- |correct |answers |- |Partial |pressure |of |oxygen |in |ARTERIAL |blood
- |Normal |range |80-100mmHg |
- |No |real |role |in |acid |base |imbalance
- |Less |than |60mmHg |can |lead |to |anaerobic |metabolism, |leading |to |lactic |acid |production |and |
metabolic |acidosis
- |Reduction |in |vital |capacity |can |lead |to |reduction
, Oxygen |Saturation |- |correct |answers |- |Normal |range |95-99%
- |Hemoglobin |saturation
- |Clients |become |hypoxic |getting |the |reserve |O2 |stored |in |the |Hgb, |to |provide |tissue |w/ |O2
- |O2 |can |be |affected |by |pH |and |PaCO2
- |When |PaO2 |falls |below |60mmHg |a |large |saturation |results
Base |Excess |- |correct |answers |- |Normal |range |of |+2 |/ |-2 |
- |Base |excess |reflects |deviations |of |pH |[7.4 |neutral]
- |Higher |values |of |base |excess |indicate |alkalosis
- |Negative |values |of |base |excess |indicates |acidosis |which |may |result |in |elimination |of |too |
many |bicarbonate |ion
Bicarbonates |- |correct |answers |- |Normal |range |22-26 |mmol/L
- |Excreted/retained |by |the |kidneys |to |maintain |normal |acid |base |environment
- |Also |the |principle |buffer |of |the |ECF's |of |body
- |A |normal |pH |is |maintained |w/ |a |bicarbonate |ratio |20 |times |that |of |the |fluid |concentration |of
|carbonic |acid
Buffering |System |- |correct |answers |- |Plasma
- |Respiratory |system
- |Renal |system
Respiratory |Acidosis |- |correct |answers |- |Results |from |retention |of |CO2 |and |decrease |in |pH
- |Pulmonary |insufficiency |because |of |respiratory |depression |causing |CO2 |build |up
- |S&S: |Increased |Pulse, |resp, |& |BP, |Mental |cloudiness, |Fullness |in |the |head, |Ventrical |
Arrythmias
- |Treatment: |improve |ventilation, |bronchodilators |to |reduce |bronco |spasm
- |Thrombolytics |or |anticoagulants |for |PE
- |Antibiotics |for |pneumonia
