NUR 301 Exam 2b Review Questions with
Verified Correct Answers
Sodium
Major role in controlling water distribution throughout the body
Affects muscle contraction & transmission of nerve impulses
Hyponatremia
Causes: Water intoxication (Dilutional Hyponatremia), vomiting, diarrhea, sweating, diuretics,
adrenal insufficiency
Can occur as a result of FVE or FVD
Clinical Manifestations depends on the underlying cause
FVD: poor skin turgor, dry mucosa, headache, orthostatic hypotension, nausea, abdominal
cramping
FVE: edema, crackles, ascites,
neurological symptoms (ms changes, headache, lethargy, muscle twitching, hemiparesis &
seizures) occur with acute hyponatremia
May necessitate water restriction or sodium replacement
Nurse must monitor:
- Fluid I&O
- Daily body weight
- Monitor GI manifestations & central nervous system changes
- Effects of medications
Confusion may be overlooked with elderly patients
Hypernatremia
Gain of sodium in excess of water or by a loss of water
Can occur with administration of hypertonic enteral feedings without adequate water
supplements
Clinical manifestations are primarily neurologic
• Increase in plasma sodium concentration
• Water moves out of the cells & into the ECF
• Cellular dehydration occurs
Neurologic Manifestations:
, Restlessness & weakness in moderate hypernatremia
Disorientation, delusions, hallucinations in severe hypernatremia
Other manifestations:
Thirst, peripheral edema, orthostatic hypotension
Treatment is usually a hypotonic electrolyte solution
Nursing care focuses on prevention and on close monitoring of fluid
Hypokalemia
rom active losses of potassium or insufficient intake
Conditions causing increased output of this
- Diuretics, vomiting, diarrhea, gastric suction
Conditions causing decreased intake of this
- NPO, anorexia, vomiting
Redistribution of this
- Metabolic alkalosis, insulin administration
Clinical manifestations: fatigue, anorexia, nausea, vomiting, dysrhythmias, muscle weakness &
cramps, paresthesias, decreased muscle strength
Treatment is oral or IV replacement therapy
Nursing treatment focuses on assessment of cardiac and motor signs and symptoms
• Severe hypokalemia is life-threatening
• Monitor EKG, dietary potassium, I&Os, nursing care related to IV potassium administration
Hyperkalemia
resulting from increased intake, medication effects, musculoskeletal injury, or decreased renal
excretion of potassium
Clinical Manifestations: cardiac changes & dysrhythmias, muscle weakness, paralysis, anxiety,
nausea, diarrhea
Medical Management: EKG monitoring, Dialysis
• Medications include regular insulin, Kayexelate, IV sodium bicarbonate
Nursing Management: Monitor potassium levels, monitor medication affects, dietary this
restriction, observe for symptoms
Hypocalcemia
inadequate intake, increased loss, malabsorption
Tetany (most characteristic manifestation)
Trousseau's sign (Apply blood pressure cuff and inflate, after four minutes the forearm will start
to spasm)
Chvostek's sign (Tap over the facial nerve and the facial muscles will begin to twitch)
Verified Correct Answers
Sodium
Major role in controlling water distribution throughout the body
Affects muscle contraction & transmission of nerve impulses
Hyponatremia
Causes: Water intoxication (Dilutional Hyponatremia), vomiting, diarrhea, sweating, diuretics,
adrenal insufficiency
Can occur as a result of FVE or FVD
Clinical Manifestations depends on the underlying cause
FVD: poor skin turgor, dry mucosa, headache, orthostatic hypotension, nausea, abdominal
cramping
FVE: edema, crackles, ascites,
neurological symptoms (ms changes, headache, lethargy, muscle twitching, hemiparesis &
seizures) occur with acute hyponatremia
May necessitate water restriction or sodium replacement
Nurse must monitor:
- Fluid I&O
- Daily body weight
- Monitor GI manifestations & central nervous system changes
- Effects of medications
Confusion may be overlooked with elderly patients
Hypernatremia
Gain of sodium in excess of water or by a loss of water
Can occur with administration of hypertonic enteral feedings without adequate water
supplements
Clinical manifestations are primarily neurologic
• Increase in plasma sodium concentration
• Water moves out of the cells & into the ECF
• Cellular dehydration occurs
Neurologic Manifestations:
, Restlessness & weakness in moderate hypernatremia
Disorientation, delusions, hallucinations in severe hypernatremia
Other manifestations:
Thirst, peripheral edema, orthostatic hypotension
Treatment is usually a hypotonic electrolyte solution
Nursing care focuses on prevention and on close monitoring of fluid
Hypokalemia
rom active losses of potassium or insufficient intake
Conditions causing increased output of this
- Diuretics, vomiting, diarrhea, gastric suction
Conditions causing decreased intake of this
- NPO, anorexia, vomiting
Redistribution of this
- Metabolic alkalosis, insulin administration
Clinical manifestations: fatigue, anorexia, nausea, vomiting, dysrhythmias, muscle weakness &
cramps, paresthesias, decreased muscle strength
Treatment is oral or IV replacement therapy
Nursing treatment focuses on assessment of cardiac and motor signs and symptoms
• Severe hypokalemia is life-threatening
• Monitor EKG, dietary potassium, I&Os, nursing care related to IV potassium administration
Hyperkalemia
resulting from increased intake, medication effects, musculoskeletal injury, or decreased renal
excretion of potassium
Clinical Manifestations: cardiac changes & dysrhythmias, muscle weakness, paralysis, anxiety,
nausea, diarrhea
Medical Management: EKG monitoring, Dialysis
• Medications include regular insulin, Kayexelate, IV sodium bicarbonate
Nursing Management: Monitor potassium levels, monitor medication affects, dietary this
restriction, observe for symptoms
Hypocalcemia
inadequate intake, increased loss, malabsorption
Tetany (most characteristic manifestation)
Trousseau's sign (Apply blood pressure cuff and inflate, after four minutes the forearm will start
to spasm)
Chvostek's sign (Tap over the facial nerve and the facial muscles will begin to twitch)
