Adult Health 1 Exam
What are the 3 hormones that help control fluid and electrolyte balance? - ANS Aldosterone: secreted
by the adrenal cortex when sodium levels are low, prevents both sodium and water loss
ADH (vasopressin): released from posterior pituitary from changes in blood osmolarity and retains water
NP: hormones secreted by heart cells in response to stretch of heart muscle, works to inhibit
reabsorption of Na and increase urine output
What is the difference between insensible and sensible water loss? - ANS Insensible loss cannot be
measured like sweat, lungs, etc. Sensible loss can be measured like urine.
Why is age the biggest cause of fluid imbalance? - ANS Skin: loss of elasticity, decreased turgor (skin
becomes an unreliable way to detect hydration status)
Muscular: decreased muscle mass & decreased total body water (greater risk for dehydration)
Kidneys: poor excretion of waste products
Neurological: reduced thirst reflex
What are good ways to detect fluid imbalance? - ANS I&O, daily weights (wear same thing, same time,
same scale)
What is the minimum urine output per hour and per day? - ANS 30 ml/hr
,400-600 ml per day
What are the first vital signs to be affected by electrolyte imbalance? - ANS If electrolytes are
imbalanced, affects muscle (heart!!)
Blood pressure and heart rate are the first vital signs affected by electrolytes
What are the normal ranges for sodium, potassium, magnesium, and calcium? - ANS Sodium: 135-145
Potassium: 3.5-5.0
Magnesium: 1.3-2.1
Calcium: 9.0-10.5
Describe some of the causes and s/s of HYPONATREMIA - ANS Hyponatremia (low sodium) usually
occurs with fluid overload. It can also be from vomiting, diarrhea, excessive sweating, and diuretics. S/S
are excitable cellular activity and cerebral, neuromuscular, intestinal, and cardiovascular changes (like
heart failure because hyponatremia puts stress on the heart muscle). Interventions include drug
therapy, IV fluids just no oral fluids (it will cause more output and further sodium loss)
Describe some of the causes and s/s of HYPERNATREMIA - ANS Hypernatremia (high sodium) occurs
with kidney failure (kidneys are not able to excrete), corticosteroids, and excessive administration of
sodium IV fluids. S/S are muscle twitching, decreased cardiac contractility (occurs b/c of cellular
shrinkage and dehydrated cells aren't able to respond to stimuli), and altered cerebral function.
Describe some of the causes and s/s of HYPOKALEMIA - ANS Hypokalemia (low potassium) usually has
no symptoms if the loss is gradual. It can cause cardiac symptoms. When we see low K values ask about
home meds like diuretics and laxatives because this will lower K levels from urine and poop output.
Interventions include preventing K loss, increasing serum potassium with K piggyback or PO K. Never
push potassium!!!
Describe some of the causes and s/s of HYPERKALEMIA - ANS Hyperkalemia (high potassium) causes
heart palpitations, & cardiac irregularities. This may be from kidney excretion issues, or potassium-
, sparing diuretic. For this you want to give insulin which will push potassium back into the cell. This can
also be given to diabetics, you will just want to make sure to give IV dextrose.
Describe some of the causes and s/s of HYPOCALCEMIA - ANS Hypocalcemia or low calcium is usually
caused by inadequate intake or someone using diuretics. It causes frequent painful muscle cramps and
leg spasms. This pt will have a positive chvosteks sign. This is a safety issue because it may lead to
broken bones. Interventions include restoring Ca, give tums (calcium carbonate) w/ out food so it will
not bind to it.
Describe some of the causes and s/s of HYPERCALCEMIA - ANS Hypercalcemia or high calcium is rate but
is caused by a person in kidney failure or pt will high K intake. It will cause severe muscle weakness,
decreased deep tendon reflexes, and decreased peristalsis.
Describe some of the causes and s/s of HYPOMAGNESIUM - ANS Low magnesium will cause s/s such as
positive chvostek & trousseau sign, cardiac changes, GI symptoms. Interventions include correcting the
changes by replacing magnesium.
Describe some of the causes and s/s of HYPERMAGNESIUM - ANS High magnesium will usually not elicit
any symptoms until it is almost double the amount (so around 4). This is usually caused by pt on dialysis.
S/S include cardiac changes, depressed nerve impulses. Interventions include reduce serum level, and
mg free IV fluid.
What is hypovolemia and the causes & s/s? - ANS Hypovolemia/dehydration is fluid intake or retention
is less than the body needs causing a fluid volume deficit. Isotonic dehydration is most common &
occurs with water and electrolyte loss. With this the fluid is only loss from the ECF and there is no fluid
shift. So, the body tries to compensate and maintain perfusion by increasing vasoconstriction in
peripheral resistance.
Causes of hypovolemia include increase GI output (vomitting, diarrhea, fistula drainage, ileostomy, GI
suctioning), increased renal output (diuretics), loss of blood/plasma (hemorrhage, burns), excessive
sweating, old age.
What are the 3 hormones that help control fluid and electrolyte balance? - ANS Aldosterone: secreted
by the adrenal cortex when sodium levels are low, prevents both sodium and water loss
ADH (vasopressin): released from posterior pituitary from changes in blood osmolarity and retains water
NP: hormones secreted by heart cells in response to stretch of heart muscle, works to inhibit
reabsorption of Na and increase urine output
What is the difference between insensible and sensible water loss? - ANS Insensible loss cannot be
measured like sweat, lungs, etc. Sensible loss can be measured like urine.
Why is age the biggest cause of fluid imbalance? - ANS Skin: loss of elasticity, decreased turgor (skin
becomes an unreliable way to detect hydration status)
Muscular: decreased muscle mass & decreased total body water (greater risk for dehydration)
Kidneys: poor excretion of waste products
Neurological: reduced thirst reflex
What are good ways to detect fluid imbalance? - ANS I&O, daily weights (wear same thing, same time,
same scale)
What is the minimum urine output per hour and per day? - ANS 30 ml/hr
,400-600 ml per day
What are the first vital signs to be affected by electrolyte imbalance? - ANS If electrolytes are
imbalanced, affects muscle (heart!!)
Blood pressure and heart rate are the first vital signs affected by electrolytes
What are the normal ranges for sodium, potassium, magnesium, and calcium? - ANS Sodium: 135-145
Potassium: 3.5-5.0
Magnesium: 1.3-2.1
Calcium: 9.0-10.5
Describe some of the causes and s/s of HYPONATREMIA - ANS Hyponatremia (low sodium) usually
occurs with fluid overload. It can also be from vomiting, diarrhea, excessive sweating, and diuretics. S/S
are excitable cellular activity and cerebral, neuromuscular, intestinal, and cardiovascular changes (like
heart failure because hyponatremia puts stress on the heart muscle). Interventions include drug
therapy, IV fluids just no oral fluids (it will cause more output and further sodium loss)
Describe some of the causes and s/s of HYPERNATREMIA - ANS Hypernatremia (high sodium) occurs
with kidney failure (kidneys are not able to excrete), corticosteroids, and excessive administration of
sodium IV fluids. S/S are muscle twitching, decreased cardiac contractility (occurs b/c of cellular
shrinkage and dehydrated cells aren't able to respond to stimuli), and altered cerebral function.
Describe some of the causes and s/s of HYPOKALEMIA - ANS Hypokalemia (low potassium) usually has
no symptoms if the loss is gradual. It can cause cardiac symptoms. When we see low K values ask about
home meds like diuretics and laxatives because this will lower K levels from urine and poop output.
Interventions include preventing K loss, increasing serum potassium with K piggyback or PO K. Never
push potassium!!!
Describe some of the causes and s/s of HYPERKALEMIA - ANS Hyperkalemia (high potassium) causes
heart palpitations, & cardiac irregularities. This may be from kidney excretion issues, or potassium-
, sparing diuretic. For this you want to give insulin which will push potassium back into the cell. This can
also be given to diabetics, you will just want to make sure to give IV dextrose.
Describe some of the causes and s/s of HYPOCALCEMIA - ANS Hypocalcemia or low calcium is usually
caused by inadequate intake or someone using diuretics. It causes frequent painful muscle cramps and
leg spasms. This pt will have a positive chvosteks sign. This is a safety issue because it may lead to
broken bones. Interventions include restoring Ca, give tums (calcium carbonate) w/ out food so it will
not bind to it.
Describe some of the causes and s/s of HYPERCALCEMIA - ANS Hypercalcemia or high calcium is rate but
is caused by a person in kidney failure or pt will high K intake. It will cause severe muscle weakness,
decreased deep tendon reflexes, and decreased peristalsis.
Describe some of the causes and s/s of HYPOMAGNESIUM - ANS Low magnesium will cause s/s such as
positive chvostek & trousseau sign, cardiac changes, GI symptoms. Interventions include correcting the
changes by replacing magnesium.
Describe some of the causes and s/s of HYPERMAGNESIUM - ANS High magnesium will usually not elicit
any symptoms until it is almost double the amount (so around 4). This is usually caused by pt on dialysis.
S/S include cardiac changes, depressed nerve impulses. Interventions include reduce serum level, and
mg free IV fluid.
What is hypovolemia and the causes & s/s? - ANS Hypovolemia/dehydration is fluid intake or retention
is less than the body needs causing a fluid volume deficit. Isotonic dehydration is most common &
occurs with water and electrolyte loss. With this the fluid is only loss from the ECF and there is no fluid
shift. So, the body tries to compensate and maintain perfusion by increasing vasoconstriction in
peripheral resistance.
Causes of hypovolemia include increase GI output (vomitting, diarrhea, fistula drainage, ileostomy, GI
suctioning), increased renal output (diuretics), loss of blood/plasma (hemorrhage, burns), excessive
sweating, old age.
