Medsurg Exam 2 Questions and Correct Answers | Latest Update| Graded 100%

Medsurg Exam 2 Prof Milhome 11/03/22 Yellow on Exam Chapters 13 (pages 237-260), Chapter 14(pages 261-274); Chapter 48 (); Chapter 49 ( ; ) Chapter 50 (page 1094- Chapter 56( page ) ,Chapter 59( page ) Chapter 60 (page ), 61( page ; ; ; ) Chapter 62 (; ; ; ; ; ; ; ), chapter 64 (),Chapter 67(; 1488) Chapter 13 Fluid and electrolyte page 240 -1L of water= weighs 1 kg -Normal Osmolarity= 270- 300mOsm/L -Risk of electrolyte imbalance= older adults, chronic kidney disorder, endocrine disorder= ALL ILL ADULTS ARE AT RISK FOR ELECTROLYTE IMBALANCE -Women of any age have less total body water and higher risk for dehydration than men of similar sizes and ages. This difference is because men tend to have more muscle mass than women and because women have more body fat. ( muscles cells contain muscle mostly water and fat cells have little water. Excretion of Fluids Measurable= oral fluid thru urine; Parenteral fluids thru emesis; enemas thru feces; irrigation fluids thru drainage from body cavities Excretion of Fluids NOT measurable= solid foods thru perspiration; metabolism thru vaporization thru the lungs Fluid volume and electrolyte balance includes= regulation of body fluids and electrolytes (body fluid body volume, osmolarity, composition = electrolytes, (filtration, diffusion, osmosis and selective secretion EFC extracellular fluid is 1/3 of of total body water -filtration- movement of fluid thru hydrostatic pressure Osmosis- movement of fluid thru seleceltive semipermeable membrane -The min amt of urine output per day needed to excrete toxic waste is 400ml- 600mL if less than this amount of urine is excreted then lethal electrolyte imbalances, acidosis and toxic build of nitrogen occur, Insensible water loss- no mechanism controls (skin, lungs, GI tract) Isotonic= 0.9% saline, 5%dextrose in .2255 SALINE, ringers' lactate Hypotonic- .45% saline, Hypertonic- 10% dextrose in water, 5% dextrose in saline, 5% dextrose in 0.45 saline, Page 245 Potassium K+ cation= 3.5-5.0 (arrythmias) “ comes from any orifices” Most K= Found in meat, fish, some veggies, fruits Lowest K = eggs, bread, cereal grains Typical intake 2/20grams/daily Low mg= Low Potassium Before giving potassium make sure urine output is 30ML / hour High= Hyperkalemia= dehydration, kidney disease, acidosis, adrenal insufficiency, crush injuries Low= Hypokalemia= fluid overload, diuretic therapy. Alkalosis, insulin admin, hyperaldosteronism =Exactilate, insulin, duiretic to treat hyperkalemia Page 246 Calcium- Ca2+= 9.0-105 (found in bone matric) (arrythmias Absorption of Calcium requires Vitamin D Calcium found in bone matrix High= hypercalcemia- hyperthyroidism, hyperparathyroidism Low= Hypocalcemia- Vit D deficiency, hypothyroidism, hypoparathyroidism, kidney disease, fluid overload, excessive vomiting and diarrhea, adrenal insufficiency, diuretic therapy Page 246 Magnesium-Mg2+ ion= 1.8-2.6 9 ( arrythmias Mg found in bones and cartilage Importance in skeletal muscle contraction, carbohydrate metabolism, generation of energy stores, vitamin activation, blood coagulation, cell growth High= hypermagnesemia= kidney disease, hypothyroidism, adrenal insufficiency, Low= Hypomagnesemia= malnutrition, alcoholism, ketoacidosis ------------------------------------------------------------------------------------------------------------------------------------- -Muscles cells carry more water -Fat cells carry very little water -Kidney is the organ most sensitive to water loss / gain -3 Hormones that help regulate Aldosterone, Antidiuretic ADH, Natriuretic peptide hormone NP Aldosterone= prevents water and Na loss; promotes excretion of potassium Antidiuretic hormone aka vasopressin- retains water (indirectly regulates electrolyte retention or excretion) Natriuretic peptides- kidney reabsorption of Sodium ----------------------------------------------------------------------------------------------------------------------------- Page 246 Dehydration (fluid volume deficient)