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Psyc Sem (PSYC 404) Adaptive Quiz Fluid And Electrolytes

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Shepherd University

Psyc Sem (PSYC 404)

Adaptive quiz fluid and electrolytes

Fluid/Electrolytes
The primary health care provider orders the nurse to infuse 1,000 mL of intravenous fluid to a patient with diarrhea over 4 hours
using gravity-flow tubing with a drop factor of 10. Calculate the minute flow rate in drops/minute. Record your answer to a
whole number.
42 drops/minute
The flow rate of the intravenous fluid is 1,000 mL over 4 hours, or 250 mL per hour. Then, 250 mL/hr divided by 60 min/hr to
get 4.167 mL/minute. Therefore, the minute flow rate is 4.167 mL/min × 10 = 41.67 drops/min, which rounds to 42 drops/min.
After reviewing a patient’s laboratory test reports, the nurse documents excessive extracellular fluid volume. Which diseases may
have caused the condition?
Cirrhosis
Heart failure
Hemorrhage
Adrenal insufficiency
Acute oliguric renal disease
An excess of extracellular fluid volume occurs when there is too much isotonic fluid in the extracellular compartment. This
condition occurs when there is sodium and water retention in the kidney, which occurs in patients with cirrhosis, heart failure,
and acute oliguric renal disease. Hemorrhage and adrenal insufficiency will cause an extracellular fluid volume deficit.
On assessment, a patient is found to have extracellular fluid volume (ECF) depletion associated with dehydration of cells. Which
fluids might the nurse choose to correct both extracellular fluid volume depletion and cellular dehydration?
5% dextrose in lactated Ringer’s
0.9% sodium chloride
0.45% sodium chloride
0.225% sodium chloride
3% and 5% sodium chloride
Sodium chloride solutions of 0.225% and 0.45% are hypotonic in nature and are used to correct both extracellular fluid volume
depletion and cellular dehydration. These solutions have an effective osmolality less than body fluids, which helps to move water
into cells. Lactated Ringer’s (LR) and 0.9% sodium chloride are isotonic and correct only extracellular volume depletion.
Solutions of 3% and 5% sodium chloride are hypertonic and they aggravate cellular dehydration.
What condition may be suspected in a patient with end-stage renal disease?
Hypokalemia
Hypercalcemia
Hypomagnesemia
Hypermagnesemia
Hypermagnesemia is an abnormally high magnesium concentration in the blood; this can be caused by end-stage renal disease.
Excessive fluid loss can cause hypokalemia. Malignant neoplasms or increased levels of parathyroid hormone can cause
hypercalcemia. Chronic diarrhea can cause hypomagnesemia.
The nurse is teaching a group of patients about the importance of fluid and electrolyte balance in a health awareness program.
About which common causes of hypokalemia would the nurse educate the patients?
Diarrhea
Acute oliguria
Repeated vomiting
Calcium-deficient diet
Glucocorticoid therapy
Hypokalemia is a low potassium concentration in the blood that results from the loss of potassium. This can occur in patients
with diarrhea or repeated vomiting. Glucocorticoid therapy can also result in potassium loss from the body and cause
hypokalemia. Acute oliguria decreases the loss of potassium from the body and results in increased concentration of potassium or
hyperkalemia. A calcium-deficient diet can cause decreased intake and absorption of calcium, thus resulting in hypocalcemia.
Which physical findings can be seen in a patient with extracellular fluid volume (ECV) deficit?
Edema
Thready pulse
Crackles in lungs
Postural hypotension
Dry mucous membranes
A thready pulse, postural hypotension, and dry mucous membranes are the physical findings of an extracellular fluid volume
deficit. Edema in dependent areas and crackles in the lungs are the physical findings of extracellular fluid volume excess.
A patient presents with muscle twitching and cramping. On examination, the health care provider diagnoses the patient with
calcium deficiency. Which dietary instructions should the nurse give to this patient?
Supplement with vitamin D.
Avoid broccoli and oranges.
Increase the intake of dairy products.
Increase the intake of canned fish with bones.
Increase consumption of dark green vegetables.
Hypocalcemia, or low levels of calcium, can manifest as muscle twitching and cramping. The signs and symptoms can be treated
by providing adequate calcium in the diet. Vitamin D facilitates the absorption of calcium from the intestines; therefore, vitamin
D should be supplemented in the diet. Dairy products, canned fish with bones, broccoli, and oranges are good sources of calcium,
and their intake should be promoted. Dark green vegetables are rich in magnesium, not calcium.
A patient has intestinal inflammation and reports frequent diarrhea. Which nursing intervention would be most beneficial in this
situation?
Avoiding high-fiber food
Providing oral fluids at the preferred temperature
Avoiding sudden position changes
Offering fluid frequently in small amounts as tolerated
Avoiding high-fiber food is an intervention for patients with diarrhea related to intestinal inflammation, because fiber-rich food
promotes diarrhea. Providing oral fluids at the preferred temperature is beneficial for patients with deficient fluid volume. In a
patient who shows little interest in eating and has increased salivation as result of nausea related to gastric irritation should avoid
sudden postural changes. Offering fluid frequently in small amounts as tolerated is a correct intervention for patients with
deficient fluid volume related to vomiting and diarrhea.
The nurse assesses four patients. Which patient is at greatest risk for the development of hypocalcemia?
56-year-old with acute kidney renal failure
40-year-old with appendicitis
28-year-old with acute pancreatitis

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Psyc Sem (PSYC 404) Adaptive Quiz Fluid And Electrolytes

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