Fluid and Electrolyte Imbalance Study Notes
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Questions and Answers

Which of the following pH values indicates an alkaline solution?

  • 7.8 (correct)
  • 7.0
  • 6.9
  • 6.5
  • Which of the following is the fastest mechanism used by the body to control acid-base balance?

  • The lungs
  • Kidneys
  • The liver
  • Cellular buffers (correct)
  • A patient with severe diarrhea is at risk of developing which acid-base imbalance?

  • Respiratory alkalosis
  • Respiratory acidosis
  • Metabolic alkalosis
  • Metabolic acidosis (correct)
  • Which of the following sets of values indicates respiratory acidosis?

    <p>pH 7.30, CO2 48, HCO3 24 (D)</p> Signup and view all the answers

    Which of the following clinical manifestations is associated with metabolic acidosis?

    <p>Hyperkalemia (A)</p> Signup and view all the answers

    A patient's lab results show a magnesium level of 1.2 mEq/L. Which of the following signs and symptoms would the nurse expect to find?

    <p>Muscle twitching and cramping (C)</p> Signup and view all the answers

    Which of the following is a common cause of hypomagnesemia?

    <p>Alcoholism (D)</p> Signup and view all the answers

    A patient is experiencing hypermagnesemia. Which of the following interventions should the nurse anticipate?

    <p>Administer calcium gluconate (C)</p> Signup and view all the answers

    Which of the following is a sign or symptom associated with hypermagnesemia?

    <p>Drowsiness and lethargy (B)</p> Signup and view all the answers

    A patient’s magnesium level is 3.0 mEq/L. What should the nurse monitor most closely in this patient?

    <p>Signs of respiratory failure (A)</p> Signup and view all the answers

    What is the primary function of a base in the body?

    <p>To bind hydrogen ions (B)</p> Signup and view all the answers

    Which of the following is considered a common base found in the human body?

    <p>Bicarbonate (HCO3) (D)</p> Signup and view all the answers

    Fixed acids are formed as end products of which metabolic processes?

    <p>Glucose, fat, and protein metabolism (D)</p> Signup and view all the answers

    What is the typical symptom associated with pleural friction rub during auscultation?

    <p>Shallow and rapid breathing (D)</p> Signup and view all the answers

    Which diagnostic test is indicated for confirming the presence of pleural effusion?

    <p>Chest X-Ray (C)</p> Signup and view all the answers

    What intervention might be performed for severe symptoms of pleural effusion?

    <p>Thoracentesis (B)</p> Signup and view all the answers

    What underlying condition is most commonly associated with empyema?

    <p>Pneumonia (D)</p> Signup and view all the answers

    Which of the following is NOT a sign or symptom of pulmonary fibrosis?

    <p>Elevated WBC count (A)</p> Signup and view all the answers

    Which of the following is NOT considered a cause of pulmonary fibrosis?

    <p>Sedentary lifestyle (C)</p> Signup and view all the answers

    Which symptom is most commonly associated with pulmonary fibrosis?

    <p>Fatigue (B)</p> Signup and view all the answers

    What diagnostic test is primarily used to confirm pulmonary fibrosis?

    <p>Lung biopsy (B)</p> Signup and view all the answers

    Which medication type is primarily used to treat pulmonary fibrosis?

    <p>Antifibrotic drugs (B)</p> Signup and view all the answers

    What is a key focus in the nursing management of atelectasis?

    <p>Preventing hypoventilation (B)</p> Signup and view all the answers

    Which symptom is characteristic of chronic bronchitis?

    <p>Chronic cough with sputum production (D)</p> Signup and view all the answers

    Which complication may develop in patients with emphysema?

    <p>Bullae formation (A)</p> Signup and view all the answers

    What respiratory condition involves the loss of elasticity in the alveoli?

    <p>Emphysema (B)</p> Signup and view all the answers

    What is the most notable complication for the nurse to monitor with a patient that has an altered potassium level?

    <p>Cardiac arrhythmias (D)</p> Signup and view all the answers

    What type of precautions would be necessary for a patient with the Flu?

    <p>Droplet precautions (A)</p> Signup and view all the answers

    What disease process would the nurse suspect with chronic inflammation of the airways and hyper-responsiveness of bronchial smooth muscles?

    <p>Asthma (C)</p> Signup and view all the answers

    What is the best determinant of a patient's fluid volume status?

    <p>Daily weight measurement (D)</p> Signup and view all the answers

    What is indicated by an increased level of specific gravity of urine?

    <p>Dehydration (D)</p> Signup and view all the answers

    How long should a patient with hoarseness in their voice wait before seeking healthcare provider guidance?

    <p>1 week (A)</p> Signup and view all the answers

    What type of diuretic is furosemide?

    <p>Loop diuretic (D)</p> Signup and view all the answers

    What symptom could indicate bleeding after a tonsillectomy?

    <p>Increased swallowing (D)</p> Signup and view all the answers

    Which of the following clinical manifestations is associated with hypernatremia?

    <p>Muscle weakness (B)</p> Signup and view all the answers

    A patient is diagnosed with hypernatremia. Which of the following laboratory results would be most consistent with this diagnosis?

    <p>Serum sodium level of 148 mEq/L (A)</p> Signup and view all the answers

    Which of the following is a key intervention for a patient with hypernatremia?

    <p>Administering fluid replacement without sodium (D)</p> Signup and view all the answers

    A patient is taking a potassium-wasting diuretic. Which of the following electrolyte imbalances is the patient at risk of developing?

    <p>Hypokalemia (A)</p> Signup and view all the answers

    What is a critical action that must be taken before administering potassium to a patient?

    <p>Ensuring that the patient has voided (A)</p> Signup and view all the answers

    Which of the following is an unsafe method of administering potassium?

    <p>Intravenous push (C)</p> Signup and view all the answers

    A patient experiencing hyponatremia is most likely to exhibit which of the following symptoms?

    <p>Muscle weakness (C)</p> Signup and view all the answers

    Which of these is a diagnostic test to identify Hypernatremia?

    <p>BUN lab test (A)</p> Signup and view all the answers

    Flashcards

    Pleural friction rub

    A sound heard during auscultation indicating inflammation of pleural membranes.

    Pleural effusion

    Excess fluid accumulation in the pleural space, more than 25ml is abnormal.

    Empyema

    Collection of pus in the pleural space, often a complication of pneumonia.

    Pulmonary fibrosis

    Scarring and fibrosis of lung tissue, causing breathing problems.

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    Chest X-Ray

    An imaging test used to diagnose pleural effusion and other lung issues.

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    pH Scale

    Ranges from 0 to 14; 7 is neutral, below 7 is acidic, above 7 is basic.

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    Cellular Buffers

    First responders to maintain normal pH; examples include bicarbonate and hemoglobin.

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    Respiratory Acidosis

    Condition with decreased pH and increased CO2 due to hypoventilation.

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    Metabolic Acidosis

    Condition with decreased pH and decreased HCO3, often related to DKA and severe diarrhea.

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    Acidosis Symptoms

    Common symptoms include headache, changes in LOC, hypotension, and dyspnea.

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    Normal Magnesium Levels

    Normal magnesium levels range from 1.5 to 2.5 mg/dL.

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    Hypomagnesemia Causes

    Causes include low magnesium intake, certain diuretics, and alcoholism.

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    Signs of Hypomagnesemia

    Symptoms include hypertension, tachycardia, muscle cramping, and arrhythmias.

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    Hypermagnesemia Definition

    Hypermagnesemia is defined as serum magnesium levels above 2.5 mg/dL.

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    Causes of Hypermagnesemia

    Caused by increased intake and decreased renal excretion, often in kidney failure.

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    Signs of Hypermagnesemia

    Signs include muscle weakness, decreased reflexes, and respiratory failure.

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    Acids and Bases

    Acids release hydrogen, while bases bind hydrogen. Bicarbonate is a common base.

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    Sources of Acids

    Acids are formed from the metabolism of glucose, fat, and protein, and carbonic acid from CO2 and water.

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    Hyponatremia Symptoms

    Symptoms include headache, seizures, muscle weakness, and altered mental status due to fluid imbalance.

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    Hypernatremia Symptoms

    Symptoms include thirst, altered mental status, muscle tremors, and skeletal muscle weakness.

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    Hypernatremia Causes

    Occurs when sodium level is above 145 due to excess sodium or inadequate excretion from kidney failure.

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    Diagnostic Tests for Hypernatremia

    Tests include serum osmolarity, BUN, urine specific gravity, and hematocrit to assess sodium levels.

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    Hypokalemia Definition

    Refers to low potassium levels (below 3.5) affecting muscle and heart functions.

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    Causes of Hypokalemia

    Caused by inadequate intake, excessive losses via kidneys, or medications like potassium-wasting diuretics and steroids.

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    Interventions for Hypokalemia

    Include oral potassium supplements for mild cases and IV potassium for severe cases, educating on side effects.

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    Potassium Administration Caution

    Potassium must be given after the patient voids; avoid IV push to prevent cardiac arrest.

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    Hypokalemia Symptoms

    Symptoms include muscle weakness, cramps, and heart arrhythmias due to low potassium.

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    Asthma Education

    Patients should know triggers, medications, and rescue inhaler use for asthma management.

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    Fluid Volume Status

    Best determinant is weight changes, reflecting fluid retention or loss.

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    Signs of Bleeding Post Tonsillectomy

    Symptoms include increased swallowing, bright red blood, or frequent throat clearing.

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    Patient with Epistaxis Care

    Apply pressure on the nares for at least 10 minutes to control nasal bleeding.

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    Hyperphosphatemia Complications

    Often causes hypocalcemia, resulting in low calcium levels.

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    Narcotics and Electrolyte Imbalance

    Use cautiously in patients with hyperkalemia due to risk of respiratory depression.

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    Causes of PF

    Factors that contribute to pulmonary fibrosis, including genetics, viral illnesses, and environmental exposures.

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    S/S of PF

    Symptoms of pulmonary fibrosis include progressive shortness of breath, crackles, cough, fatigue, and clubbing of fingers.

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    Diagnostic Tests for PF

    Tests used to confirm pulmonary fibrosis, such as chest X-ray, CT scan, spirometry, and lung biopsy.

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    COPD

    Chronic obstructive pulmonary disease characterized by narrowed airways and loss of alveolar elasticity, making breathing difficult.

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    Chronic Bronchitis

    A COPD condition diagnosed by symptoms present for at least 3 months in two consecutive years.

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    Atelectasis

    Collapse of alveoli commonly occurring in post-surgical patients due to hypoventilation and lack of deep breathing.

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    Interventions for PF

    Treatment measures for pulmonary fibrosis including antifibrotic drugs, smoking cessation, and vaccines.

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    Study Notes

    Fluid and Electrolyte Imbalance Study Notes

    • Fluid Balance:
      • Intracellular fluid (ICF): Fluid inside body cells
      • Extracellular fluid (ECF): Fluid outside body cells
        • Interstitial fluid: Surrounds cells, includes lymph
        • Intravascular fluid: Blood plasma in arteries, veins, capillaries
        • Transcellular fluid: Specialized compartments (cerebrospinal, digestive, synovial)
    • Movement of Fluids & Electrolytes:
      • Active transport: Requires energy (ATP)
      • Passive transport: No energy required
        • Diffusion: Movement from high to low concentration
        • Filtration: Movement from high to low pressure across a semipermeable membrane
        • Osmosis: Movement of water across a semipermeable membrane from low to high solute concentration
    • Tonicity/Osmolarity:
      • Isotonic: Same osmolarity as blood (e.g., normal saline 0.9%)
      • Hypertonic: Higher osmolarity than blood (water leaves cells)
      • Hypotonic: Lower osmolarity than blood (water enters cells)
    • Fluid Imbalances:
      • Dehydration/Hypovolemia: Loss of fluid, decreased blood volume
        • Causes: Hemorrhage, vomiting, diarrhea, excessive sweating, NPO status
        • Diagnostic tests: Elevated BUN, hematocrit, decreased skin turgor, cap refill
        • Interventions: Fluid replacement, address underlying cause
      • Fluid Overload/Fluid Excess/Hypervolemia: Too much fluid in the body
        • Causes: Poorly controlled IV therapy, excessive fluid intake, adrenal gland dysfunction, corticosteroid use
        • Diagnostic tests: Decreased BUN
        • Interventions: Replace fluids & resolve dehydration cause, encouraging fluid intake, daily weight monitoring, monitoring I&O.

    Electrolyte Imbalances

    • Electrolytes: substances carrying electrical charge in body fluids (dividied into cations and anions)
      • Sodium (Na+): Normal range = 135-145 mEq/L
        • Hyponatremia: Sodium level < 135 mEq/L causes cellular swelling
        • Hypernatremia: Sodium level > 145 mEq/L causes cellular dehydration
      • Potassium (K+): Important for cardiac muscles, normal range is 3.5-5.0 mEq/L
        • Hypokalemia: Potassium level < 3.5 mEq/L (muscle weakness, cardiac arrhythmias)
        • Hyperkalemia: Potassium level > 5.0 mEq/L (cardiac arrest)
      • Calcium (Ca2+): Normal range 9-11 mg/dL
        • Hypocalcemia: Calcium level <9 mg/dL (muscle cramps, tetany, seizures)
        • Hypercalcemia: Calcium level > 11 mg/dL (weakness, constipation, cardiac arrhythmias)
      • Magnesium(Mg2+): Normal range =1.5 to 2.5 mg/dl
        • Hypomagnesemia: Muscle weakness, tremors, lethargy
        • Hypermagnesemia: Decreased reflexes, bradycardia, lethargy.

    Acid-Base Balance

    • Acids and Bases: Acids release hydrogen ions; bases bind hydrogen ions
      • Maintaining blood pH: essential for body functions via buffers, lungs, and kidneys
    • Respiratory Acidosis: Decreased blood pH and increased CO2 levels (Hypoventilation)
    • Respiratory Alkalosis: Increased blood pH and decreased CO2 levels (Hyperventilation)
    • Metabolic Acidosis: Decreased blood pH and bicarbonate levels
    • Metabolic Alkalosis: Increased blood pH and bicarbonate levels
    • Pneumonia (Bacterial/Viral/Aspiration/Ventilator-associated): Infection of the lungs
    • Tuberculosis (TB): Infectious bacterial disease
    • Bronchiectasis: Dilation of the airways
    • Pulmonary Fibrosis: Scarring and thickening of lung tissues
    • Pleural Effusion/Empyema: Fluid buildup in the pleural cavity
    • Pulmonary Embolism: Blood clot traveling to the lungs
    • Pneumothorax: Air in the pleural space
    • Acute Respiratory Distress Syndrome (ARDS): Lung injury leading to fluid buildup in alveoli, most commonly caused by widespread sepsis

    General Notes

    • Lab values: Know normal ranges and implications of abnormal values.
    • Signs and symptoms: Understand clinical manifestations of imbalances.
    • Interventions: Recognize proper treatment strategies.
    • Patient education: Understand the importance of patient self-management.
    • Diagnostic tests: Recognize their role in assessing and treating imbalances.

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    Description

    Dive into the essential concepts of fluid and electrolyte balance within the body. This study guide covers key topics like intracellular and extracellular fluid, methods of fluid movement, and the significance of tonicity and osmolarity. Perfect for students in health and medical sciences.

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