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Questions and Answers
Which of the following is an example of an electrolyte?
What is the primary control of water in the body?
What is the movement of a substance from an area of higher concentration to an area of lower concentration called?
What is the force that water exerts called?
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Which term refers to the movement of water from an area of lower substance concentration to an area of higher concentration?
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What is the normal osmolarity of blood?
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Which term refers to a fluid that has the same osmolarity as the blood?
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What is the major indicator that a healthy adult needs more water?
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Which term refers to an excessive amount of calcium in the blood?
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Which term refers to a condition of low potassium levels in the blood?
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Which term refers to an excessive amount of sodium in the blood?
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Which term refers to a condition of low sodium levels in the blood?
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Which of the following is the most common result of fluid excess?
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Which of the following conditions can cause excessive fluid intake?
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What are some signs and symptoms of fluid excess?
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What is the goal of treatment for fluid excess?
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Which population is considered high-risk for developing dehydration?
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What is the recommended daily fluid intake for adults?
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What is a common manifestation of dehydration in older adults?
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What is considered poor skin turgor in a dehydrated person?
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Which of the following is a common symptom of dehydration?
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What is the most reliable indicator of fluid loss or gain?
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What is the primary nursing diagnosis for a patient with dehydration?
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What should be done to correct the underlying cause of fluid deficit in a dehydrated patient?
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Which of the following vital sign changes is commonly seen in patients with fluid excess?
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What is the maximum amount of oxygen that should be administered per minute?
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What should be monitored carefully when administering oxygen?
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What type of medication is commonly administered to rapidly rid the body of excess fluid?
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What is the medical term for swelling?
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What should be avoided when irrigating a patient's stomach?
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Which of the following is a common symptom of dehydration?
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What is the recommended daily fluid intake for adults?
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What is the primary control of water in the body?
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What is the major indicator that a healthy adult needs more water?
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Which of the following patients is at highest risk for developing dehydration?
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What is the recommended daily fluid intake for adults?
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What is the initial symptom of dehydration experienced by otherwise healthy adults?
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What is considered poor skin turgor in a dehydrated person?
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Which term refers to a fluid that has a lower osmolarity than blood?
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What is the term for the concentration of substances in body fluids?
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Which of the following is a risk factor for fluid deficits in older adults?
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What is the term for the movement of fluid from the intravascular space into the interstitial fluid space?
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Which of the following is NOT an example of an electrolyte?
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What is the primary control of water in the body?
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What is the movement of water from an area of lower substance concentration to an area of higher concentration called?
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What is the force that water exerts called?
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Which term refers to the movement of water from an area of higher concentration to an area of lower concentration?
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What is the medical term for swelling?
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What is the primary control of water in the body?
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What is the goal of treatment for fluid excess?
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Which of the following is a common cause of fluid excess?
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What is the term for excessive fluid in the intravascular space?
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What are some signs and symptoms of fluid excess?
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What is the goal of treatment for fluid excess?
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Which of the following signs and symptoms are commonly seen in patients with fluid excess?
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What is the maximum amount of oxygen that should be administered per minute?
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Which of the following is a common symptom of dehydration?
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What is the primary nursing diagnosis for a patient with dehydration?
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What is the movement of water from an area of lower substance concentration to an area of higher concentration called?
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What is the goal of treatment for fluid excess?
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Which term refers to the movement of water from an area of higher concentration to an area of lower concentration?
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What is the term for excessive fluid in the interstitial fluid space?
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What is the term for a condition of low potassium levels in the blood?
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Which of the following is NOT an example of an electrolyte?
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Which of the following is an example of an electrolyte?
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What is the primary control of water in the body?
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What is the movement of a substance from an area of higher concentration to an area of lower concentration called?
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What is the force that water exerts called?
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Which of the following is a risk factor for developing dehydration in older adults?
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What is the recommended daily fluid intake for adults?
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What is considered poor skin turgor in a dehydrated person?
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What is the major indicator that a healthy adult needs more water?
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Which of the following is a reliable indicator of fluid loss or gain?
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Which of the following is NOT a recommended way to identify patients?
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What is the primary nursing diagnosis for a patient with dehydration?
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What is the most common symptom of dehydration in otherwise healthy adults?
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What is the primary cause of fluid excess in the body?
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What is the term for excessive fluid in the intravascular space?
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What are some signs and symptoms of fluid excess?
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What is the goal of treatment for fluid excess?
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Which term refers to the movement of water from an area of higher concentration to an area of lower concentration?
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What is the term for the concentration of substances in body fluids?
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What is the maximum amount of oxygen that should be administered per minute?
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What is the medical term for swelling?
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Which of the following is a sign of fluid excess in a patient?
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What is the term for excess water in tissues?
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What should be monitored carefully when administering oxygen to a patient?
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What is the term for medications that are commonly administered to rapidly rid the body of excess fluid?
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What is the maximum amount of oxygen that should be administered per minute?
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What are the vital sign changes seen in patients with fluid excess?
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Which term refers to a fluid that has the same osmolarity as the blood?
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What is the force that water exerts called?
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What is the term for a condition of low sodium levels in the blood?
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What is the primary nursing diagnosis for a patient with dehydration?
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Which term refers to the movement of water from an area of higher concentration to an area of lower concentration?
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What is the term for excess water in tissues?
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Which of the following is a reliable indicator of fluid loss or gain?
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What is the primary nursing diagnosis for a patient with dehydration?
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Which of the following conditions can cause excessive fluid intake?
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What is the term for excess fluid in the intravascular space?
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Which of the following is a complication of acute fluid excess?
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What is the goal of treatment for fluid excess?
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Which of the following is NOT an electrolyte?
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What is the term for the movement of a substance from an area of higher concentration to an area of lower concentration?
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What is the force that water exerts called?
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What is the primary control of water in the body?
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Which of the following is NOT a way to identify patients when administering isotonic fluids?
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What is the most reliable indicator of fluid loss or gain?
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What is the primary nursing diagnosis for a patient with dehydration?
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What should be done to correct the underlying cause of fluid deficit in a patient with dehydration?
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Which of the following is a risk factor for developing dehydration in older adults?
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What is the recommended daily fluid intake for adults?
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What is considered poor skin turgor in a dehydrated person?
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What is the term for the concentration of substances in body fluids?
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Which of the following is a sign of fluid excess in a patient?
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What is the term for excessive fluid in the intravascular space?
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What is the primary cause of fluid excess in the body?
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What is the movement of water from an area of higher concentration to an area of lower concentration called?
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Which term refers to the movement of water from an area of lower substance concentration to an area of higher concentration?
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What is the recommended daily fluid intake for adults?
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True or false: Fluid excess is characterized by elevated blood pressure, bounding pulse, and increased and shallow respirations.
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True or false: Pitting edema is a sign of excess water in the tissues.
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True or false: Administering more than 2 L per minute of oxygen can cause the patient to lose the stimulus to breathe.
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True or false: Diuretics are commonly used to quickly eliminate excess fluid from the body.
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True or false: Monitoring pulse oximetry and respiratory rate is important when administering oxygen.
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True or false: Patients with fluid excess exhibit vital sign changes opposite to those of dehydration.
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True or false: Excessive fluid absorption during gastric lavage should be avoided.
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True or false: The neck veins may become distended in patients with fluid excess.
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True or false: Fluid excess can lead to respiratory arrest.
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True or false: The primary goal of treatment for fluid excess is to eliminate excess fluid from the body.
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True or false: Monitoring the amount of fluid used for irrigations is important to prevent excessive fluid absorption.
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True or false: The vital sign changes seen in patients with fluid excess are opposite to those found in patients with dehydration.
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True or false: Elevated blood pressure, bounding pulse, and increased and shallow respirations are signs of fluid excess.
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True or false: Distended neck veins may be seen in patients with fluid excess.
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True or false: Pitting edema is a sign of excess water in tissues.
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True or false: Administering more than 2 L per minute of oxygen should be done cautiously.
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True or false: Higher oxygen doses can cause respiratory arrest in patients.
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True or false: Monitoring pulse oximetry and respiratory rate is important when administering oxygen.
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True or false: Diuretics are commonly administered to rapidly remove excess fluid from the body.
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True or false: The medical term for swelling is edema.
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Which organization is recognized as a global authority in infusion nursing and publishes standards of practice for infusion therapy?
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What is the term for any medication route other than the digestive tract?
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Which administration mode of IV medications involves a large-volume infusion of solution or medications administered over 2 to 24 hours?
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What is the primary goal of treatment for fluid excess?
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Which of the following is an indication for IV therapy?
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What is the flow rate for the IV solution ordered for Mrs. Brown?
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Which of the following is a common complication associated with IV therapy?
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What is the difference between isotonic, hypertonic, and hypotonic solutions?
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What is the purpose of a needleless connector in IV therapy?
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What is the recommended fluid for flushing peripheral intermittent devices?
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How long should the hub be scrubbed before each access to prevent infection?
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What is the term for administering a small volume of fluid or medication over 15 minutes to 2 hours by IV push or infusion through a needleless connector?
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Which of the following is true about maintaining positive pressure during the administration of a flush solution?
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Which technique is used to maintain positive pressure during the administration of a flush solution?
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When is an IV push drug usually administered?
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What is the purpose of Patient-Controlled Analgesia (PCA)?
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Which of the following is a characteristic of dextrose solutions?
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What is the primary purpose of using a 0.22-micron filter for nonlipid solutions?
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Which of the following is a disadvantage of hypertonic dextrose solutions?
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What is the primary purpose of using leukocyte-depleting filters for blood administration sets?
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Which of the following formulas is used to determine drops per minute for an IV infusion?
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When calculating drops per minute, what should you do?
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What is the formula for determining milliliters per hour for an IV infusion?
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What is the correct calculation for determining the drops per minute for an order of 125 mL of 5% dextrose and 0.45% sodium chloride per hour, with a drop factor of 15 gtt/mL?
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Which of the following solutions has the same tonicity as body fluid?
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Which solution is isotonic when infused, but quickly becomes hypotonic due to its metabolism?
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Which type of veins provide easy access to the venous system?
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What are CVADs?
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Which type of solution expands the extracellular fluid volume when administered to patients requiring water?
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Which of the following is an example of an isotonic solution?
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Study Notes
Fluid and Electrolyte Balance
- Isotonic fluids, like normal saline, have the same osmolarity as blood (270-300 mOsm/L).
- Patient identification requires at least two identifiers (e.g., name and date of birth).
- Fluid loss can be estimated using the mnemonic “A pint's a pound the world around”; each lost pound indicates about 1 pint of fluid loss.
Complications of Dehydration
- Untreated dehydration leads to decreased organ function and potential organ failure.
- Daily patient weight measurement is crucial; a loss of 1-2 pounds indicates potential fluid loss rather than fat loss.
- Moist mucous membranes and elastic skin turgor are indicators of hydration status.
Nursing Process for Dehydration Management
- Assess patients for signs of dehydration; older patients may require specific skin assessments on the forehead or sternum.
- Monitor intake and output (I&O); assess daily weights for hospitalized patients and a minimum of three times a week for those at risk in other settings.
- Develop a care plan that includes identifying the cause of fluid imbalance and planning fluid intake accordingly.
Expected Outcomes
- A well-hydrated patient will exhibit stable weight, moist mucous membranes, and elastic skin turgor.
- Be vigilant about fluid intake for confused patients who may not self-hydrate.
Patient Education
- Educate patients and families on recognizing early signs of dehydration and the necessity of reporting symptoms to health care providers.
Fluid Excess (Overhydration)
- Caused by hypervolemia and dilutes electrolytes and red blood cells, leading to complications like pulmonary edema.
- Conditions like renal failure and excessive IV fluids can lead to inadequate fluid excretion.
Symptoms and Diagnostic Tests for Fluid Excess
- Signs include rapid weight gain, dilated urine, and potential respiratory difficulties.
- Laboratory tests reveal decreased BUN and hematocrit levels due to hemodilution.
Therapeutic Measures for Fluid Excess
- Treatment focuses on removing excess fluid and addressing underlying causes; oxygen therapy may be necessary for respiratory support.
- Positioning patients in high Fowler's position can aid respiratory function.
Cultural Considerations
- Special considerations for Muslim patients during Ramadan, as fasting may impact hydration.
Calls for Preventive Measures
- Monitor IV therapy closely for signs of fluid overload; consider using electronic pumps for accuracy.
Fluid Balance Dynamics
- Intracellular fluid (ICF) is fluid within cells; extracellular fluid (ECF) includes interstitial, intravascular, and transcellular compartments.
- Antidiuretic hormone (ADH) regulates water balance; it promotes fluid retention when blood volume drops.
Mechanisms of Fluid and Electrolyte Movement
- Active and passive transport govern the movement of fluids and electrolytes; diffusion, osmosis, and filtration are key processes.
Key Terms and Definitions
- Isotonic: Same osmolarity as blood; e.g., normal saline (0.9%).
- Hypotonic: Lower osmolarity than blood, leading to cell swelling.
- Hypertonic: Higher osmolarity than blood, causing cell shrinkage.
- Dehydration: Insufficient fluid in the body; can lead to hypovolemia.
- Hypovolemia: Low blood volume due to fluid loss, which can cause reduced blood flow and oxygen supply to organs.
Prevention Strategies
- Encourage adequate hydration, particularly in older adults who have a reduced thirst response and body water composition.
- Early intervention in high-risk patients (e.g., older adults and infants) is essential to prevent dehydration.### Dehydration Overview
- Poor skin turgor is an indicator of dehydration, characterized by "tenting" of skin when pinched.
- Elevated body temperature signifies the body's struggle to cool itself through perspiration.
- Symptoms such as temperature elevation may be less obvious in older adults due to lower baseline body temperatures.
Urine Output and Symptoms
- Decreased urine output of less than 30 mL per hour suggests dehydration.
- Urine becomes darker and more concentrated due to water conservation by the kidneys.
- Constipation can occur as intestines absorb more water from feces during dehydration.
Weight Loss as an Indicator
- Weight loss is a major indicator of dehydration; 16 ounces of water weighs approximately 1 pound.
- A typical adult should drink about 30 mL of fluid per kilogram of body weight daily.
Diagnostic Tests
- Conditions of dehydration commonly present with elevated blood urea nitrogen (BUN) and hematocrit levels.
- Increased specific gravity of urine indicates kidney conservation of water.
Therapeutic Measures
- Fluid replacement and addressing the underlying cause are crucial in treating dehydration.
- Intravenous (IV) therapy is administered for moderate to severe dehydration, often using isotonic fluids (e.g., normal saline).
Importance of Fluid Balance
- Total body water content varies: ~60% in young adults, <50% in older adults, and 70%-80% in infants.
- Antidiuretic hormone (ADH) regulates fluid retention; lower fluid pressures increase ADH release.
Transport Mechanisms
- Active transport (e.g., sodium-potassium pump) and passive transport (diffusion, filtration, osmosis) facilitate fluid and electrolyte movement.
- Osmolarity measures the concentration of solutes in fluids, with normal blood osmolarity ranging from 270 to 300 mOsm/L.
Fluid Imbalances
- Older adults and infants are at higher risk for dehydration due to proportionate fluid intake and loss.
- Common causes of dehydration include severe vomiting, diarrhea, and excessive sweating.
Symptoms and Prevention
- Initial thirst response indicates dehydration; inadequate circulatory volume leads to lightheadedness and altered mental status, particularly in older adults.
- Prevention strategies include recognizing high-risk individuals and encouraging adequate fluid intake.
Nursing Care and Evaluation
- Daily weight assessments and monitoring of intake/output (I&O) are essential.
- Nursing diagnosis may include Risk for Deficient Fluid Volume, with goals of hydration evidenced by stable weight and moist mucous membranes.
- A systematic approach to fluid intake planning enhances compliance and effectively addresses fluid deficits without risking overhydration.### Dehydration and Patient Education
- Early signs and symptoms of dehydration must be reported to healthcare providers promptly.
- Infections can cause fever and sepsis, leading to potential dehydration as the body sweats to reduce temperature.
- Symptoms of dehydration include dark amber urine, foul odor, rapid pulse, and increased heart rate.
Case Study: Mrs. Levitt
- Mrs. Levitt is a 92-year-old nursing home resident showing signs of dehydration.
- Important to check and document additional data such as fluid intake, skin turgor, and neurological status.
- Expected findings may include poor skin turgor, dry oral mucosa, and confusion.
- Interventions should include encouraging fluid intake, possibly providing IV fluids, and monitoring vital signs closely.
- Documentation should include assessment findings, interventions performed, and patient responses.
- Team members to inform include nursing staff, physicians, and dietitians.
- Improvement indicators may involve increased urine output, normal vital signs, and improved mental status.
Fluid Excess
- Fluid excess occurs when there is an excessive amount of fluid in the body, leading to hypervolemia.
- Common causes include ineffective IV therapy, kidney failure, and excessive water intake.
- Vital sign changes in fluid excess include elevated blood pressure, bounding pulse, and increased shallow respirations.
- Symptoms can include distended neck veins, pitting edema, dyspnea, pulmonary edema, and ascites.
Diagnostic Tests and Management
- In fluid excess, BUN and hematocrit levels decrease due to hemodilution.
- Lower urine specific gravity indicates increased urinary output.
- Treatment focuses on managing oxygenation, addressing fluid overload through diuretics, and providing proper positioning to ease respiratory effort.
Prevention and Care Recommendations
- Monitor IV fluid intake carefully to prevent fluid excess.
- Employ electronic infusion pumps to regulate IV therapy rates.
- Encourage regular fluid presentation to bedridden patients to maintain hydration.
- Position patients in semi-Fowler’s or high Fowler’s to optimize lung function during treatment.
Cultural Considerations
- Special attention is required for Muslim patients during Ramadan as fasting can contribute to dehydration.
- Adjustments may include timing of medication administration to accommodate fasting times.
Key Terms
- Hypervolemia: Excess fluid in the blood.
- Dehydration: Insufficient body fluid.
- Edema: Swelling due to fluid accumulation.
- Acidosis and Alkalosis: Imbalances in blood pH.
Learning Outcomes
- Understand fluid and electrolyte functions in the body.
- Recognize signs and symptoms of fluid imbalances.
- Identify patients most at risk of dehydration and fluid excess.
- Collect relevant data regarding fluid and electrolyte status.
- Implement therapeutic measures for imbalances.
- Address educational needs for patients regarding fluid management.
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Description
Test your knowledge on fluid excess and its effects on the body with this quiz. Learn about the pathophysiology and etiology of fluid excess, including the most common result of hypervolemia. Explore the cultural considerations related to fluid excess in the Muslim population.
