Fluid Volume Deficit Quiz
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Questions and Answers

Which of the following is NOT a cause of fluid volume deficit (FVD)?

  • Diabetes insipidus
  • Increased intake of fluids (correct)
  • Abnormal fluid losses due to vomiting, diarrhea, or sweating
  • Third-space fluid shifts due to burns or ascites

What is the primary way healthy individuals gain fluids?

  • Through osmosis
  • By diffusion
  • Through intravenous (IV) infusions
  • By consuming fluids and food (correct)

Which of the following is a homeostatic mechanism that helps regulate fluid balance?

  • The digestive system
  • The skeletal system
  • The nervous system
  • The endocrine system (correct)

Which of the following clinical manifestations is NOT typically associated with fluid volume deficit (FVD)?

<p>Increased blood pressure (A)</p> Signup and view all the answers

What is the primary distinction between dehydration and fluid volume deficit (FVD)?

<p>Dehydration involves only water loss, while FVD involves loss of both water and electrolytes. (D)</p> Signup and view all the answers

Which of the following is NOT a characteristic of gerontologic considerations for FVD?

<p>Older adults typically have increased cardiac reserve, making FVD less concerning. (C)</p> Signup and view all the answers

What is the preferred route of administering fluids to treat FVD?

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

Which type of IV solution is commonly used to treat FVD?

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

Which of the following is a potential consequence of fluid volume deficit (FVD)?

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

What is the primary route of fluid loss through the skin?

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

What observation may NOT be associated with acute respiratory acidosis?

<p>Decreased respiratory rate (C)</p> Signup and view all the answers

In the management of respiratory acidosis, which intervention is least likely to be utilized?

<p>Increasing physical activity (C)</p> Signup and view all the answers

When interpreting arterial blood gas results, a pH of 7.5, PaCO2 of 37, and HCO3 of 30 indicates which condition?

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

Which of the following statements about respiratory alkalosis is true?

<p>It can occur in response to hyperventilation. (D)</p> Signup and view all the answers

Which treatment is NOT commonly utilized in managing respiratory alkalosis?

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

Which of the following is NOT a major cation in the body?

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

Which of the following best describes the movement of fluid through capillary walls?

<p>Fluid moves from areas of high hydrostatic pressure to areas of low hydrostatic pressure. (D)</p> Signup and view all the answers

Which of the following processes is responsible for maintaining a higher concentration of potassium inside cells compared to outside?

<p>Active transport (Sodium-Potassium pump) (B)</p> Signup and view all the answers

Which of the following statements about the composition of body fluids is FALSE?

<p>Transcellular fluid is a type of intracellular fluid. (D)</p> Signup and view all the answers

What is the primary factor that determines the direction of fluid movement during osmosis?

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

Which of the following statements accurately describes the difference between osmosis and diffusion?

<p>Osmosis is the movement of water across a membrane, while diffusion is the movement of solutes. (D)</p> Signup and view all the answers

What is the term used to describe the fluid that surrounds cells in the body?

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

Which of the following is NOT a function of the Sodium-Potassium pump?

<p>Facilitates diffusion of ions across the cell membrane (D)</p> Signup and view all the answers

Which of the following is NOT a contributing factor to Hypercalcemia?

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

A patient presents with clinical manifestations of apathy, depressed mood, psychosis and confusion. Which electrolyte imbalance is most likely responsible for these symptoms?

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

A client is diagnosed with hypermagnesemia. What is the priority nursing intervention?

<p>Administering IV calcium gluconate (D)</p> Signup and view all the answers

What is the primary goal in the management of hypophosphatemia?

<p>Preventing further phosphorus depletion (B)</p> Signup and view all the answers

What is the most common cause of metabolic alkalosis?

<p>Vomiting or gastric suction (B)</p> Signup and view all the answers

Which of the following is a FALSE statement about respiratory acidosis?

<p>It is often caused by excessive intake of antacids (C)</p> Signup and view all the answers

A patient with a history of chronic respiratory acidosis is admitted to the hospital. Which of the following is a priority nursing assessment?

<p>Assessing for signs of respiratory distress. (C)</p> Signup and view all the answers

What is the MOST significant finding associated with hyperphosphatemia?

<p>Increased risk of bone fractures (B)</p> Signup and view all the answers

A client is admitted to the hospital with severe hyperchloremia. Which of the following is a priority nursing assessment?

<p>Assessing for signs of respiratory distress (D)</p> Signup and view all the answers

A patient with hypochloremia is being treated with IV fluids. Which of the following IV fluids is appropriate for this condition? (Select all that apply)

<p>Normal Saline (0.9% NaCl) (A), 0.45% Sodium Chloride (D)</p> Signup and view all the answers

A client with metabolic alkalosis may experience which of the following clinical manifestations? Select ALL that apply.

<p>Respiratory depression (A), Tetany (B), Muscle weakness (C), Hypokalemia (F)</p> Signup and view all the answers

Which electrolyte imbalances are commonly associated with severe hyperchloremia?

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

Which of the following is NOT a common cause of hypophosphatemia?

<p>Excessive fluid intake (A)</p> Signup and view all the answers

What is a common clinical manifestation of both hypermagnesemia and hypocalcemia?

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

Which electrolyte imbalance is commonly associated with Addison's disease?

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

What is the MOST common cause of hypokalemia inducing alkalosis?

<p>Long-term diuretic use (B)</p> Signup and view all the answers

Which of the following situations can cause hypernatremia?

<p>Excess sodium administration. (C)</p> Signup and view all the answers

Identify the most common clinical manifestation of hypernatremia.

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

A patient presents with ECG changes and a serum potassium level of 2.8 mEq/L. Which of the following nursing interventions is most appropriate?

<p>Administer potassium replacement therapy. (D)</p> Signup and view all the answers

Which of the following conditions is NOT a common cause of hypokalemia?

<p>Rapid administration of potassium. (B)</p> Signup and view all the answers

Choose the correct statement regarding the relationship between hyperkalemia and renal function.

<p>Hyperkalemia is a frequent complication of kidney disease. (A)</p> Signup and view all the answers

Which of the following clinical manifestations is associated with hyperkalemia?

<p>Muscle weakness and dysrhythmias. (D)</p> Signup and view all the answers

Which of the following interventions is NOT recommended in the management of hyperkalemia?

<p>IV potassium replacement therapy. (C)</p> Signup and view all the answers

Identify the correct statement regarding hypocalcemia.

<p>Hypocalcemia is a common cause of hyperactive deep tendon reflexes (DTRs). (C)</p> Signup and view all the answers

Which of the following signs indicates a potential complication of hypocalcemia?

<p>Trousseau's sign. (B)</p> Signup and view all the answers

Which of the following lab values would confirm a diagnosis of hyponatremia?

<p>Serum sodium less than 135 mEq/L. (B)</p> Signup and view all the answers

Which of the following conditions can lead to hyponatremia?

<p>Diuretic therapy. (D)</p> Signup and view all the answers

Which of the following electrolytes is NOT directly involved in the development of muscle weakness?

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

Which of the following is an appropriate nursing intervention when caring for a patient with hyponatremia?

<p>Restrict fluid intake. (B)</p> Signup and view all the answers

Which of the following is a potential complication of untreated hyperkalemia?

<p>Cardiac arrest. (B)</p> Signup and view all the answers

Which of the following is a common cause of hypercalcemia?

<p>Multiple myeloma. (C)</p> Signup and view all the answers

Which of the following lab tests would be most helpful in determining the cause of hypercalcemia?

<p>Parathyroid hormone (PTH) levels. (C)</p> Signup and view all the answers

Flashcards

Metabolic Alkalosis

A condition where the body's pH is too high due to an excess of bicarbonate.

Respiratory Acidosis

A condition where the body's pH is too low due to a buildup of carbon dioxide in the blood.

Respiratory Alkalosis

A condition where the body's pH is too high due to a decrease in carbon dioxide in the blood.

Metabolic Acidosis

A condition where the body's pH is too low due to a buildup of acids in the blood.

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Arterial Blood Gas (ABG)

A blood gas analysis that measures the pH, partial pressure of carbon dioxide (PaCO2), and bicarbonate levels (HCO3) in the blood.

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Diffusion

The movement of solutes from an area of higher concentration to an area of lower concentration.

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Homeostasis

The process by which the body maintains a stable internal environment.

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Fluid Volume Deficit (FVD)

The loss of extracellular fluid exceeding the intake ratio of water.

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Dehydration

A condition where the body loses more water than electrolytes, leading to increased serum sodium levels.

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Fluid Volume Excess (FVE)

A condition where the body retains too much fluid, leading to an increase in blood volume.

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Isotonic Solution

A type of IV fluid that has the same concentration of solutes as blood.

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Hypotonic Solution

A type of IV fluid that has a lower concentration of solutes than blood.

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Hypertonic Solution

A type of IV fluid that has a higher concentration of solutes than blood.

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Colloid Solution

A type of IV fluid that contains large molecules, helping to increase blood volume.

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Third-space fluid shift

The outward movement of fluid from the bloodstream into the interstitial space.

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Tonicity

The tension exerted by the osmotic pressure of a solution on cell size due to water movement across the cell membrane.

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Hyponatremia

A decrease in the blood's sodium level, below 135 mEq/L.

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Hypernatremia

An increase in the blood's sodium level, above 145 mEq/L.

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Hypokalemia

A decrease in the blood's potassium level, below 3.5 mEq/L.

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Hyperkalemia

An increase in the blood's potassium level, above 5.0 mEq/L.

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Hypocalcemia

A decrease in the blood's calcium level, below 8.6 mg/dL.

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Hypercalcemia

An increase in the blood's calcium level, above 10.4 mg/dL.

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Asthenia

A state of general weakness and fatigue.

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Paresthesia

A tingling or pricking sensation, usually in the hands or feet.

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Trousseau's Sign

A sign of hypocalcemia, where a blood pressure cuff inflated above systolic pressure causes carpal spasm.

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Chvostek's Sign

A sign of hypocalcemia, where tapping lightly on the facial nerve in front of the ear causes facial muscle twitching.

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Osmosis

The movement of water across a semi-permeable membrane from an area of low solute concentration to an area of high solute concentration.

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Osmotic Pressure

The force that pulls water into blood vessels due to the presence of proteins in the plasma.

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Hydrostatic Pressure

The outward force exerted by the blood against the vessel walls.

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Filtration

Movement of fluid and solutes across a membrane from an area of high hydrostatic pressure to an area of low hydrostatic pressure.

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Sodium-Potassium Pump

A mechanism that actively pumps sodium out of cells and potassium into cells, using energy.

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Interstitial Fluid

The fluid that surrounds cells in the body.

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Intravascular Fluid

The fluid within blood vessels, including plasma, red blood cells, white blood cells, and platelets.

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Hypercalcemia Crisis

A life-threatening condition characterized by extremely high calcium levels in the blood, often associated with severe symptoms and a high risk of complications.

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Hypomagnesemia

A low magnesium level in the blood, frequently linked to conditions like alcoholism, gastrointestinal losses, or inadequate magnesium intake.

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Hypermagnesemia

An abnormally high magnesium level in the blood, often due to kidney problems, excessive magnesium intake, or tissue damage.

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Hypophosphatemia

A low phosphorus level in the blood, often linked to conditions like alcoholism, refeeding after starvation, or certain medical conditions.

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Hyperphosphatemia

An abnormally high phosphorus level in the blood, commonly associated with kidney problems, excessive phosphorus intake, or certain medical conditions.

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Hypochloremia

A low chloride level in the blood, frequently caused by conditions like Addison's disease, excessive sweating, or certain medications.

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Hyperchloremia

An abnormally high chloride level in the blood, often due to medical interventions or certain medical conditions.

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Hypomagnesemia

A medical condition characterized by abnormally low levels of magnesium in the blood, often associated with conditions such as alcoholism, gastrointestinal losses, or inadequate magnesium intake.

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Study Notes

Fluid and Electrolytes

  • Fluids are essential for life and homeostasis
  • Nurses must anticipate, identify, and respond to fluid electrolyte imbalances.
  • Approximately 60% of the typical adult human body is comprised of fluid.
  • Fluid content varies with age, body fat, and gender.
  • Intracellular fluid (ICF): found inside cells, comprising ~2/3 of total body fluid, with skeletal muscle contributing significantly.
  • Extracellular fluid (ECF): found outside cells.
    • Intravascular fluid: within blood vessels, including plasma, red blood cells, white blood cells, and platelets.
    • Interstitial fluid: surrounds cells and includes lymph.
    • Transcellular fluid: located in specialized body compartments such as cerebrospinal, pericardial, and synovial fluids.

Electrolytes

  • Electrolytes are active chemicals that carry electrical charges (cations and anions).
  • Major cations include sodium, potassium, calcium, magnesium, and hydrogen ions.
  • Major anions include chloride, bicarbonate, phosphate, and sulfate, along with negatively charged protein ions.
  • Electrolyte concentrations vary between intracellular and extracellular fluids.
  • Electrolytes are measured in milliequivalents (mEq) per liter.

Fluid Regulation

  • Osmosis: Water diffuses across a semipermeable membrane from an area of low solute concentration to an area of high solute concentration.
  • Diffusion: Solutes move from an area of high concentration to an area of low concentration.
  • Filtration: Movement of water and solutes from an area of high hydrostatic pressure to an area of low hydrostatic pressure.
  • Active transport: Sodium-potassium pump maintains higher extracellular sodium and intracellular potassium levels. This requires energy input.

Fluid and Electrolyte Gains and Losses

  • Gains: Consumption of fluids via drinking and eating. Daily intake and output are generally equal.
  • Losses:
    • Kidneys: Excrete urine (~1 mL/kg/hr).
    • Skin: Sensible (sweat) and insensible (fever, exercise, burns) losses.
    • Lungs: Expire water vapor (~300 mL/day), with increased output related to respiration.
    • Gastrointestinal (GI) tract: Significant losses can occur due to diarrhea and fistulas.

Homeostatic Mechanisms

  • The body uses various mechanisms to maintain fluid and electrolyte balance within normal limits
  • These mechanisms include the kidney, heart and blood vessels, lungs, pituitary gland, adrenal glands, parathyroid glands, and baroreceptors.
  • Specific hormonal systems, such as renin-angiotensin-aldosterone system and antidiuretic hormone, help regulate fluid and electrolyte balance.

Gerontologic Considerations

  • Clinical manifestations of fluid and electrolyte imbalances may be subtle in older adults.
  • Dehydration is common in older adults due to age-related thinning of skin, loss of strength and elasticity, and decreased cardiac reserve.
  • Reduced renal function can exacerbate fluid balance problems.

Fluid Volume Deficit (FVD)/Hypovolemia

  • FVD occurs when extracellular fluid loss exceeds fluid intake. Electrolytes are lost proportionately to the loss of fluid, and this is not the same as dehydration.
  • Causes of FVD include abnormal fluid losses (vomiting, diarrhea, sweating, GI suctioning), decreased intake (nausea, lack of access), and third-space fluid shifts (burns, ascites).
  • Underlying conditions such as Diabetes Insipidus and adrenal insufficiency can also cause FVD.
  • Diagnosis and treatment require an assessment of the clinical manifestations and the degree of loss, along with appropriate laboratory findings.

Fluid Volume Excess (FVE)/Hypervolemia

  • FVE results from abnormal retention of water and sodium, often in proportional amounts.
  • Causes include fluid overload and diminished homeostatic mechanisms as in cases of; heart failure, kidney injury, cirrhosis of the liver.
  • Excessive intake of table salt or sodium-containing fluids, and over-administration of sodium-containing solutions.
  • Diagnosis and management involve assessment of clinical manifestations (edema, distended neck veins, crackles) and laboratory findings, such as BUN and HCT.

Electrolyte Imbalances

  • Specific electrolyte imbalances, such as sodium (hyponatremia, hypernatremia), potassium (hypokalemia, hyperkalemia), calcium (hypocalcemia, hypercalcemia), magnesium (hypomagnesemia, hypermagnesemia), phosphorus (hypophosphatemia, hyperphosphatemia), and chloride (hypochloremia, hyperchloremia).
  • Specific causes, symptoms, and management strategies for each electrolyte imbalance are discussed in detailed notes for each electrolyte.

Medical and Nursing Management

  • The management of FVD/FVE, along with electrolyte imbalances, depends on the specific imbalances, along with any underlying causes.
    • Treatment may involve replacing lost fluids and electrolytes either orally or intravenously. Solutions may be isotonic, hypotonic, or hypertonic, and colloids are also an option, depending on the specific electrolyte imbalances.
    • Nursing management often involves monitoring and maintaining fluid and electrolyte balance, alongside other interventions specific to the issue.

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Fluid and Electrolytes PDF

Description

Test your knowledge on fluid volume deficit (FVD) and its implications. This quiz covers causes, clinical manifestations, homeostatic mechanisms, and treatment methods related to FVD. Explore the distinctions between dehydration and FVD and understand the considerations for different age groups.

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