Human Physiology Chapter 5

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Questions and Answers

What is the primary driving force for the movement of water and electrolytes from the arterial capillary bed to the interstitial fluid?

Hydrostatic pressure resulting from the pumping action of the heart (correct)

Osmotic pressure from dissolved particles

Active transport mechanisms in capillary walls

Concentration gradient of solutes

Which process requires energy expenditure to move substances against a concentration gradient?

Osmosis

Filtration

Diffusion

Active transport (correct)

What role do baroreceptors play in the regulation of blood volume?

They respond to changes in volume and regulate neural and endocrine activities. (correct)

They facilitate the active transport of ions in the heart.

They cause the release of hormones that increase blood pressure.

They regulate hydrostatic pressure in blood vessels.

Which statement best distinguishes between filtration and osmosis?

Filtration refers to the movement of water due to hydrostatic pressure, whereas osmosis is the movement of water based on solute concentration. Signup and view all the answers

What effect does sympathetic stimulation have on renal arterioles?

It constricts renal arterioles, decreasing blood flow. Signup and view all the answers

What does a brief contraction of the upper lip indicate?

Chvostek's sign Signup and view all the answers

What adverse effect should a nurse closely monitor in an elderly patient undergoing surgery?

Hypothermia Signup and view all the answers

Which task is the circulating nurse solely responsible for during a cesarean section?

Performing documentation Signup and view all the answers

What factor does NOT contribute to inadvertent hypothermia during surgery?

Dehydration Signup and view all the answers

What is a primary responsibility of the circulating nurse in the operating room?

Verifying consent and coordinating the team Signup and view all the answers

Which of the following is NOT a recognized effect of general anesthesia?

Increased pain sensitivity Signup and view all the answers

What condition should a nurse suspect if a patient exhibits Chvostek's sign?

Hypomagnesemia Signup and view all the answers

Which statement about the responsibilities of a circulating nurse is correct?

They perform a thorough documentation of the procedure. Signup and view all the answers

What is the most common acid-base imbalance associated with hyperventilation?

Respiratory alkalosis Signup and view all the answers

How do you interpret arterial blood gas results indicating a pH of 7.26, PaCO2 of 28, and HCO3 of 11 mEq/L?

Metabolic acidosis with a compensatory respiratory alkalosis Signup and view all the answers

What should be documented when edema is noted around a peripheral IV insertion site?

Infiltration Signup and view all the answers

Which acid-base imbalance is primarily associated with hypoventilation?

Respiratory acidosis Signup and view all the answers

What evidence suggests that a metabolic problem may be the primary issue in a patient with a below-normal pH?

The bicarbonate level is low while pH is also low Signup and view all the answers

What might be a significant complication to monitor for in a patient receiving IV therapy?

Infiltration Signup and view all the answers

What does a PaCO2 level below normal typically indicate in patients?

Respiratory alkalosis Signup and view all the answers

In emergency settings, which situation is most likely to cause respiratory acidosis?

Severe hypoventilation Signup and view all the answers

What does a pH level of 7.21 indicate about a patient's acid-base status?

Acidosis Signup and view all the answers

What does a normal HCO3 level of 24 indicate in relation to metabolic acidosis?

Metabolic acidosis is ruled out Signup and view all the answers

What is the primary purpose of administering a fluid challenge in a patient exhibiting oliguria?

To distinguish reduced renal blood flow from decreased renal function Signup and view all the answers

What is a likely response of a patient with fluid volume deficit after a fluid challenge?

Increased urine output and blood pressure Signup and view all the answers

What symptom might indicate that the elderly woman is experiencing dehydration?

Uncharacteristic confusion Signup and view all the answers

What might be an appropriate nursing response regarding the patient's reluctance to drink water during the day?

Encourage her to drink more fluids earlier in the day to prevent dehydration Signup and view all the answers

What is the significance of recognizing oliguric symptoms in a post-surgical patient?

May indicate an underlying fluid volume deficit or renal issues Signup and view all the answers

In the context of urinary output, what does oliguria refer to?

Reduced urine production Signup and view all the answers

What can limiting fluids in elderly patients lead to?

Imbalances resulting in confusion Signup and view all the answers

What might cause confusion in elderly patients post-surgery?

Urinary retention Signup and view all the answers

What is the most likely reason for low urine output in the 73-year-old man admitted to the ED?

His sympathetic reaction diminished urine output Signup and view all the answers

How does a sympathetic response affect urine output?

By diminishing urine production Signup and view all the answers

Which condition is NOT typically associated with confusion in elderly patients?

Normal cognitive development Signup and view all the answers

What hormone's lack might suggest a possible traumatic brain injury in the patient?

Antidiuretic hormone (ADH) Signup and view all the answers

What characterizes the clinical manifestations of fluid and electrolyte disturbances in elderly patients?

They may be subtle or atypical Signup and view all the answers

Which of the following statements regarding urinary output and fluid management is accurate?

Low urine output could indicate a sympathetic nervous system reaction Signup and view all the answers

What is the primary use of Maalox in the gastrointestinal system?

To break up gas Signup and view all the answers

Why should TPN be initiated slowly in malnourished patients?

To prevent rapid shifts of phosphorus Signup and view all the answers

In which condition would KCl be indicated for a patient?

Hypokalemia Signup and view all the answers

What is a key consideration when managing patients on TPN?

Gradually introduce calories to avoid phosphorus shift Signup and view all the answers

For a patient with hypophosphatemia, what dietary recommendation is appropriate?

Choose foods high in phosphate Signup and view all the answers

Which complication is NOT associated with rapid initiation of TPN in malnourished patients?

Hypercalcemia Signup and view all the answers

What is a significant risk for patients receiving parenteral nutrition too aggressively?

Hyperglycemia Signup and view all the answers

What physiological issue might arise from the administration of fluids too rapidly to malnourished patients?

Hypernatremia Signup and view all the answers

Study Notes

Fluid and Electrolyte Balance and Disturbance

Specific Gravity Testing: Detects fluid volume deficits or excesses in patients with SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion). It does not directly assess nutritional status, potassium, or calcium levels.
High Magnesium Levels: Prioritize assessment for diminished deep tendon reflexes in patients with acute kidney injury and elevated magnesium levels. Tachycardia, cool clammy skin, and acute flank pain are not the priority in this case.
Third Spacing: Third spacing, a shift of fluid, leads to hypovolemia. Increased calcium and magnesium levels are not indicators of third-spacing shifts.

Respiratory Acidosis/Alkalosis

Hyperventilation and Respiratory Alkalosis: Hyperventilation, often caused by anxiety, is a primary cause of respiratory alkalosis.
Blood Gas Results: A patient with blood gas results of pH 7.26, PaCO2 28, HCO3 11 mEq/L has metabolic acidosis with a compensatory respiratory alkalosis.
Third-Spacing Fluid Shift: Third-spacing fluid shift, which occurs when fluid moves out of the intravascular space but not into the intracellular space, can cause hypovolemia.

Complications of IV Therapy

Peripheral IV Infiltration: Infiltration is the administration of a nonvesicant solution or medication into the surrounding tissue. Common findings include edema around the insertion site, leakage of IV fluid from the insertion site, discomfort, and coolness in the area of infiltration.
Infiltration Assessment: The nurse should check for diminished deep tendon reflexes, which are an indicator of high magnesium levels. Tachycardia, flank pain, and cool, clammy skin are not usually associated with hypermagnesemia.

Peripheral IV Insertion

Selection of Site: Select a hairless site if available, but also consider the potential impact on the patient's mobility when selecting a site.
Tourniquet Time: Never leave a tourniquet in place for longer than 2 minutes.

Electrolyte Imbalances

Hypocalcemia: Tetany (muscle spasms) is a critical manifestation of hypocalcemia.
Hypokalemia: Patients with hypokalemia are likely to exhibit signs of dilute urine.
Hypomagnesemia: Tingling, especially in the hands and feet is a key observation to be aware of in hypomagnesemic patients.
Hypermagnesemia: Absent deep tendon reflexes may indicate hypermagnesemia.
Hypernatremia: In the elderly, this condition can manifest as confusion, but it is not a normal condition associated with aging.
Hypophosphatemia: This condition creates central nervous system dysfunction, resulting in seizures and coma.
Hyperkalemia: Paresthesias and anxiety are common findings when assessing patients' risk for hyperkalemia.

Fluid Imbalance

Fluid Challenge: A fluid challenge of 100 to 200 mL of normal saline over 15 minutes is used to evaluate renal blood flow.
Fluid Deficit: In the elderly, dehydration may cause confusion, but this should not be considered normal, and interventions should be made.

Acid-Base Imbalance

Acute Respiratory Alkalosis: A common occurrence in emergency situations such as pulmonary edema. Characteristics of hyperventilation include increased respiratory rate, decreased PaCO2, and low serum pH levels.
Acute Respiratory Acidosis: Is a rare occurrence. It may be associated with acute respiratory distress syndrome.

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Description

Test your knowledge on key concepts related to water and electrolyte movement in the human body. This quiz covers fundamental processes such as filtration, osmosis, and the role of baroreceptors in blood volume regulation. Dive into the physiological responses and mechanisms that govern these critical functions.