Questions and Answers
Which electrolyte has the greatest influence on water balance in the body?
Which regulatory system is the body's second line of defense in maintaining pH within normal limits?
Which dietary selections contain foods with the most potassium?
What is the primary major route of excretion of sodium by the body?
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The movement of water from an area of lower concentration to an area of higher concentration occurs through which process?
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What is the largest fluid compartment in the body?
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Passive transport includes which physiological processes? (Select all that apply)
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Which abbreviation is used to indicate hydrogen ion concentration in the body?
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Potential causes of hypocalcemia may include which conditions? (Select all that apply)
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This change in weight reflects a loss or gain of what amount of body fluid?
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When the body senses hypoxemia or hypercapnia, the chemoreceptors in the medulla of the brainstem will have what response?
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What actions should be included in the plan of care for a patient with severe hyperkalemia? (Select all that apply)
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In acute respiratory acidosis, the renal compensatory mechanisms begin to operate within how many hours?
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Normal daily water intake and output (I&O) is approximately how many milliliters?
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How many milliliters of urine per hour must the kidneys secrete to eliminate waste products from the body?
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The normal pH of blood is approximately __________.
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Which statement best describes the risk of fluid and electrolyte imbalances in the older adult?
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What assessment is most critical for a patient with a potassium imbalance?
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The patient's potassium level is 5.2. Which food items should the patient limit intake of? (Select all that apply)
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Fluid balance is maintained in the body by which of the following systems? (Select all that apply)
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A central line is preferred over a peripheral IV line under which conditions? (Select all that apply)
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What is the goal of IV therapy?
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Which symptoms indicate infiltration at the IV site?
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What is likely indicated if redness, swelling, and warmth are noted at the IV site?
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Which symptom would indicate fluid volume excess in an elderly patient receiving IV therapy?
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When selecting a site for a new IV line, the nurse should perform which of the following?
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During a blood transfusion, a patient complains of a headache, nausea, and vomiting. What action is necessary for the nurse to take immediately?
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Which nursing intervention is most important in preventing the introduction of microorganisms to the patient during IV infusion initiation?
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Which needle gauge should be chosen when starting a rapid transfusion of whole blood?
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What is most indicative that the patient is experiencing a blood transfusion reaction 15 minutes after the blood infusion was initiated?
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Study Notes
Fluid and Electrolyte Balance
- Sodium (Na+) significantly impacts water balance within the body, influencing edema.
- Blood buffers, respiratory, and renal systems work to regulate pH; the renal system is the second line of defense.
- Foods high in potassium include baked chicken, green salads, and fresh fruit; good dietary choices promote potassium sufficiency.
Sodium and Fluid Excretion
- The kidneys are the primary route for sodium excretion in the body.
- Osmosis describes the movement of water from lower to higher concentration areas, a critical process in fluid balance.
- The body's largest fluid compartment is intracellular, ensuring vital cellular functions.
Passive Transport Mechanisms
- Passive transport processes essential for cellular function include osmosis, diffusion, and filtration.
- Blood pH is measured using the pH scale, which indicates hydrogen ion concentration.
Conditions Causing Imbalances
- Hypocalcemia may result from vitamin D deficiency, certain diuretics, thyroid injury, severe burns, and renal failure.
- Weight changes in patients receiving diuretics can indicate fluid loss; a 2 kg weight decrease represents significant fluid reduction.
Respiratory Response
- Hypoxemia or hypercapnia triggers increased depth and rate of respirations, facilitating gas exchange.
- Patient assessment for hyperkalemia must prioritize heart rate and rhythm monitoring to prevent complications.
Dietary Restrictions
- Patients with elevated potassium levels (e.g., 5.2) should limit intake of high-potassium foods like bananas, tomatoes, and orange juice.
- Fluid balance maintenance involves the respiratory and renal systems as key regulators.
IV Therapy Considerations
- Central lines are preferable for patients requiring irritating IV fluids, children, or those receiving chemotherapy due to poor peripheral access.
- The primary goal of IV therapy is to uphold fluid and electrolyte balance.
Infiltration Symptoms
- Symptoms of IV site infiltration include burning, pain, and puffiness; vigilance is required for early detection.
- Redness, swelling, and warmth at the IV site may indicate inflammation or phlebitis.
Fluid Volume Excess in Elderly
- Symptoms of fluid volume excess can include shortness of breath and a bounding pulse, particularly in elderly patients.
- New IV placements should be proximal to any previous site to avoid complications from infiltration.
Blood Transfusion Protocols
- Immediate action during a transfusion reaction is to stop the transfusion and flush the line with normal saline.
- Hand hygiene is the most critical intervention to prevent infection during IV initiation, emphasizing patient safety.
Transfusion Safety
- For rapid blood transfusions, a 14-to 16-gauge needle is required to facilitate proper flow.
- A significant drop in blood pressure within 15 minutes of starting a transfusion could indicate a transfusion reaction, requiring prompt intervention.
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Description
Test your knowledge on fluids and electrolytes with this chapter 18 quiz. Explore how electrolytes influence water balance in the body, focusing on key concepts and dietary implications for patients. Perfect for nursing students and healthcare professionals.
