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Week 4 BSN 366 Electrolyte, and Acid-Base Imbalances Questions With Complete Solutions
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Week 4 BSN 366 Electrolyte, and Acid-Base Imbalances Questions With Complete Solutions
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Week 4 BSN 366 Electrolyte, and Acid-Base ImbalancesQuestions With Complete Solutions
Assessment Related To Fluid Balance
Rapid weight loss is an important clinical manifestation
associated with FVD. The severity of dehydration is categorized
based on percentage of total body weight:
2% loss = mild dehydration
5% loss = moderate dehydration
8% loss = severe dehydration
15% loss = life-threatening, usually fatal
In severe fluid volume deficit with a 20% decrease in blood
volume, hypovolemic shock can lead to potentially irreversible
organ and tissue damage or death. -
Causes of Fluid Imbalance:
Question 1 of 4
A nurse has been assigned to care for four patients. Which
patient condition would the nurse recognize as at risk for fluid
volume deficit (FVD)?
Foot infection
Heart failure
Acute kidney injury
Hemorrhage - Hemorrhage
Hemorrhage, significant loss of blood volume from bleeding,
would definitely increase the risk for isotonic fluid volume
deficit.
Fluid Volume Excess
When a person's intake is greater than the output, fluid volume
excess (FVE) occurs. An increase in circulating volume can
,ultimately lead to decreased oxygenation and perfusion to
organs and tissues. - For example, patients who develop severe
kidney disease (e.g., acute kidney injury) can no longer produce
a sufficient amount of urine (decreased output). Water is
retained (increased input), which contributes to an ever
increasing circulating volume. Eventually, the increased volume
puts a strain on the pumping ability of the heart. Heart failure
can develop with possible back up of fluid into the lungs,
causing pulmonary edema. What originally began as a fluid
excess related to a kidney disease has now involved three organ
systems.
Implementation and Evaluation of Interventions Related to Fluid
Balance:
Mrs. Walters is an 82-year-old patient with a history of Type II
diabetes, hypertension, and renal failure. She is admitted to a
medical floor. Julie is assigned to be her nurse, and performs an
assessment of Mrs. Walters' fluid balance.
Julie records these findings after completing her assessment:
Skin: Pitting edema, pale, cool skin
Respiratory: Increased respiratory rate (22-24/min), dyspnea (a
distressful subjective sensation of uncomfortable breathing) on
exertion
Cardiovascular: Increased heart rate (96-104/min), elevated
blood pressure (174/92), distended neck veins, bounding pulse
Neurological: Mild confusion
Mrs. Walters is able to eat a small amount of food, with
assistance and is receiving supplemental enteric feedings. She
has IV fluid infusing at a slow rate. There is an order for
monitoring of strict intake and output measurement -
,Physiology of Fluid Balance:
Question 1 of 4
Match each type of fluid to its description.
=Intracellular
Inside of the cell membrane
=Extracellular
Outside of the cell membrane
=Interstitial
Between the cells in the tissues
=Intravascular
=Within the blood vessels - Question 2 of 4
Match each element to its description.
=Solutes
Substances dissolved in a solvent
=Crystalloids
Solutes that dissolve easily
=Colloids
Solutes that do not dissolve easily
=Electrolytes
Charged atoms or molecules
Question 1 of 12
A nurse is asked to assess a patient for fluid volume deficit. The
patient reports that he has lost 10 kg of total body weight in the
last 48 hours due to vomiting and diarrhea. Based on the
relationship between volume and weight, about how much fluid
has this patient lost?
1 liter of fluid
5 liters of fluid
10 liters of fluid
15 liters of fluid - 10 liters of fluid
, The principles states that 1 liter of fluid weighs 1 kg; therefore,
if the patient has lost 10 kg of total body weight, around 10 liters
of fluid have been lost.
Question 1 of 16
The nurse admits an older person suffering from chronic
alcoholism. Based on which factors would the nurse assess for
alteration in total body water (TBW)?
Select all that apply.
Age
Overall health
Body weight
Gender
Height - Age
Older adults have significantly less TBW than the average
healthy adult.
Overall health
A patient's overall health can affect TBW. Some health issues
that can change TBW are acute kidney injury, heart failure, and
liver failure.
Body weight
Obese patients have less TBW compared to the average healthy
adult.
Gender
Men have a higher TBW compared to women.
Question 1 of 16
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