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NR 226/ NR226 EXAM 2: FUNDAMENTALS:
PATIENT CARE GUIDE | QUESTIONS & ANSWERS|
GRADE A| 100% CORRECT (VERIFIED
SOLUTIONS)- CHAMBERLAIN (NEW 2025/ 2026
UPDATE)
1. Hypotonic Solution - ANS ✓A solution that is has less particles than
plasma. A hypotonic fluid will shift and flow into a more concentrated
solution. Cells will start to absorb liquid and expand
2. Isotonic Solution - ANS ✓A solution with the same number of particles as
plasma. Two isotonic fluids on different sides of a barrier don't move.
3. Hypertonic Solution - ANS ✓A solution with more particles than plasma.
It will pull a less concentrated solution into itself. Cells will start to shrivel.
4. Regulation of Water Balance - ANS ✓Controlled by juxtaglomerular
apparatus, adrenal cortex, hypothalamus, and heart
5. First Spacing Fluid - ANS ✓Normal distribution of fluid in ICF and ECF
6. Second Spacing Fluid - ANS ✓Abnormal accumulation of interstitial fluid
Ex: edema, fluid in lower extremities
7. Third Spacing Fluid - ANS ✓Fluid accumulation in part of the body where
it is not easily exchanged with ECF. Not usually treated unless it causes
other health problems
Ex: ascites, pleuracy, fluid around lungs in CHF
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8. Gerontologic Considerations with F&E - ANS ✓Decreased body weight,
45-50% water instead of 60%
Places them at risk for fluid and electrolyte imbalance
Decreased muscle mass (muscle contains water)
Kidneys decreased GFR, decreased renin/aldosterone
Decreased creatinine clearance, decreased ability to concentrate urine, decreased
ability to conserve water
Loss of subq tissue
Decreased thirst
Mental status change
9. Hypovolemia (extracellular fluid volume deficit) causes and
treatment - ANS ✓An abnormal loss of normal body fluids and
electrolytes
Caused by diarrhea, fistula drainage, haemorrhage, inadequate intake, plasma-to-
interstitial fluid shift (edema, 3rd spacing), sweating, renal failure, use of
diuretics
Treat by replacing water and electrolytes with balance IV solutions
10. Clinical Dehydration - ANS ✓More water is lost than electrolytes
Fluid volume deficit + hypernatremia
Ex: sweating, just the water is lost but the solutes stay
11. Moderate Signs of Fluid Deficit - ANS ✓Thirst, dizziness,
weakness, confusion, anxiety, postural hypotension, flushed dry skin,
possible fever, dry mucus membranes, decreased urine output, dark
yellow-amber urine, change in skin turgor, weight loss
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12. Severe Signs of Fluid Deficit - ANS ✓Increased heart rate,
increased respirations, decreased blood pressure, lethargy progressing to
coma, dry cracked tongue, cold clammy skin, delayed cap refill, tenting,
dark or no urine, no tears or sweat, sunken eyeballs
13. Hypovolemia Lab Values (h/h, BUN, specific gravity) - ANS
✓Hematocrit/Hemoglobin: increased, body compensating
BUN: increased
Specific Gravity: increased
14. Dehydration Lab Values (h/h, sodium, serum osmolality,
specific gravity) - ANS ✓Hematocrit: elevated
Sodium: elevated
Serum Osmolality: elevated
SG: elevated
15. Treatment for Dehydration - ANS ✓Replace missing fluids orally
or with IV hypotonic solution (low sodium) because they will draw fluid
into the cells, administer slowly
16. Hypovolemia Treatment - ANS ✓Replace missing fluids IV with
isotonic fluids to restore blood volume and normalize BP
17. Nursing Management: Fluid Volume Deficit - ANS ✓Check vitals
signs regularly, assess LOC changes, make sure pt is in safe environment,
monitor I&O, take daily weights (same time, same scale, same clothing),
check lab values, assess skin turgor and integrity, IV access, give urinary
catheter if necessary to monitor output
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