patho test 3 chapter 24
What is likely to lead to hyponatremia
frequent nasogastric tube irrigation with water
A patient who reports an intestinal fistula also reports feeling "week and dizzy" when she stands. While taking her blood pressure she becomes temporarily unresponsive but quickly regains consciousness when put into supine position. What nursing interventions will the nurse implement before calling the physician?
give her water or juice and some salty crackers and ask if she has had any diarrhea or vomiting
The nurse provides teaching regarding dietary intake of potassium to avoid and electrolyte imbalance when a patient
has chronic heart failure that is treated with diuretics
A person who has hyperparathyroidism is likely to develop
hypercalcemia
Decreased neuromuscular excitability if often the result of
hypercalcemia and hypermagnesemia
An increase in the resting membrane potential (hyperpolarized) is associated with
hyperkalemia
The imbalance that occurs with oliguric renal failure is
hyperkalemia
Which electrolyte imbalances cause increased neuromuscular excitability
hypocalcemia and hypomagnesemia
A person who overuses magnesium-aluminum antacids for along period of time is likely to develop
hypophosphatemia
Abnormalities in intracellular regulation of enzyme activity and cellular production of ATP are associated with
hypophosphatemia
What is the most likely explanation for a diagnosis hypernatremia in an elderly patient receiving tube feeding?
inadequate water intake
A patient has a positive Chvostek sign. The nurse interprets this is a sign of
increased neuromuscular excitability
A known cause of hypokalemia is
insulin overdose
Clinical manifestations of moderate to severe hypokalemia include
muscle weakness and cardiac dysrhythmias
The fraction of total body water (TBW) volume contained in the intracellular space in adults is
one-half
The process responsible for distribution of fluid between the interstitial and intracellular compartments is
osmosis
The person at highest risk for developing hypernatremia is a person who
receives tube feedings because he or she is comatose after a stroke
How is a patient with a malignant tumor that secretes parathyroid hormone related peptide monitored for the resulting electrolyte imbalance ?
serum calcium, bowel function, level of consciousness
The electrolyte that has a higher concentration in the extracellular fluid than in the intracellular fluid is ____ ions
sodium
Osmoreceptors located in the hypothalamus control the release of
vasopressin (antidiuretic hormone, ADH)
Clinical manifestations of extracellular fluid volume deficit include
weak pulse, low blood pressure, and increased heart rate
Effects of hypernatremia on the central nervous system typically include
confusion
Clinical manifestations of hyponatremia include
confusion, lethargy, coma, and perhaps seizures
Excessive antidiuretic hormone (ADH) secretion can cause ____ concentration
decreased serum sodium
Signs and symptoms of clinical dehydration include
decreased urine output
Clinical manifestations of severe symptomatic hypophosphatemia are caused by
deficiency of ATP
When a parent asks how they will know if their 2-month-old-baby, who is throwing up and has frequent diarrhea, is dehydrated, the nurse's best response is
"if the soft spot on the top of their head feels sunken in and his mouth is dry between his cheeks and his gums, he is probably dehydrated"
Hyperaldosteronism causes
ECV excess and hypokalemia
How do clinical conditions that increase vascular permeability cause edema?
By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure
What age groups has a larger volume of extracellular fluid than intracellular fluid?
Infants
A patient diagnosed with chronic compensated heart failure reports that "My feet swell if I eat salt but I don't understand why" the nurses best response is
Salt holds water in your blood and makes more pressure against your blood vessels so fluid leaks out into your tissues and makes them swell
What form of oral rehydration, bottled water or salty broth, is best suited for a patient who is demonstrating signs of clinical dehydration?
Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid
Which change in a patient's assessment has the greatest urgency
Serum potassium concentration is increasing; has developed cardiac dysrhythmias but denies any difficulty breathing
Signs and symptoms of extracellular fluid volume excess include
bounding pulse
The inward-pulling for of particles in the vascular fluid is called _____ pressure
capillary osmotic
Manifestations from sodium imbalances occur primarily due to
cellular fluid shifts
A patient who is 8 months pregnant has developed eclampsia and is receiving intravenous magnesium sulfate to prevent seizures to determine if her infusion rate is too high, you should regularly
check the patellar reflex if it becomes weak or absent her infusion rate is probably too high and she is at risk for respiratory depression or cardiac arrest
Cause of hypomagnesemia include
chronic alcoholism
Hypernatremia may be caused by
decreased antidiuretic hormone secretion
Which alterations can lead to edema?
decreased capillary membrane permeability
Total body water in adults is
decreased due to increased adipose tissue and decreased muscle mass