Chapter 13--Med/Surg

hypertonic solution:

a solution with an osmolality higher than that of serum

hypotonic solution:

a solution with an osmolality lower than that of serum

isotonic solution:

a solution with the same osmolality as serum and other body fluids

ascites:

a type of edema in which fluid accumulates in the peritoneal cavity

The nurse should assess the patient for signs of lethargy, increasing intracranial pressure, and seizures when the serum sodium reaches what level? a. 115mEq/L b. 130mEq/L c. 145mEq/L d. 160mEq/L

a. 115mEq/L

The nurse notes that a patient's urine osmolality is 980mOsm/kg. What should the nurse assess as a possible cause of this finding? a. acidosis b. fluid volume excess c. diabetes insipidus d. hyponatremia

a. acidosis

What labratory findings does the nurse determine are consistent with hypovolemia in a female patient? (SATA) a. hematocrit level of >47% b. BUN: serum createnine ratio of >12.1 c. urine specific gravity of 1.027 d. urine osmolality of >450mOsm/kg e. urine positive for blood

a. hematocrit level of >47% c. urine specific gravity of 1.027 d. urine osmolality of >450mOsm/kg

alkalosis:

an acid-base imbalance characterized by a reduction in H+ concentration (increased blood pH) (A high arterial pH with increased bicarbonate concentration is called metabolic alkalosis; a high arterial pH due to reduced PCO2 is called respiratory alkalosis.)

acidosis:

an acid-base imbalance characterized by an increase in H+ concentration (decreased blood pH) (A low arterial pH due to reduced bicarbonate concentration is called metabolic acidosis; a low arterial pH due to increased PCO2 is called respiratory acidosis.)

A patient's serum sodium concentration is within normal range. What should the nurse estimate the serum osmolality to be? a. <136 mOsm/kg b. 275-300mOsm/kg c. >408mOsm/kg d. 350-544mOsm/kg

b. 275-300mOsm/kg

A patient has been involved in a traumatic accident and is hemorrhaging from multiple sites. The nurse expects that the compensatory mechanisms associated with hypovolemia would cause what clinical manifestations? (SATA) a. hypertension b. oliguria c. tachycardia d. bradycardia e. tachypnea

b. oliguria c. tachycardia e. tachypnea

What does the nurse recognize as one of the indicators of the patient's renal function? a. blood urea nitrogen (BUN) b. serum creatinine c. specific gravity d. urine osmolality

b. serum creatinine

A patient who is semiconscious presents with restlessness and weakness. The nurse assesses a dry, swollen tongue and a body temperature of 99.3 degress F. The urine specific gravity is 1.020. What is the most likely serum sodium value for this patient? a. 110mEq/L b. 140mEq/L c. 155mEq/L d. 165mEq/L

c. 155mEq/L

In a patient with excess fluid volume, hyponatremia is treated by restricting fluids to how many mililiters in 24 hours? a. 400 b. 600 c. 800 d. 1,200

c. 800

With which condition should the nurse expect that a decrease in serum osmolality will occur? a. diabetes insipidus b. hyperglycemia c. kidney failure d. uremia

c. kidney failure

tonicity:

fluid tension or the effect that osmotic pressure of a solution with impermeable solutes exerts on cell size because of water movement across the cell membrane

homeostasis:

maintenance of a constant internal equilibrium in a biologic system that involves positive and negative feedback mechanisms

active transport:

physiologic pump that moves fluid from an area of lower concentration to one of higher concentration; active transport requires adenosine triphosphate for energy

osmolality:

the number of milliosmoles (the standard unit of osmotic pressure) per kilogram of solvent; expressed as milliosmoles per kilogram (mOsm/kg) (The term osmolality is used more often than osmolarity to evaluate serum and urine.)

osmolarity:

the number of milliosmoles (the standard unit of osmotic pressure) per liter of solution; expressed as milliosmoles per liter (mOsm/L); describes the concentration of solutes or dissolved particles

hydrostatic pressure:

the pressure created by the weight of fluid against the wall that contains it. In the body, hydrostatic pressure in blood vessels results from the weight of fluid itself and the force resulting from cardiac contraction.

osmosis:

the process by which fluid moves across a semipermeable membrane from an area of low solute concentration to an area of high solute concentration; the process continues until the solute concentrations are equal on both sides of the membrane

diffusion:

the process by which solutes move from an area of higher concentration to one of lower concentration; does not require expenditure of energy