Med Surg Chapter 13 Quiz
With which condition should the nurse expect that a decrease in serum osmolality will occur?
Kidney Failure
Adrenal insufficiency
Low
Diarrhea
Low
Diuretics
Low
Vomitting
Low
Excessive parenteral administration of dextrose and water solution
Low (Hyponatremia)
The nurse is caring for a patient with a diagnosis of hyponatermia. What nursing intervention is appropriate to include in the plan of care for this patient? (Select all that apply)
- Assessing for symptoms of nausea and malaise - Monitoring neurologic status - Restricting tap water intake
What laboratory findings does the nurse determine are consistent with hypovolvemia in a female patient? (Select all that apply)
- Hematocrit level of >4% - Urine specific gravity of 1.027 - Urine osmolality of>450 Mosm/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? (Select all that apply)
- Oliguria - Tachycardia - Tachypnea
The physician has described a hypotonic IV solution for a patient. Which IV solution should the nurse administer?
0.45% sodium chloride
A patient si admitted with severe vomiting for 24 hours as well as weakness and "feeling exhausted." The nurse observes flat T waves and ST segment depression on the electrocardiogram. Which potassium level does the nurse observe when the laboratory studies are complete?
2.0 mEq/L
List four of six symptoms associated with air embolism a complication of intravenous therapy.
1. Dyspnea 2. Cyanosis 3. Weak pulse 4. Hypotension 5. Unresponsiveness 6. Pain
The average daily urinary output inane adult is:
1.5 L
The nurse should assess the patient for signs of lethargy, increasing intracranial pressure and seizures when the serum sodium reaches what level?
115 mEq/ L
A patient who is semiconscious presents with restlessness and weakness. The nurse assesses a dry, swollen tongue and a body temperature of 99.3. the urine specific gravity is 1.020. What is the most likely serum sodium value for this patient?
155 mEq/L
A patient's serum sodium concentration is within the normal range. What should the nurse estimate the serum osmolality to be?
275-300 mOsm/kg
A patient is admitted with a diagnosis of renal failure. the patient complains of stomach distress and describe ingesting several antacid tablets over the the past 2 days. Blood pressure is 110/70, face is flushed, and the patient is experiencing generalized weakness. Which is the most lily magnesium level associated with the symptoms the patient is having?
5 mEq/L
The upper and lower blood pH levels that are incompatible with life are:
6.8 on the lower range; and 7.8 on the upper range
About ------% of total body fluid is in the intracellular space; the major positively charged ion in intracellular fluid is -----. the extracellular space is divided into three compartments: -------------------,----------------, and -------------; the major positively charged ion in the extracellular fluid is -----. About -----% of the ------ of total blood volume is ---------.
66; potassium. Intravascular, interstitial, and transcultural. Sodium. 50% of 6, plasma.
The normal blood ph is:
7.35-7.45
Cardiac effects of hyperkalemia are usually present when the serum potassium level reaches:
8 mEq/ L
In a patient with excess fluid volume, hyponatremia is treated by restricting fluids to how many milliliters in 24 hours?
800
A normal oxygen saturation value for aerial blood is:
95%
Sedative overdose
MAcid
Diarrhea
Macid
Ketoacidosis
Macid
Lactic Acidosis
Macid
The nurse notes that a patient's urine osmoliality is 980 mOsm/Kd. What should the nurse assess as a possible cause of this finding?
Acidosis
Distinguish between the terms baroreceptors and osmoreceptors.
Baroreceptors are responsible for monitoring the circulating volume, are small nerve receptors that detect changes in pressure within blood vessels. Osmoreceptors sense changes in sodium concentration.
The most common buffer system in the body is the:
Bicarbonate carbonic acid buffer system.
The primary concentration of phosphorus (85%) is located in the ----------, with about 15 percent located in the ----------.
Bones; Soft tissue.
How are calcium levels regulated?
By the combined actions of parathyroid hormone and vitamin D.
A patient complains of tingling in the fingers as well as feeling depressed. The nurse assesses positive Trousseaus's and Chvostek's signs. Which decreased laboratory results does the nurse observe when he patient's laboratory work has returned?
Calcium
The nurse is caring for a patient with hypernatermia. What complication of hypernatremia should the nurse continuously monitor for?
Cerebral edema
What foods can the nurse recommend for the patient with hypokalemia?
Fruits such as bananas, and apricots
Burns over a large surface area
High
Heat stroke
High
Inability to quench thirst
High
Status post therapeutic abortion
High
Syndrome of inappropriate antidiuretic hormone
High
Watery Diarrhea
High
Diabetes insipid us with water restriction
High (Hypernatremia)
A patient with mild fluid volume excess is prescribed a diuretic that blocks sodium reabsorption in the distal tubule. Which diuretic does the nurse anticipate administering to this patient?
HydroDiuril
Immobilization because of multiple fractures
Hypercalcemia
Malignant tumors
Hypercalcemia
Thiazide diuretic
Hypercalcemia
hyperparathyroidism
Hypercalcemia
Adrenal steroid deficiency
Hyperkalemia
Kidney failure
Hyperkalemia
Leukocytosis
Hyperkalemia
Tourniquet too tight when collecting a blood sample
Hyperkalemia
Kidney failure
Hyperphosphatemia
Aminoglycoside administration
Hypocalcemia
Kidney failure
Hypocalcemia
Massive administration of citrated blood
Hypocalcemia
Alkalosis
Hypokalemia
Anorexia nervosa
Hypokalemia
Furosemide administration
Hypokalemia
Gastric suction
Hypokalemia
Hyperaldosteronism
Hypokalemia
Penicillin administration
Hypokalemia
Steroid administration
Hypokalemia
Vomiting
Hypokalemia
Alcohol abuse
Hypomagnesemia
diarrhea
Hypomagnesemia
Alcohol withdraw
Hypophosphatemia
Comprises fluid surrounding the cell
Interstitial space
Comprises about 60% of body fluid
Intracellular space
Third space fluid shift
Intravascular fluid volume deficit
Space where plasma is contained
Intravascular space
Which medication does the nurse anticipate administering to antagonize the effects of potassium on the heart for a patient in severe metabolic acidosis?
Magnesium sulfate
Hypokalmia
Malka
Vomiting
Malka
The nurse is caring for a patient with diabetes type 1 who is having sever vomiting and diarrhea. what condition that exhibits blood values with a low ph and a low plasma bicarbonate concentration should the nurse assess for?
Metabolic Acidosis
Name the primary complication of hyperphosphatemia which occurs when calcium-magnesium product exceeds 70mg/dL.
Metastatic calcification of soft tissue, joints, and arteries.
Write the mathematical formula that a nurse would use to approximate the value of serum osmolality.
Na X2= Glucose divided by 18 + Bun divided by 3
A patient with abnormal sodium losses is receiving a regular diet. How can the nurse supplement the patient's diet to provide 1,600 mg of sodium daily?
One beef cube and 8oz of tomato juice
Acute pulmonary edema
Racid
Severe pneumonia
Racid
Gram negative bacterial infection
Ralka
Hypoxemia
Ralka
What does the nurse recognize as one of the indicators of the patient's renal function?
Serum creatinine
The most characteristic manifestations of hypocalcemia and hypomagnesemia is:
Tetany
What clinical indication of hypophosphatemia does the nurse assess in a patient?
Tetany
Define the term osmotic pressure
The amount of hydrostatic pressure needed to stop the flow of water by osmosis.
The smallest compartment of the extracellular fluid space
Transcellular space
Distinguish between the terms urine specific gravity, blood urea nitrogen, and creatinine,
Urine specific gravity measures the kidney's ability to excrete or conserve water. Blood urea nitrogen, mdd up of urea, is an end product of protein metabolism by the liver. Creatinine, as the end product of muscle metabolism, is a better indicator of renal function that blood urea nitrogen.
Comprises the intravascular, interstitial, and transcellular fluid
extracellular fluid
Kidney failure
hypermagnesemia
Neoplastic disease chemotherapy
hyperphosphatemia
Pancreatitis
hypocalcemia
Gentamicin administration
hypomagnesemia
Untreated ketoacidosis
hypomagnesemia
Hyperparathyroidism
hypophosphatemia
Major thermal burns
hypophosphatemia
Sodium establishes the electrochemical state necessary for ------------- and the ------------.
muscle contraction, transmission impulses
Sodium, the most abundant electrolyte in extracellular fluid, is primarily responsible for maintaing fluid ------------, which -----------------------------.
osmolarity; affects the movement of water between fluid compartments.
Sodium is regulated by -----------, ----------------, and the ----------------system.
thirst, antidiuretic & angiotensin aldosterone