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