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