NR283: Homeostasis and Elimination

What are some common reasons for dehydration? Select all that apply.

Diarrhea Bleeding from trauma​ Vomiting Medications (diuretics)​ Decreased fluid intake​

A high school student has been outside for marching band practice for four hours on a hot, humid afternoon. They have been drinking water to replace fluids lost through sweat. An hour after getting home, the student's caregiver finds them in bed with muscle cramps, lethargy, a headache, and confusion. The student continues to drink water to replace fluid lost during band practice. Which action by the student could have prevented them from becoming hyponatremic?

Drank an isotonic sports drink instead of water​

In which direction will potassium diffuse through the cell membrane?

From intracellular space to extracellular space

A friend decided to decrease their dietary intake of sodium and is discussing the steps they are taking. Which statement made by the friend indicates they do not understand a low-sodium diet?​

"I'm glad I can still eat sandwiches with bologna."​

Read the case scenario below, and then select all the signs or symptoms that are consistent with a fluid imbalance.​

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Scenario 3/4

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Select the common symptom of altered bowel elimination to match each description.​

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Select the correct hormones to match the corresponding description.

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Select the mechanism that best explains the corresponding example.

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Signs and clues of dehydration

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The table below lists locations where edema can occur. Match the cause and pathology of the disease or injury to the correct location of edema.

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Using the laboratory results, select the name of the electrolyte imbalance from the drop-down menu.​

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A high school student has been outside for marching band practice for four hours on a hot, humid afternoon. They have been drinking water to replace fluids lost through sweat. An hour after getting home, the student's caregiver finds them in bed with muscle cramps, lethargy, a headache, and confusion. The student continues to drink water to replace fluid lost during band practice. Based on the cues provided, the student is most likely experiencing _________ which could be confirmed by a __________ test.​

Hyponatremia Blood

What type of solution would you use to make this cell "normal?"​

Hypotonic

A high school student has been outside for marching band practice for four hours on a hot, humid afternoon. They have been drinking water to replace fluids lost through sweat. An hour after getting home, the student's caregiver finds them in bed with muscle cramps, lethargy, a headache, and confusion. The student continues to drink water to replace fluid lost during band practice. Based on the cues, which body systems are impacted by the student's alteration in health? Select all that apply.

Musculoskeletal Neurological

Which conditions can cause metabolic alkalosis? Select all that apply.​

Nasogastric suctioning​ Diuretic therapy​ Excessive use of antacids​ Vomiting Mineralocorticoid use​

Based on the cues, which body systems are impacted by the alteration in serum potassium? Select all that apply. ​

Neurological Gastrointestinal Musculoskeletal

What clinical manifestation is not associated with hyperkalemia ?

Positive Chvostek's sign​

Which statement best describes hydrostatic pressure?​

Pressure against the wall of a vessel is caused by the force of fluid traveling through a vessel.

Which statement best describes osmotic pressure?​

Pressure is caused by the differences in the concentrations of two solutions.

A lack of which of the following can cause an increase in edema?

Protein or albumin

Changes in carbon dioxide (CO2) that cause alterations in the serum pH are caused by which mechanism?

Respiratory system

Which environmental sources of potassium should a person avoid who follows a low potassium diet? Select all that apply.​

Salt substitutes​ Fertilizer Home water filters​

Based on the assessment data, what hypothesis can be made about her underlying condition?

She is dehydrated

Which individuals are at risk for hypocalcemia? Select all that apply.​

Someone experiencing an increase in serum pH​ An adolescent living with renal failure​ A person with decreased parathyroid hormone production​

Which clients are at risk for hypomagnesemia due to preexisting alterations in health? Select all that apply.​

Someone taking a diuretic every day​ A person living with alcohol use disorder​

Which meal contains the lowest amount of potassium?​ Click the name of the meal to indicate your choice.

Spaghetti with tomato sauce

Which are possible signs or symptoms of edema? Select all that apply.

Swelling of the lower extremities Weight gain

Jack (preferred pronouns: he, him), a 70-year-old adult male, is in the clinic with difficulty breathing. His triage history states that he has heart failure and had several high-sodium meals over the holidays. Jack's ankles are swollen and he says he gained 5 pounds in the past 2 days. How Can This Be Prevented? Which strategies can reduce or prevent edema? Select all that apply.

Taking diuretic medication as ordered Propping up the legs above the level of the heart Reducing sodium intake

Chris (preferred pronouns: he, him) is a high school football player who came into the office after practice. He said that he was dizzy and lightheaded. The nurse in the office took his blood pressure and it was low. His pulse rate was elevated. He also had bruising on both arms. The outside temperature during practice was 105 degrees Fahrenheit, and Chris forgot to bring water. He has no medical history, but his father has a history of heart disease and kidney disease.​

Taking frequent rest breaks Having water available at the practice Offer shaded areas at practice

A person with a low magnesium level is most likely to experience which symptoms? Select all that apply.​

Tetany Tremors Seizures

Which condition may result in tissue edema?

The ingestion if a large amount of salt

What is the difference in osmotic pressure between the two bottles of cola in the image below? Two bottles of cola were poured into a glass containing a semi-permeable membrane separating the cola.

The osmotic pressure is the same between both bottles.

What alteration is present in a person with hyperkalemia?​

They have too much potassium

When the osmoreceptors detect a decreased blood volume and increased blood concentration of salt, what function increases in the body?

Thirst

Other than measuring fluid intake and output, how can fluid changes be accurately measured in the body? Select all that apply.

Urinary frequency Weight

Which stimulates increased peristalsis and secretions in the digestive tract?

Vagus nerve

Which conditions result in a serum pH of greater than 7.45? Select all that apply.

Vomiting Excessive antacid intake Hyperventilation

What occurs during osmosis?

Water moves from an area of lower solute concentration to an area of higher solute concentration.

What are some signs and symptoms of dehydration? Select all that apply.​

What are some signs and symptoms of dehydration? Select all that apply.​ Confusion Decreased urine output​ Dry mucosal membranes​ Fatigue

An individual with hyperkalemia may have alterations in their __________

heart rate and rhythm

An alteration in serum bicarbonate levels indicates a/n _____ cause of acid-base imbalance.​

unknown

Based on what you know about tonicity, what type of dehydration will occur in the body if you were to consume salt water from the ocean?

Hypertonic

What type of solution would you use to make this cell "normal?"​

Hypertonic

Properties of Electrolytes

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Case study : edema

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Categorize the following conditions with which type of fluid imbalance.​

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Chris (preferred pronouns: he, him) is a high school football player who came into the office after practice. He said that he was dizzy and lightheaded. The nurse in the office took his blood pressure and it was low. His pulse rate was elevated. He also had bruising on both arms. The outside temperature during practice was 105 degrees Fahrenheit, and Chris forgot to bring water. He has no medical history, but his father has a history of heart disease and kidney disease.​

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Compensation

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Drag and drop the location of the edema to match the most likely pathophysiologic condition.

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Drag the compartment name to the corresponding location on the image.

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Find the following electrolytes on the periodic table: calcium, sodium, potassium, chlorine (chloride), and magnesium.

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For each factor listed, click to specify if the factor is a symptom or a cause of altered potassium.​

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From the cues available, select those that provide information about this person's health.​

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Identify the signs and symptoms most likely seen with each type of fluid imbalance. Each sign or symptom may be seen in more than one type of fluid imbalance.​

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Identify whether the signs and symptoms below relate to mild/moderate or severe dehydration.

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Interpret the arterial blood gas (ABG) results below.​ Determine if the pH, PaCO2, and HCO3 levels represent acidosis, alkalosis, or are within normal ranges. Drag and drop each result in the appropriate field. pH: 6.99 PaCO2: 76 HCO3-: 22

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Interpret the arterial blood gas (ABG) results below.​ Determine if the pH, PaCO2, and HCO3 levels represent acidosis, alkalosis, or are within normal ranges. Drag and drop each result in the appropriate field. pH: 7.41 PaCO2: 44 HCO3: 23

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Interpret the arterial blood gas (ABG) results below.​ Determine if the pH, PaCO2, and HCO3 levels represent acidosis, alkalosis, or are within normal ranges. Drag and drop each result in the appropriate field. pH: 7.5 PaCO2: 38 HCO3: 37

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Interpret the arterial blood gas (ABG) results below.​ Determine if the pH, PaCO2, and HCO3- levels represent acidosis, alkalosis, or are within normal ranges. Drag and drop each result in the appropriate field. pH: 7.16 PaCO2: 82 HCO3-: 26

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Interpret the arterial blood gas (ABG) results listed here. Determine if the pH, PaCO2, and HCO3 levels represent acidosis, alkalosis, or are within normal ranges. Drag and drop each result in the appropriate field. pH: 7.58 PaCO2: 32 mm/Hg HCO3: 24 mEq/L

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Jack (preferred pronouns: he, him), a 70-year-old adult male, is in the clinic with difficulty breathing. His triage history states that he has heart failure and had several high-sodium meals over the holidays. Jack's ankles are swollen and he says he gained 5 pounds in the past 2 days.

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Match each cause of edema to its description.​

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Match each type of dehydration to the proper cell.

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Match the description with the type of fluid imbalance. (Select an item from the left column first, then select the corresponding item in the right column, and a line will appear to match the two chosen items. To deselect a chosen item, just select that item again.)

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Match the pH levels with each symptom below.

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Match the symbol of the electrolyte to the chemical compound and function with which it is associated.

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Match the type of dehydration with the correct definition.

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Potassium and Kidney Disease

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An adult has lost water through sweating while mowing the yard in the middle of a hot summer day. Unfortunately, the person did not keep water nearby to replace what was being lost. Based on this history, which serum sodium level would most likely be found if tested?​

155 mEq per liter​

Which external signs of severe dehydration would the healthcare provider look for in your 69-year-old grandmother? Select all that apply.

Confusion Dizziness Sunken eyes

A person cannot survive if pH drops below_____or rises to ___________ for more than a brief time.

6.8 to 7.8

Which statement best describes increased permeability?​

A change in the consistency of a wall or membrane allows more fluid to pass through.

What interventions do you expect the healthcare provider to prescribe for your grandmother?

Administer a hypotonic solution and monitor urinary output

Which conditions result in a serum pH of less than 7.35? Select all that apply.

All are correct

Which statements best describe edema? Select all that apply.​

All are correct

Which individual is likely to be experiencing metabolic acidosis?

An older adult who has been vomiting with diarrhea for 26 hours

You suspect someone may have hypervolemia. Which tests would most accurately support this?​

Daily weight

How do the kidneys respond to an increase in serum pH (alkalosis)? Select all that apply.

Decrease tubular reabsorption of HCO3- Decrease tubular excretion of H+ ions

Which hormones will the body use when there is too much fluid (fluid overload) or too little fluid (dehydration)? Select all that apply.

Antidiuretic hormone Aldosterone Atrial natriuretic peptide

Which conditions can contribute to the development of respiratory acidosis? Select all that apply.​

Atelectasis Chest wall abnormality​ Respiratory muscle weakness​ Central nervous system (CNS) depression​ Pulmonary edema​​

What steps can be taken to prevent alterations in urinary elimination? Select all that apply.​

Avoid caffeine and alcohol​ Eat a well-balanced diet​ Control chronic medical conditions

How could the older adult have best avoided becoming hyperkalemic? Select all that apply. ​

Avoiding potassium-based salt substitutes​ Eat less potassium-rich foods​

A client has a serum chloride level of 190 mEq/L. Which foods should the client avoid? Select all that apply.

Black olives ​ Tomato juice ​ Table salt ​ Canned corn​

A client who had been experiencing vomiting and diarrhea for 2 days is feeling well enough to eat. Which foods are the best choice to replace the potassium that has been lost? ​

Cereal with dried apricots

What is the most likely cause of hyperkalemia in an older adult?​

Chronic kidney disease

Which underlying conditions increase the risk of edema? Select all that apply.​

Chronic kidney disease​ Vascular disease​ Liver failure​

Chris (preferred pronouns: he, him) is a high school football player who came into the office after practice. He said that he was dizzy and lightheaded. The nurse in the office took his blood pressure and it was low. His pulse rate was elevated. He also had bruising on both arms. The outside temperature during practice was 105 degrees Fahrenheit, and Chris forgot to bring water. He has no medical history, but his father has a history of heart disease and kidney disease.​ What Could It Mean?​ Which of the following types of fluid imbalance could this student be experiencing?​

Hypovolemia due to dehydration​

After being out at the beach for hours, an adult suffered from an extensive sunburn covering their back, arms, and legs. Which fluid imbalance is this person most likely experiencing?​

Hypovolemic fluid imbalance​

Why are infants and older adults at higher risk of dehydration? Select all that apply.

Infants' inability to vocalize Both infants and older adults lack fluid reserves in their body Decreased thirst sensation in older adults

In a healthy person, most of the potassium in the body is located ________-

Inside the cells

Which statement is the best definition of electrolytes?​

Ions in bodily fluids that regulate metabolic processes​

What type of solution would you use to keep this cell "normal?"​

Isotonic

Which risk factors make older adults and children more sensitive to fluid imbalances? Select all that apply.​

Kidney function​ Weight and height​ Total body water differences​

Which environmental factors directly affect fluid balance? Select all that apply.​

Lack of potable water in a small town Regular daily temperature is 120 degrees Fahrenheit Concentration of bisphenol A in food containers

Which symptoms would an individual with hypokalemia exhibit? Select all that apply.​

Leg cramps​ Anorexia

A high potassium level can lead to which condition(s)? Select all that apply.

Low heart rate Decreased reflexes Low blood pressure Weakness

Which items should be included in the diet of a person who wants to increase their calcium intake? Select all that apply.​

Milk and cheese Almonds Green, leafy vegetables Vitamin D supplement