Fluid and Electrolyte Worksheet HW 1 PDF

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1. Fill in the table with assessment findings of fluid volume imbalances: Fluid Volume Deficit (FVD) Dizziness or Orthostatic Hypotension Lethargy Dry Mouth or Skin Thirst or Nausea Low Blood Pressure

Fluid Volume Excess (FVE) Edema on upper and lower extremities Shortness of Breath High Blood Pressure Abdominal Distention or cramping Headache

2. Fill in the table with lab results of fluid volume imbalances: Lab Hct Serum osmolarity Urine specific gravity Serum sodium Electrolytes, BUN, CR

FVD Increased Increased Increased Increased Abnormally Increased

FVE Decreased Decreased Decreased Decreased Abnormally Decreased

3. Identify whether the following statements are true (T) or false (F) a._____

A patient with consistent dietary intake who loses 1 kg of weight in 1 day

has lost 500 mls of fluid. F b._____

Major tissue damage that causes release of intracellular electrolytes into

extracellular fluid will cause hypernatremia. T c._____

A cell surrounded by a hypo-osmolar fluid will shrink and die as water

moves out of the cell. F d._____

Third spacing refers to the abnormal movement of fluid into nonfunctional

spaces. T

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e._____

The primary hypothalamic mechanism of water intake is thirst. T

f._____

Monitoring weight is considered more accurate than monitoring intake and

output. T

4. Aldosterone is secreted by the adrenal cortex in response to : a._____

Excessive water intake

b._____

Loss of serum potassium

c._____

Increased release of renin

d._____

Increased serum osmolality. Correct

5. A patient at risk for hypernatremia is one who: a._____

Has a deficiency of aldosterone

b._____

Has prolonged vomiting and diarrhea

c._____

Receives excessive 5% dextrose (D5W) solution intravenously

d.____Has impaired consciousness and decreased thirst sensitivity. Correct

6. Symptoms of sodium imbalances are primarily manifested through altered: a._____

Kidney function

b._____

Cardiovascular function

c._____

Neuromuscular function

d._____

Central nervous system function - Correct

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7. Match the electrolyte imbalances with their primary associated causes (answers may be used more than once) 4 6 1 7&8 6 5 3 2

Metabolic alkalosis Parathyroidectomy Diabetes insipidus Chronic alcoholism Prolonged immobilization Fleet’s enemas Milk of Magnesia use in renal failure Vitamin D deficiency

1. 2. 3. 4. 5. 6. 7. 8.

Hypernatremia Hypocalcemia Hypermagnesemia Hypokalemia Hyperphosphatemia Hypercalcemia Hypomagnesemia Hyponatremia

8. A patient with chronic kidney disease has hyperphosphatemia. A commonly associated electrolyte imbalance is: a._____

Hypokalemia

b._____

Hyponatremia

c._____

Hypocalcemia- Correct

d._____

Hypomagnesemia

9. Match the acid-base imbalances with their common causes (answers may be used more than once) 4 3

Prolonged vomiting Renal failure

1. Respiratory acidosis 2. Respiratory

alkalosis 2 Response to anxiety, fear, and pain 3. Metabolic acidosis 1 Respiratory failure 4. Metabolic alkalosis 4 Baking soda use as antacid 4 Diabetic ketosis 1 Sedative or opioid overdose 10. Identify and describe the compensatory mechanism that occurs in each of the following:

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a) Respiratory acidosis: Respiratory Acidosis is usually a result of failure of ventilation and the accumulation of carbon dioxide. Cellular Buffering which is plasma protein usually occurs which elevates the bicarbonate in the blood or there is renal compensation which is excretion of carbonic acid which allows the reabsorption of bicarbonate into the blood. b) Metabolic acidosis: Metabolic Acidosis occurs when the acid produced or ingested by the body is elevated. The body will begin to increase the absorption of hydrogen ions which proteins and carbonate from the bone. c) Metabolic alkalosis: Metabolic Alkalosis occurs when there is an increase in bicarbonate in the body, usually caused by excessive vomiting. The respiratory response to metabolic alkalosis is usually hypoventilation.

11. A client who has been diagnosed with acute renal failure has an intake of 2,000 mL and a urine output of 200 mL for the past 24 hours. Which assessment by the nurse is most important? a._____

Palpate peripheral pulses

b._____

Auscultate breath sounds- Correct

c._____

Check urine specific gravity

d._____

Monitor blood urea nitrogen and creatinine

12. Fill in the table with standard lab values: Sodium Potassium Chloride BUN Creatinine

136-145 mEq/L 3.5-5.0 mEq/L 98-106 mEq/L 10-20 mg/dL M – 0.6-1.2 mg/dL F – 0.5-1.1 mg/dL

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Magnesium Calcium Phosphorus

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1.3-2.1 mg/dL 9-10.5 mg/dL 3.0-4.5 mg/dL

13. An older adult client is admitted to the hospital with a history of intractable vomiting for 3 days. During the admission interview, the nurse notes that the client is confused. Which fluid, electrolyte, and acid-base imbalances are most likely affecting the client? (Select all that apply) a._____

Hyponatremia- correct

b._____

Hypernatremia

c._____

Respiratory acidosis

d._____

Metabolic alkalosis

e._____

Fluid volume excess

f._____

Fluid volume deficit- correct

14. A nurse assessing a client who experienced a seizure during a water-drinking contest should associate the client’s seizure with which electrolyte imbalance? a._____

Hyponatremia related to actual decrease in sodium- correct

b._____

Hyponatremia related to relative decrease in sodium

c._____

Hypernatremia related to actual increase in sodium

d._____

Hypernatremia related to relative increase in sodium

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15. A nurse is caring for a client who has been diagnosed with uncompensated respiratory acidosis secondary to hypoxia. When reviewing this client’s laboratory data, which value should the nurse anticipate? a._____

Increased pH

b._____

Increased PaCO2- correct

c._____

Decreased HCO3-

d._____

Decreased serum calcium level

16. Fill in the table with food sources of the following electrolytes: (at least 4) Sodium

Aged Cheese, Salmon or Fish, Dried Sunflower Seeds, Clams or

Potassium

Shrimp, Tomato Sauce, Beets, Celery, Carrots, Spinach, Red Meat Lentil, Potatoes, Avocado, Salmon, Coconut Water, Yogurt, Banana,

Calcium

Watermelon, Sweet Potatoes, Nuts, Prunes & Dates Seeds, Cheese, Yogurt, Sardines, Almonds, Whey Protein found in milk, Dark leafy greens (spinach and kale)...