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NUR3129 Patho Finals study guide-2021

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Hypodipsia in elderly Ch 8 p. 146-147 1. Recognizing the prevalence and incidence of dehydration among older adults, a care aide at a long-term care facility is in the habit of encouraging residents to drink even though they may not feel thirsty at the time. Which of the following facts underlies the care aide's advice? A) Older adults often experience a decrease in the sensation of thirst, even when serum sodium levels are high. B) The metabolic needs for both fluid and sodium in older adults differ from those of younger individuals. C) Regulation and maintenance of effective circulating volume by the kidneys is less effective in the elderly. D) The renin–angiotensin–aldosterone system (RAAS) is less able to facilitate sodium clearance in older adults. Ans: A Feedback: The elderly are prone to hypodipsia even when osmolality and serum sodium levels are elevated, a fact that is compounded by sensory and/or neurological deficits. Hypodipsia in the elderly is not related to differing metabolic needs, ineffective kidney function, or compromise of the RAAS. 2. Indicators of fluid volume overload. p. 150 A client is brought to the emergency department with complaints of shortness of breath. Assessment reveals a full, bounding pulse, severe edema, and audible crackles in lower lung fields bilaterally. What is the client's most likely diagnosis? A) Hyponatremia B) Fluid volume excess C) Electrolyte imbalance: hypocalcemia D) Hyperkalemia Ans: B Feedback: Peripheral and pulmonary edema as well as a bounding pulse and dyspnea are indicators of fluid volume overload. Etiology of Hyperparathyroidism Ch 8 p.160-161 3. A 52-year-old patient has just passed a kidney stone and has high levels of calcium in her urine. Blood tests show high levels of calcium in her blood as well. What subsequent lab results would be most likely to distinguish between primary hyperparathyroidism and hypercalcemia of malignancy? A) Parathyroid hormone level B) Bone scan C) Plasma phosphate levels D) Serum magnesium level Ans: A CONTINUED........

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