NSG 123 Exam 5 - Questions and Answers

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NSG 123 Exam 5 - Questions and Answers Manifestations of Hypovolemia: Weight Loss Decreased Skin Turgor Oliguria Prolonged Capillary Refill Flat Neck Veins Increased Pulse Thirst Confusion Increased... Temp: Cool, Clammy, Pale Labs for Fluid Volume Deficit: Hypovolemia Decreased BP Increased Hemoglobin & Hematocrit Increased BUN & Creatinine Increased Urine Specific Gravity Increased Serum & Urine Osmolality Treatment of Hypovolemia: If deficit is not severe: Oral Route Severe: IV Route Isotonic Electrolyte Solutions (Lactated Ringer & 0.9% Sodium Chloride) First line for hypotension As soon as the patient becomes normotensive, a hypotonic electrolyte solution (e.g., 0.45% sodium chloride) is often used to provide both electrolytes and water for renal excretion of metabolic wastes. Manifestations of Hypervolemia: Peripheral Edema Ascites Distended Neck Veins Weight Gain Shortness of Breath Bounding Pulse Cough Increased urination Labs for Fluid Volume Overload: Hypervolemia Increased BP Decreased Hemoglobin & Hematocrit Decreased Urine Specific Gravity & Sodium Decreased Serum & Urine Osmolality Isontonic Solutions Fluids that are classified as isotonic have a total osmolality close to that of the ECF and do not cause red blood cells to shrink or swell Normal Saline 0.9% Sodium Chloride Lactated Ringers Hypotonic Solutions One purpose of hypotonic solutions is to replace cellular fluid because it is hypotonic compared with plasma. Another is to provide free water for excretion of body wastes. 0.45% Sodium Chloride Safety for Hypotonic Solutions Excessive infusions of hypotonic solutions can lead to intravascular fluid depletion, decreased blood pressure, cellular edema, and cell damage. These solutions exert less osmotic pressure than the ECF D5W May be both isotonic and hypotonic D5W is used mainly to supply water and to correct an increased serum osmolality. Hypertonic Solutions Higher concentrations of dextrose, such as 50% dextrose in water, are strongly hypertonic and must be given into central veins so that they can be diluted by rapid blood flow. Hypertonic solutions exert an osmotic pressure greater than that of the ECF. these solutions must be given cautiously and usually only when the serum osmolality has decreased to dangerously low levels. Ascites Ascites is a type of edema in which fluid accumulates in the peritoneal cavity; it results from nephrotic syndrome, cirrhosis, and some malignant tumors. The patient commonly reports shortness of breath and a sense of pressure because of pressure on the diaphragm. Buffer System prevent major changes in the pH of body fluids by removing or releasing H+; they can act quickly to prevent excessive changes in H+ concentration. Hydrogen ions are buffered by both intracellular and extracellular buffers. The body's major extracellular buffer system is the bicarbonate-carbonic acid buffer system, which is assessed when arterial blood gases are measured. Dietary Management of Gout Management between gout attacks needs to include lifestyle changes such as avoiding purine-rich foods, weight loss, decreasing alcohol consumption, and avoiding certain medications. Severe dietary restriction is not necessary; however, the nurse encourages the patient [Show More]

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