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1. a. Is the fluid outside the cell (interstitial, intravascular, and transcellular fluid)
b. Comprises all fluid within the cells of the body (42% of body weight)
2. Positively charged electrolytes (sodium, potassium, and calcium)
3. Negatively charged electrolytes (chloride, bicarbonate, and sulfate)
4. Represents the number of grams of the specific electrolyte dissolved in a liter of
plasma
5. Is an electrolyte; oxygen, carbon dioxide, glucose, and proteins
6. Involves the movement of a pure solvent across a semipermeable membrane from
an area of lesser solute concentration to an area of greater solute concentration.
7. The concentration of a solution is measured in osmols, which reflects the amount of
a substance in the form of molecules, ions, or both.
8. Is the drawing power of water and depends on the number of molecules in solution
9. The osmotic pressure of a solution
10. Another term that describes the concentration of solution
11. The solutions on both sides of the semipermeable membrane are equal in
concentration (expand the body’s fluid volume without causing a fluid shift from
one compartment to another).
12. A solution of higher osmotic pressure (pulls fluid from cells, causing them to
shrink)
13. A solution of lower osmotic pressure (moves fluids into the cells, causing them to
enlarge)
14. Random movement of a solute in a solution across a semipermeable membrane
from an area of higher concentration to an area of lower concentration
15. The difference between two concentrations
16. Is the process by which water and diffusible substances move together across a
membrane, in response to fluid pressure, moving from an area of higher pressure to
one of lower pressure
17. Requires metabolic activity and expenditure of energy to move substances across
the cell membrane
18. a. Fluid intake
b. Hormonal controls
c. Fluid output
19. Continually monitor the serum osmotic pressure
20. Excess fluid is lost.
21. Risk for clients who are unable to perceive or respond to the thirst mechanism
22. Is stored in the pituitary gland and is released in response to changes in the blood
osmolarity
23. a. Causes vasoconstriction
b. Causes massive selective vasoconstriction of blood vessels and relocates blood
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Answer Key to Study Guide 41-2
flow to kidneys and stimulates the release of aldosterone (when the sodium is low)
c. Adrenal cortex releases in response to increased plasma potassium levels
24. Plays a critical role in the balance of fluid and electrolytes and the maintenance of
vascular tone
25. a. Kidneys
b. Skin
c. Lungs
d. Gastrointestinal tract
26. a. Is continuous and occurs through the skin and lungs, not perceived by the person
b. Occurs through excess perspiration and can be perceived by the client
27. See Table 41-1, p. 967
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Answer Key to Study Guide 41-3
28. a. Chemical
b. Biological
c. Physiological buffering
29.
Imbalance Laboratory Finding Signs and Symptoms
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Answer Key to Study Guide 41-4
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Answer Key to Study Guide 41-5
fractures (chronic
hypocalcemia)
Hypercalcemia Serum ionized calcium level Anorexia, nausea and
above 5.5 mEq/L or total vomiting, weakness,
serum calcium level above hypoactive reflexes,
10.5 mg/dL; x-ray lethargy, flank pain (from
examination showing kidney stones), decreased
generalized osteoporosis, level of consciousness,
widespread bone cavitation, personality changes, and
radiopaque urinary stones; cardiac arrest
and elevated blood urea
nitrogen (BUN) level 25
mg/100 mL and elevated
creatinine level 1.5 mg/100
mL caused by fluid volume
deficit (FVD) or renal
damage caused by
urolithiasis; ECG
abnormalities: heart block
Hypomagnesemia Serum magnesium level Muscular tremors,
below 1.5 mEq/L hyperactive deep tendon
reflexes, confusion and
disorientation, tachycardia,
hypertension,
dysrhythmias, and positive
Chvostek’s sign and
Trousseau’s sign
Hypermagnesemia Serum magnesium level Acute elevations in
above 2.5 mEq/L; ECG magnesium levels:
abnormalities: prolonged hypoactive deep tendon
QT interval, AV block reflexes, decreased depth
and rate of respirations,
hypotension, and flushing
30. a. Measures the hydrogen ion concentration in the body fluids (7.35 to 7.45)
b. Is the partial pressure of carbon dioxide in arterial blood (35 to 45 mm Hg)
c. Is the partial pressure of oxygen in the blood (80 to 100 mm Hg)
d. Is the point at which hemoglobin is saturated by oxygen (95% to 99%)
e. Is the amount of blood buffer (hemoglobin and bicarbonate) that exists (+/– 2
mEq/L)
f. Is the major renal component of acid-base balance (22 to 26 mEq/L)
31.
Acid-Base Imbalance Laboratory Findings Signs and Symptoms
Respiratory acidosis Arterial blood gas Confusion, dizziness,
alterations: pH < 7.35, lethargy, headache,
PaCO2 > 45 mm Hg, PaO2 < ventricular dysrhythmias,
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Answer Key to Study Guide 41-6
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Answer Key to Study Guide 41-7
36. The greater the body surface burned, the greater the fluid loss.
37. Predispose to respiratory acidosis and/or respiratory alkalosis
38. Can result in cerebral edema and diabetes insipidus
39. Cancer, congestive heart failure (CHF), or renal disease
40. Depends on the type and progression of the cancer and its treatment (diarrhea and
anorexia)
41. Diminished cardiac output, which reduces kidney perfusion and decreases urine
output
42. Causes an abnormal retention of sodium, chloride, potassium, and water (metabolic
acidosis)
43. Gastroenteritis and nasogastric suctioning result in the loss of fluid, potassium, and
chloride ions.
44. Vigorous exercise or exposure to extreme temperatures
45. Recent changes in appetite or the ability to chew and swallow (breakdown of
glycogen and fat stores, metabolic acidosis, hypoalbuminemia, edema)
46. History of smoking or alcohol consumption (respiratory acidosis)
47. Diuretics—Metabolic alkalosis, hyperkalemia, and hypokalemia
Steroids—Metabolic alkalosis
Potassium supplements—GI disturbances, including intestinal and gastric ulcers
and diarrhea
Respiratory center depressants (e.g., opioid analgesics)—Decreased rate and depth
of respirations, resulting in respiratory acidosis
Antibiotics—Nephrotoxicity (e.g., vancomycin, methicillin, or aminoglycosides);
hyperkalemia and/or hypernatremia (e.g., azlocillin, carbenicillin, piperacillin,
ticarcillin, or Unasyn)
Calcium carbonate (Tums)—Mild metabolic alkalosis with nausea and vomiting
Magnesium hydroxide (Milk of Magnesia)—Hypokalemia
Nonsteroidal antiinflammatory drugs—Nephrotoxicity
48. a. Weight loss of 5% to 8%: Mild to moderate fluid volume deficit (FVD)
b. Irritability: Metabolic or respiratory alkalosis, hyperosmolar imbalance,
hypernatremia, hypokalemia
c. Lethargy: FVD, metabolic acidosis or alkalosis, respiratory acidosis,
hypercalcemia
d. Periorbital edema: Fluid volume excess (FVE)
e. Sticky, dry mucous membranes: FVD, hypernatremia
f. Chvostek’s sign: Hypocalcemia
g. Distended neck veins: FVE
h. Dysrhythmias: Metabolic acidosis, respiratory alkalosis and acidosis, potassium
imbalance, hypomagnesemia
i. Weak pulse: FVD, hypokalemia
j. Low blood pressure: FVD, hyponatremia, hyperkalemia, hypermagnesemia
k. Third heart sound: FVE
l. Increased respiratory rate: FVE, respiratory alkalosis, metabolic acidosis
m. Crackles: FVE
n. Anorexia: Metabolic acidosis
o. Abdominal cramps: Metabolic acidosis
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Answer Key to Study Guide 41-8
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Answer Key to Study Guide 41-9
1 Skin blanched
Edema, < 1 inch in any direction
Cool to touch
With or without pain
2 Skin blanched
Edema 1-6 inches in any direction
Cool to touch
With or without pain
3 Skin blanched, translucent
Gross edema >6 inches in any direction
Cool to touch
Mild to moderate pain
Possible numbness
4 Skin blanched, translucent
Skin tight, leaking
Skin discolored, bruised, swollen
Gross edema >6 inches in any direction
Deep pitting tissue edema
Circulatory impairment
Moderate to severe pain
Infiltration of any amount of blood product,
irritant, or vesicant
Phlebitis Scale
Grade Clinical Criteria
0 No symptoms
1 Erythema at access site with or without pain
2 Pain at access site with erythema and/or edema
3 Pain at access site with erythema and/or edema
Streak formation
Palpable venous cord
4 Pain at access site with erythema and/or edema
Streak formation
Palpable venous cord >1 inch in length
Purulent drainage
68. A technique in which a vein is punctured through the skin by a rigid stylet
(butterfly), a stylet covered with a plastic cannula (ONC), or a needle attached to a
syringe
69. For administering small hourly volumes (<20 mL/hr) and for clients who are at risk
for volume overloads
70. a. Keeping the system sterile
b. Changing solutions, tubing, and site dressings
c. Assisting the client with self-care activities
71. a. Increase circulating blood volume after surgery, trauma, or hemorrhage
b. Increase the number of red blood cells (RBCs) and maintain hemoglobin levels in
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Answer Key to Study Guide 41-10
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Answer Key to Study Guide 41-11
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