Exam 1 NR 324 Adult Health 1
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1. What age group has the high- Preterm / Neonates
est percentage of water con-
tent?
2. Two fluid compartments in the Intracellular space (inside cells) located in
body the ICF
Extracellular space (outside cells) located
in the ECF
3. ICF makes up what percent of 40%
total body weight?
4. What are the two main com- Interstitial fluid (fluid in the spaces between
partments containing ECF? cells)
What other compartments are Intravascular fluid (plasma)
there? Other compartments include lymph and
transcellular fluids
5. Transcellular fluid includes Cerebrospinal fluid, fluid in the gastroin-
testinal tract, and joint spaces as well as
pleural, peritoneal, intraocular, and peri-
cardial fluid.
6. 1L of water = _____ lb. 2.2 lb (1kg)
7. The concentrations of elec- milliequivalents (mEq) per Liter
trolytes in body fluids is ex-
pressed in _________
8. What are the main Ions found ECF cation- sodium, with small amounts of
in the ECF and ICF potassium, calcium, and magnesium
ECF anion- chloride, with small amounts
of bicarbonate, sulfate, and phosphate an-
ions.
ICF cation- potassium, with small amounts
of magnesium and sodium
ICF anion- phosphate, with some protein
and a small amount of bicarbonate.
9.
, Exam 1 NR 324 Adult Health 1
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Hypovolemia (ECF volume abnormal loss of normal body fluids, (D/V,
deficit) hemorrhage, polyuria) inadequate intake,
or plasma-to-interstitial fluid shift
10. Fluid volume deficit Assessment- Restlessness, drowsiness,
Assessment- Causes-Treat- lethargy, confusion
ment-Client education • Thirst, dry mucous membranes
• Cold clammy skin
• Decreased skin turgor, “ capillary refill
• Postural hypotension, ‘ pulse, “ CVP
• “ Urine output, concentrated urine
• ‘ Respiratory rate
• Weakness, dizziness
• Weight loss
• Seizures, coma
Causes- • ‘ Insensible water loss or perspi-
ration (high fever, heatstroke)
• Diabetes insipidus
• Osmotic diuresis
• Hemorrhage
• GI losses: vomiting, NG suction, diarrhea,
fistula drainage
• Overuse of diuretics
• Inadequate fluid intake
• Third-space fluid shifts: burns, pancreati-
tis
Treatment- replace water and electrolytes
with balanced IV solutions
Client education- Good skin care, if or-
thostatic hypotension is present, teach to
change positions slowly, remind patient to
drink
11. Hypervolemia (ECF volume ex- Excessive intake of fluids, abnormal reten-
cess) tion of fluids (HF or renal failure), or inter-
stitial-to-plasma fluid shift
12. Assessment- • Headache, confusion,
lethargy
, Exam 1 NR 324 Adult Health 1
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Fluid volume excess • Peripheral edema
Assessment- Causes-Treat- • Jugular venous distention
ment-Client education • S3 heart sound
• Bounding pulse, ‘ BP, ‘ CVP
• Polyuria (with normal renal function)
• Dyspnea, crackles, pulmonary edema
• Muscle spasms
• Weight gain
• Seizures, coma
Causes- • Excessive isotonic or hypotonic
IV fluids
• Heart failure
• Renal failure
• Primary polydipsia
• SIADH
• Cushing syndrome
• Long-term use of corticosteroids
Treatment-Remove fluid without changing
electrolyte composition or osmolality of
ECF
Client education- elevate edematous ex-
tremities
13. Nutrition related to potassium Diet is the source
-Fruit, dried fruits and vegetables
-Many salt substitutes contain substantial
K+
14. Nutrition related to sodium -Daily intake far exceeds bodys daily re-
quirments
-Glucose promotes sodium and water ab-
sorption
15. Hypertonic solutions initially raises the osmolality of ECF and
expands it
-higher osmotic pressure draws water out
of the cells into the ECF
-Useful in treatment of hyponatremia and
trauma patients with head injuries
, Exam 1 NR 324 Adult Health 1
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16. Isotonic solutions has a similar concentration of water and
electrolytes to plasma, with an osmolality
of 250 to 375 mOsm/L
-administering an isotonic solution ex-
pands only ECF and the fluid does not
move into cells
-the ideal fluid replacement for patients
with ECF volume deficits
17. Hypotonic solutions solution has more water than electrolytes,
with an osmolality of less than 250
mOsm/kg.
-Infusing a hypotonic solution dilutes ECf
-good for treating patients with hyperna-
tremia
18. As a nurse it is important to • IV KCl must always be diluted and never
remember what administration given in concentrated amounts.
guidelines when administering • Never give KCl via IV push or as a bolus.
IV KCL? • Invert IV bags containing KCl several
times to ensure even distribution in the
bag.
• Do not add KCl to a hanging IV bag to
prevent giving a bolus dose.
19. Hypernatremia Occurs when either too much water is lost
or not enough water intake, or too much
salt is taken in
20. What S/S should the nurse Hypernatremia with decreased ECF vol-
look for when a patient is ex- ume: • Restlessness, agitation, lethargy,
periencing hypernatremia with seizures, coma
decreased, normal and in- • Intense thirst, dry swollen tongue, sticky
creased ECF volume? mucous membranes
• Postural hypotension, “ CVP, weight loss, ‘
pulse
• Weakness, muscle cramps
Hypernatremia with normal or increased
ECF volume: • Restlessness, agitation,
twitching, seizures, coma
