Nokea
When planning the care of a patient with a fluid imbalance, the nurse understands that in the human body, water and electrolytes move from the arterial capillary bed to the interstitial fluid. What causes this to occur?
- A. Active transport of hydrogen ions across the capillary walls
- B. Pressure of the blood in the renal capillaries
- C. Action of the dissolved particles contained in a unit of blood
- D. Hydrostatic pressure resulting from the pumping action of the heart
Correct Answer: D
Rationale: An example of filtration is the passage of water and electrolytes from the arterial capillary bed to the interstitial fluid; in this instance, the hydrostatic pressure results from the pumping action of the heart. Active transport does not move water and electrolytes from the arterial capillary bed to the interstitial fluid, filtration does. The number of dissolved particles in a unit of blood flow is concerned with osmolality. The pressure in the renal capillaries causes increased filtration.
You may also like to solve these questions
You are the nurse evaluating a newly admitted patients laboratory results, which include several values that are outside of reference ranges. Which of the following would cause the release of antidiuretic hormone (ADH)?
- A. Increased serum sodium
- B. Decreased serum potassium
- C. Decreased hemoglobin
- D. Increased platelets
Correct Answer: A
Rationale: Increased serum sodium causes increased thirst and the release of ADH by the posterior pituitary gland. When serum osmolality decreases and thirst and ADH secretions are suppressed, the kidney excretes more water to restore normal osmolality. Levels of potassium, hemoglobin, and platelets do not directly affect SDH release.
The ICU nurse is caring for a patient who experienced trauma in a workplace accident. The patient is complaining of having trouble breathing with abdominal pain. An ABG reveals the following results: pH 7.28, pH 7.3, PaCO2 50 mm Hg, HCO3 23 mEq/L. The nurse should recognize the likelihood of what acidbase disorder?
- A. Respiratory acidosis
- B. Metabolic alkalosis
- C. Respiratory alkalosis
- D. Mixed acid-base disorder
Correct Answer: D
Rationale: Patients can simultaneously experience two or more independent acid-base disorders. A normal pH in the presence of changes in the PaCO2 and plasma HCO3 concentration immediately suggests a mixed disorder, making the other options incorrect. The pH of 7.28 indicates acidosis, and the elevated PaCO2 suggests a respiratory component, while the normal HCO3 suggests no metabolic compensation, pointing to a mixed disorder.
Diagnostic testing has been ordered to differentiate between normal anion gap acidosis and high anion gap acidosis in an acutely ill patient. What health problem typically precedes normal anion gap acidosis?
- A. Metastases
- B. Excessive potassium intake
- C. Water intoxication
- D. Excessive administration of chloride
Correct Answer: D
Rationale: Normal anion gap acidosis results from the direct loss of sodium bicarbonate, as in diarrhea, loss from lower intestinal fistulas, ureterostomies, and use of diuretics; early renal insufficiency; excessive administration of chloride; and the administration of parenteral nutrition without bicarbonate or bicarbonate-producing solutes (e.g., lactate). Based on these facts, the other listed options are incorrect.
A patient has questioned the nurses administration of IV normal saline, asking whether sterile water would be a more appropriate choice than saltwater. Under what circumstances would the nurse administer electrolyte-free water intravenously?
- A. Never, because it rapidly enters red blood cells, causing them to rupture.
- B. When the patient is severely dehydrated resulting in neurologic signs and symptoms
- C. When the patient is in excess of calcium and/or magnesium ions
- D. When a patient's fluid volume deficit is due to acute fluid or chronic renal failure
Correct Answer: A
Rationale: IV solutions contain dextrose or electrolytes mixed in various proportions with water. Pure, electrolyte-free water can never be administered IV because it rapidly enters red blood cells and causes them to rupture.
The nurse is caring for a patient in metabolic alkalosis. The patient has an NG tube to low intermittent suction for a diagnosis of bowel obstruction. What drug would the nurse expect to find on the medication orders?
- A. Cimetidine
- B. Maalox
- C. Potassium chloride elixir
- D. Furosemide
Correct Answer: A
Rationale: H2 receptor antagonists, such as cimetidine (Tagamet), reduce the production of gastric HCl, thereby decreasing the metabolic alkalosis associated with gastric suction. Maalox is an oral simethicone used to break up gas in the GI system and would be of no benefit in treating a patient in metabolic alkalosis. KCl would only be given if the patient were hypokalemic, which is not stated in the scenario. Furosemide (Lasix) would only be given if the patient were fluid overloaded, which is not stated in the scenario.