Question

22. Fluid	Example	Uses	Nursing Implications
Isotonic
Hypotonic
Hypertonic

23. Condition	Assessment Early Signs	Assessment Late Signs	Type of fluid replacement
Dehydration
Fluid volume deficit
Fluid volume excess

24. Term	Signs and Symptoms	Treatment
Hyponatremia
Hypernatremia
Hypokalemia
Hyperkalemia
Hypocalcemia
Hypercalcemia
Hypomagnesemia
Hypermagnesemia
Hypophosphatemia
Hyperphosphatemia
Age	Risk Factors of fluid imbalance	Nursing implications
Infants 0 – 12 months
School age children
Adolescents
Adults
Older adults

25. Of the five age considerations in the above table, which two are most at risk for fluid imbalance and what would be your nursing considerations for these patients?

26. Which patients would be candidates for fluid restriction therapy and what other diet restrictions would be implemented to control fluid intake?

27. Which patients would be candidates for therapy to promote excretion? What type of therapy would be used and what medications can be administered to promote urinary excretion?

28. How is protein intake involved in fluid balance?

29. How would you monitor a patient on fluid balance therapy (whether fluid restriction or to promote excretion)? Give five assessment parameters e.g. assessing for dyspnea etc.

30. What is the difference between respiratory acidosis and respiratory alkalosis?

31. What is the difference between metabolic acidosis and metabolic alkalosis?

32. Disorder	Clinical Manifestations	Nursing Interventions
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis

Interpret the following ABG results:

33.     pH= 7.40     PCO2 = 39mmHG   HCO3- = 25mEq/L

34.      pH= 7.30   PCO2= 70mmHG    HCO3- = 30mEq/L

Answer 1

QUESTION NO 22

FIUID	EXAMPLE	USES	NURSING IMPLICATIONS
ISOTONIC	0.9% normal saline and ringer lactated ringers.	This fluids are useful when the patient has lost fluid volume from blood loss,trauma,dehydration due to excessive vomiting or diarrhea.	When administering isotonic solutions,continue monitoring the patient to ensure the rehydration does not turn into fluid overload.
HYPOTONIC	0.45 % normal saline (half normal saline)	When a patient develop ketoacidosis ,the intra cellular space becomes dehydrated,so the hypotonic solution help to rehydrate the cells.	The patient should be monitored during administration for hypovolemia as more fluid leave the bloodstream.
HYPERTONIC	D5 in 0.9%normal saline and D5 in lactated ringers.	when hypertonic solution is administered intravenously ,fluid shift from the interstitial apace and intracellular spaces into the blood stream to dilute the electrolytes.	The administration of hyperytonic solution should be monitored extremely closely , as the can quickly lead to fluid overload.