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NUR 210 EXAM 3 2025-2026|ACTUAL EXAM QUESTIONS
AND ANSWERS|ALREADY GRADED A+
What percentage of our body weight is body water? 60% What are the functions of body fluid in the body? Lubricant Metabolism Transport Regulates body temperature What are electrolytes and what does concentration depend on?
- na+, cl-, mg+, ca+, k+
- electrically charged when in solution
- influenced by fluid intake and output, acid base balance, hormones, cell functions
- concentration depends on intake, absorption, distribution, and excretion How is water distributed throughout the body?
- intracellular: Two-thirds of water in body
2)extracellular: Remaining third is divided into 2 compartments:
- interstitial fluid (in between cells and organs)
- plasma What electrolytes are highest in the intracellular fluid? Extracellular fluid? Icf: high k+, mg+, phosphate Ecf: high na+, cl-, bicarbonate ions What is hydrostatic pressure? Is it higher at arteriole or venous end of capillary? When does hydrostatic pressure increase?
- water pushing pressure
- higher at arteriole end (pushing oxygen and nutrients out of capillary to go to cells)
- increases due to venous obstruction or salt/water retention (due to chf/kidney failure), edema occurs What is osmotic pressure? Is it higher at arteriole or venous end of capillary?
- water pulling pressure
- high at venous end (want to pull fluid back into capillary from cells to bring back to heart, and get rid of waste products)
What is active transport? Movement of particles against concentration gradient, requires energy What is third spacing? How can it happen? What can it cause?
- fluid moves where it is not supposed to be
- cannot be used for anything
- occurs in abdomen (ascites), liver disease, pancreatitis
- area rich in proteins (keeps pulling fluid in)
- have to drain Causes: slow diffusion, compression of blood vessels, slow healing, increased risk of infection, pressure ulcers What is thirst triggered by?
- triggered by osmolality of ecf High osmolality: concentrated Low osmolality: diluted
- decreased circulating blood volume (low bp)
- dry mucous membranes
What is capillary hydrostatic pressure? Is it increased at the venous or arteriole end? Outward force, pushes fluid out of capillary Increased at arteriole end What is colloid osmotic pressure? Is it higher at the arteriole or venous end? Draws fluid back into capillaries Increased at venous end What is interstitial fluid hydrostatic pressure? Is it higher at the arteriole or venous end? Draws fluid out of interstitial back into capillaries Increased at venous end What is interstitial fluid osmotic pressure? Is it higher at the arteriole or venous end? Draws fluid into interstitial out of capillaries Increased at arteriole What is edema? What are causes of edema?
- excessive fluid in interstitial fluid
Loop: main diuretic, prevents reabsorption of sodium in loop of henle (furosemide) Thiazide: prevents reabsorption of sodium Potassium sparring: keeps k+ in blood (spirolactone) Osmotic: used in emergency situations, increase osmotic pressure, pulls fluid into blood vessels, use if have edema (mannitol) What does it mean if a solution is isotonic? Solution with same salut concentration as body, doesn't influence movement of water What does it mean if a solution is hypertonic? Solution with higher salt concentration that body, pulls water into blood vessels, cells shrink What does it mean if a solution is hypotonic? Solution with lower salt concentration than body, water moves out of blood vessels into cell, cell swells
What is hypovolemia? What are causes? What are clinical manifestations?
- occurs when there is a decrease in water and na+
- loosing too much water and salt, not getting enough in Causes: diarrhea, edema, burns, hemorrhage, excessive perspiration, emesis (vomit), gastric drainage, ascites Cm: increased hr, postural hypotension, weight loss, flat neck veins, prolonged capillary refill, syncope, oliguria (decreased urine), decreased skin turgor, hard stool, dry mucous membranes, sunken eyes, no tears/sweat, sunken fontanel What is hypervolemia? What are causes? What are clinical manifestations?
- occurs when there is volume excess Causes: excessive infusion of isotonic solutions, renal retention of na+ and water (due to heart, liver, kidney issues), increased intake Cm: weight gain, edema, bounding pulses, neck vein distention, crackles (fluid in lungs), orthopnea, bulging fontanel What are the cations? Positively charged ions Sodium, potassium, magnesium, calcium
Treatment: sodium replacement, normal saline, fluid restriction, treat underlying problem, diuretic What is hypernatremia? What are the causes? What are the clinical manifestations? What is the treatment?
- high na+ not enough water (gain of na+ without water loss) Causes: concentrated tube feedings (pulls water into gut, lost water in vessels), iv infusion Cm: confusion, lethargy, seizures, coma, thirst, oliguria Treatment: add water/remove sodium, gradually achieve na+ level over 48 hours to avoid edema of cerebral cells What does potassium do? What is normal potassium level?
- main icf cation
- regulates excitability of cells, helps to control intracellular osmolarity, determines cell electrical status Normal: 3.5 to 5
What is hypokalemia? What are the causes? S/s? Treatments?
- low potassium Causes: loss from renal (diuretics)/gi system (diarrhea), decreased k+ intake in diet, shift from k+ from ecf to icf (acid base problem) Acid base problem: h+ shifts out of cells to correct ph, k+ shifts into cells to maintain electroneutrality S/s: cardiac rhythm disturbance, muscle weakness, leg cramping, decreased bowel motility Treatment: Potassium supplement (potassium chloride kcl) May cause gi bleeding, ulcers, monitor for n/v Iv potassium must be diluted and given slowly, need to have kidney function *never given potassium iv push (will cause fatal cardia arrhythmia) What is hyperkalemia? What are the causes? What is the treatment?
- high k+ Causes: increased k intake, decreased k output (kidney failure), shift of k+ from icf to ecf, massive cell injury occurred when k+ escapes into serum
Causes: exogenous ingestion (take in too much), impaired renal excretion S/s: not usually any Treatment: eliminate exogenous source of mg What are the three types of fluid replacement? Crystalloid, colloid, blood products What do crystalloids do? What are the names of some?
- replace water and sodium
- maintenance and replacement of fluids or specific electrolytes
- inexpensive
- no risk for anaphylaxis, viral transmission, or coagulation problems Names: sodium chloride, dextrose, lactate ringers What do colloids do? What are the names of some?
- increase osmotic pressure (pull fluid back into bv)
- fluid pulled from interstitial space to the intravascular space
- plasma expanders, no oxygen carrying ability
- consists of proteins, carbs, collagen
- more expensive than crystalloids
- can affect coagulation Names: albumin, dextran, hespan What do blood products do? What are adverse effects? What the different kinds?
- carry o2, clotting factors, increases cop and volume
- give to some because they have lost blood
- most expensive, least available, require human donors Ae: incompatibility with recipient's immune system, transmission of pathogen's from donor to recipient Packed rbc:increase oxygen carrying capacity of blood Fresh frozen plasma: increases clotting factors and volume expansion Whole blood: increases volume and oxygen carrying capacity of blood, adds clotting factors Pooled platelets: indicated to treat acute hemorrhage, secondary to thrombocytopenia/to provide prophylaxis from hemorrhage in patient with bone marrow disorders What do alpha cells secrete?
- prevents huge spikes in blood sugar after you eat
- suppresses glucagon secretion
- tells us we are full (satiety) What does insulin do?
- tells liver to store more glucose which decreases blood glucose
- stimulated by an increase in blood glucose, pns, amino acids, gi hormones
- binds and activates cell surface receptors
- allows the cells (in muscle, liver, adipose tissue) to be able to uptake glucose for energy production
- facilitates mouvement of k+, phosphate, magnesium, within the cell
- anabolic hormone
- stimulates protein and fat synthesis Inhibits breakdown of fat (bc able to use glucose for energy) What happens when glucose rises? Beta cells release insulin, cells uptake glucose and liver stores glucose as glucagon, glucose decreases What happens when glucose falls? Alpha cells release glucagon, liver breaks down glycogen and releases glucose, glucose increases
Which cells don't require insulin for glucose uptake? Brain, rbcs, kidneys, lens of eye What happens when glucose enters hemoglobin? Irreversibility binds there until rbc death (about 120 days) Hemoglobin a1c levels: good indicator of how controlled person's blood sugar is, small level may indicate pre-diabetic Diabetes is a problem with what? Metabolism
- abnormalities in insulin production, secretion, or utilization What is type 1 diabetes?
- immune system attacks insulin producing beta cells, so they don't produce insulin What are two types of type 1 diabetes? Idiopathic: no evidence of autoimmune activity against beta cells, genetic component, asian or african descent
If there is no glucose for energy, what does the body use? Fat and protein Why is there slow wound healing associated with diabetes? Blood vessels become stiff, decreased flow of nutrients and oxygen to tissues What are risk factors for type 2 diabetes? Age, obesity, lack of exercise, genetic predisposition, hypertension, poor diet, alaskan/native american What happens with type 2 diabetes? What are s/s? Insulin resistance
- cells in muscle, liver, adipose tissue don't respond to insulin correctly, so glucose is unable to enter blood stream, glucose rises S/s: may show classic signs, but not as evident because their is still insulin production What are problems associated with type 2 diabetes?
Adipokines, free fatty acids, inflammation, mitochondrial dysfunction, hyperinsulinemia What is common with both types of diabetes? Excess amount of glucose in blood that cannot be used by cells What are the three acute complications of diabetes? Hypoglycemia Diabetic ketoacidosis Hyperosmolar hyperglycemic nonketoic syndrome (hhns) What is hypoglycemia? What are s/s? Causes? Treatment?
- get too much insulin for blood sugar
- can happen if take insulin then don't eat
- related to treatment (insulin shock/reaction)
- common with type 1 S/s: pallor, anxiety, tachycardia, shaking, diaphoresis, dizzy weak, confused, seizures Causes: insulin overdose, decreased caloric intake, v/d, excessive alcohol, unaccustomed exercise, childbirth
