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Nursing 120 Writing Assignment 8.

1 Chapter 41-Fluid, Electrolyte, and Acid-Base Balance Fundamentals of Nursing Study Guide Question #27 - Give the normal values, function, and regulatory mechanisms for the major body electrolytes in the following table: Electrolyte Values Sodium 135-145 mEq/L Potassium 3.5-5.0 mEq/L Function Maintaining water balance,nerve impulse transmission, regulation of acid base balance Glycogen deposits in the liver and skeletal muscle, transmission and conduction of nerve impulses, normal cardiac conduction, skeletal and smooth muscle contraction Bone and teeth formation, blood clotting, hormone secretion, cell membrane integrity, cardiac conduction, transmission of nerve impulses, muscle contraction Enzyme activities, neurochemical activities, cardiac and skeletal muscle excitability The transport of chloride follows sodium The major chemical base buffer, essential to acid base balance Assists in acid-base regulation, works with calcium in the formation of bones and teeth Regulatory Mechanism Dietary intake and aldosterone secretion Dietary intake and renal excretion

Calcium

4.5-5.5 mEq/L

Magnesium

1.5-2.5 mEq/L

Chloride

95-105 mEq/L

Bicarbonate 22-26 (arterial) 24-30(venous) mEq/L Phosphate 2.8-4.5 mEq/L

Dietary intake, renal mechanisms, and actions of the parathyroid hormone Dietary intake and kidneys Kidneys Dietary intake, renal excretion, intestinal absorption and the PTH

Question #29 - For each electrolyte disturbance identify the diagnostic laboratory finding and list at least four characteristic signs and symptoms in the following table: Imbalance Hyponatremia Lab Finding Below 135 mEq/L Signs and Symptoms Postural hypotension, abdominal cramping, dry mucous membranes,

Hypernatremia Hypokalemia

Above 145 mEq/L Below 3.5 mEq/L

Hyperkalemia Hypocalcemia

Above 5.0 mEq/L Below 4.5 (serum ionized) or Below 8.5 mEq/L (total serum) Above 5.5 (serum ionized) or Above 10.5 (total serum) Below 1.5 mEq/L

Hypercalcemia

Hypomagnesemia

Hypermagnesemia

Above 2.5 mEq/L

tachycardia, convulsions Extreme thirst, dry flushed skin, dry sticky tongue and mucous membranes, fever Weakness and fatigue, muscle weakness, nausea and vomiting, irregular pulse, ventricular dysrhythmias Dysrhythmias, paresthesia, weakness, abdominal cramps, diarrhea Numbness and tingling of fingers and circumoral region, hyperactive reflexes, tetnay, muscle cramps Weakness, nausea vomiting, lethargy, flank pain, cardiac arrest, decreased level of consciousness Muscular tremors, hyperactive deep tendon reflexes, tachycardia, positive Chvosteks sign Hypotension, flushing, hypoactive deep tendon reflexes, decreased depth and rate of respirations

Question #31-For the four primary types of acid-base imbalances listed identify the diagnostic laboratory findings and lists the characteristic signs and symptoms. Acid-Base Imbalance Respiratory acidosis Respiratory alkalosis Metabolic acidosis Metabolic alkalosis Lab Findings Ph<7.5 Paco2 >45 Pao2<80 Ph> 7.45 Paco2 <35 Pao2 normal Ph <7.35 Paco2 normal Pao2 normal or increased Ph >7.45 Paco2 normal Pao2 normal Signs and Symptoms Confusion, dizziness, lethargy, headache, flushed skin Coma, convulsions, tachypenia, dysrhythmias, confusion Headache, lethargy, confusion, deep respirations, cramps Tetany, dizziness, dysrhythmias, muscle cramps.

Also, answer and provide rationale for review questions 88-91 on p. 176 of Study Guide. To receive full credit, all answers must be typed using the template provided. Assignment is due Monday, May 7, 2012 at 9 a.m. and will be collected at the beginning of class, Please ensure that assignment is received by instructor confirmation. No late assignments will be accepted.

Review Questions: Select the appropriate answer and cite the rationale for choosing that particular answers. Write out the rationale, please do not give only a page number. 88. The body fluids, constituting the interstitial fluid and blood plasma are: 1. Hypotonic 2. Hypertonic 3. Intracellular 4. Extracellular Answer: ___4______ Rationale: 3 different components ake up 17% of body fluid.

89. Mrs. Greens arterial blood gas results are as follows: pH, 7.32; PACO-2, 52MM Hg; PaO2, 78 mm Hg; HCO3, 24mEq/L. Mrs. Green has: 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis Answer: ____3____ Rationale: This is based on the patients arterial blood gas levels

90. Mr. Frank is an 82 year old client who has had a 3 day history of vomiting and diarrhea. Which symptoms would you expect to find on a physical examination? 1. Tachycardia 2. Hypertension

3. Neck vein distention 4. Crackles in the lungs Answer: 1 Rationale: Mr. Frank is experiencing fluid volume deficit

91. Which of the following is most likely to result in respiratory alkalosis? 1. Steroid use 2. Fad dieting 3. Hyperventilation 4. Chronic alcoholism Answer: _____3_______ Rationale: Hyperventilation often begins due to causes outside of the respiratory system.