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Student Name
Date
Fluids and Electrolytes
Answer Key: Textbook page references are provided as a guide for answering these questions. A complete
answer key was provided for your instructor.
FLUID AND PARTICLE MOVEMENT
Objectives
1.
•
•
List, describe, and compare the body fluid compartments.
Discuss active and passive transport processes, and give two examples of each.
a.
Identify the body fluid compartments in the body. (661) ___________________________________
b.
Most of the body fluid in an adult is located in the __________________________compartment. (661)
2.
What is the relationship of body weight to fluid? (660)
3.
For the following types of fluids, identify the how the fluid will move when administered to the patient
intravenously. (664)
4.
a.
1-lypertonic solution:
b.
Hypotonic solution:____________________________________________________________________
___________________________________________________________________
Provide examples for each of the following processes in the body. (664-665)
a.
Diffusion:
b.
Filtration:
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Chapter 22
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Fluids and Electrolytes
c.
Osmosis:
d.
Active transport:
The minimum hourly urinary output is
5.
______,
and the minimum daily output
______.
(662)
ELECTROLYTES
Objectives
6.
•
•
Discuss the role of specific electrolytes in maintaining homeostasis.
, potassium, chloride, calcium,
Describe the cause and effect of deficits and excesses of sodium
magnesium, phosphorus, and bicarbonate.
a.
The major extracellular electrolyte is ______________________________
b.
The major intracellular electrolyte is ______________________________
_______.
(665)
_____________.
(665)
, and nursing interventions for the im-
7.
Identify the most common signs and symptoms of hyponatremia
balance. (666)
8.
Identify the most common signs and symptoms of hypokalemia,
balance. (668)
9.
What are the most serious problems associated with hyperkalemia
tions for the imbalance? (669)
and nursing interventions for the im-
, and what are the nursing interven-
10. The role of calcium in the body is the following:
(669-670)
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_________________________________________
art affiliate of Elsevier Inc. All rights reserved.
Chapter 22
1. a.
b.
Fluids and Electrolytes
163
Identify the most common signs and symptoms of hypocalcemia, and the nursing interventions for
the imbalance. (670-671)
In the illustrations, what assessments are being performed to determine the presence of this
imbalance? (670-671)
12. Identify possible causes of hypomagnesemia, its common signs and symptoms, and nursing interventions for the imbalance. (672)
13. For the following labOratory results, identify the electrolyte imbalance.
a.
Serum sodium 127 mEq/L:
b.
Serum potassium 5.6 mEq/L:
c.
Serum calcium 3.8 mEq/L: (669)
d.
Serum magnesium 2.7 mEq/L: (672)
(665)
______________________________________________________
(666)
____________________________________________________
___________________________________________________
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Chapter 22
Fluids and Electrolytes
167
35. What are the general nursing interventions that should be implemented for patients
with fluid, electrolyte, or acid-base imbalances? (678)
Multiple Choice
36. The best way for the nurse to determine the patient's fluid balance is to: (663)
1. assess vital signs.
2. weigh the patient daily.
3. monitor IV fluid intake.
4. check diagnostic test results.
37. For the patient with intracellular dehydration, the nurse anticipates that the
patient will receive a(n):
(664)
1. hypotonic solution.
2. hypertonic solution.
3. isotonic solution.
4. parenteral feeding.
38. A postoperative patient is receiving an isotonic IV solution. The patient
asks the nurse why he is receiving this solution. The nurse's best response is: (664)
1. "This fluid will expand your body's fluid volume that has been lost from
your surgery."
2. "This is a solution that will pull fluid from your cells into your circulat
ory system."
3. "This solution will pull fluid from your circulatory system into your cells,
where it is needed."
4. "Since the physician ordered this P1, it would be best if you discuss
ed the reason with your physician."
39. The nurse is aware that electrolytes serve a variety of purposes, includin
g: (Select all that apply) (665)
1. maintenance of normal body metabolism.
2. regulation of water balance in the body.
3. regulation of water andelectrolyte contents within cells.
4. formation of hydrochloric acid in gastric juice.
40. The patient has been placed on a low-sodium diet to assist
in the treatment of hypertension. The nurse
perceives that the patient has understood diet teaching when the patient
states: (665)
1. "Cheese is a good between-meal snack for me."
2. "It is okay for me to eat at my favorite seafood restaurant."
3. "In order for me to eat enough vegetables, I can prepare canned peas
and corn."
4. "1 love cooked frozen broccoli. I'm glad I will still be able to eat it."
41. The nurse realizes that the patient's bicarbonate level
is significant in maintaining: (673)
1. electrolytebalance.
2. fluid balance.
3. acid-base balance.
4. serum potassium levels.
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of Elsevier Inc. All rights reserved.
Date
Student Name
chapter
Care of the Patient with a
Blood or Lymphatic Disorder
Answer Key: Textbook page references are provided as a guide for answering these questions. A complete
answer key was provided for your instructor.
COMPONENTS OF BLOOD
Objectives
Describe the components of blood.
Differentiate between the functions of erythrocytes, leukocytes, and thrombocytes.
Discuss the several factors necessary for the formation of erythrocytes.
Describe what the leukocyte differential means.
•
•
•
•
1.
Complete the table below with information on the components of blood. (1499-1500)
Component
a.
•
Common Name
Normal Value
Function
Significance of
Abnormality
Erythrocytes
What are the factors necessary for the formation of erythrocytes?
b.
Leukocytes
Describe what differential means.
c.
Neutrophils
d.
Eosinophils
e.
Basophils
f.
Monocytes
g.
Thrombocytes
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381
Student Name
Date
chapter
Care of the Patient with an
Immune Disorder
Answer Key: Textbook page references are provided as a guide for answering these questions. A complete
answer key was provided for your instructor.
Objective
Differentiate between natural and acquired immunity.
1.
Describe how natural and acquired immunity work within the body. (1956)
a.
Natural immunity:
b.
Acquired immunity:
TYPES OF IMMUNITY
Objective
Compare and contrast humoral and cell-mediated immunity.
2.
How is cell-mediated immunity achieved? (1956)
3.
What happens to sensitized T cells? (1959)
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Care of the Patient with an tmmune Disorder
4.
What is the significance of cell-mediated immunity?
5.
What type of cells initiate antibody production?
6.
What is active immunity? Include an example.
7.
What
8.
Which cells
9.
What
10. What
is passive immunity?
is
mediate
released
Include
humoral
(1957)
(1957)
an example.
immunity?
does humoral
__________________________________
____________________________________________
_____________________________________________
(1957)
(1957) __________________________________________________
in an antigen-antibody reaction?
type of antigens
(1959, 1966)
(1957-1958)
immunity respond to?
(195 7-1958)
IMMUNITY DIFFERENCES
Objective
Explain the concepts of immunocompetency, immunodeficiency, and autoimmunity.
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Chapter 55
Care of the Patient with an Immune Disorder
515
ompetency, immunodefi11. The patient has asked the nurse to explain the differences among immunoc
not have any
ciency, and autoimmunity. She said that she had written these three words down, but does
understand?
idea what they mean. How will the nurse explain the differences to her in terms she can
(1956-1958)
ORGANIZATION OF THE IMMUNE SYSTEM
Objective
•
Review the mechanisms of immune response.
body develop
12. Describe how immunization and immunotherapy can be used to help the
immunity
(1959)
a.
Immunizations:
b.
Immunotherapy:
HYPERSENSITIVITY DEVELOPMENT
Objective
Discuss five factors that influence the development of hypersensitivity.
_____
13. Identify common substances that can initiate a hypersensitivity disorder. (1960) __________________
14. Discuss the manner in which exposure to substances may occur. (1960)
15. What is thought to be the primary cause of hypersensitivity disorders? (1960)
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All rights reserved.
Chapter 55
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Care of the Patient with an Immune Disorder
16. How are hypersensitivity disorders diagnosed? (1961)
__________________________________________
17. What are common clinical manifestations of hypersensitivity disorders? (1961) ______________________
18. List factors that can increase the symptoms of hypersensitivity. (1961)
19. List three nursing diagnoses applicable to a patient experiencing a hypersensitivity reaction. (1962)
a.
b.
c.
_______
ANAPHYLAXIS
Objectives
•
•
Identify the clinical manifestations of anaphylaxis.
Outline the immediate aggressive treatment of systemic anaphylactic reaction.
20. List the body system and the sign or symptom that would indicate that the patient may be having an
anaphylactic response. In the last row, outline the treatment of a systemic anaphylac-tic reaction. (1963)
Sign or Symptom
System
a.
b.
c.
d.
e.
Treatment:
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Chapter 55
Care of the Patient with an Immune Disorder
517
LATEX ALLERGIES
Objective
•
Discuss the two types of latex allergies and recommendations for preventing allergic reactions to
latex in the workplace.
21. Describe the differences between type IV allergic contact dermatitis and type I allergic reactions.
(1964)
22. List the eight recommendations from the National Institute for Occupational Safety and Health (NIOSH)
that can be used to prevent allergic reactions to latex in the workplace. (1964-1965)
a.
b.
c.
d.
e.
f.
h.
_________________
TRANSFUSION REACTION
Objective
Discuss selection of blood donors, typing and cross-matching, storage, and administration in
preventing transfusion reaction.
23. List all of the ways that transfusion reactions can be prevented.
24. What is the best method for preventing transfusion reactions?
(1965)
_______________________________
(1965)
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Chapter 55
Care of the Patient with an Immune Disorder
IMMUNODEFICIENCY DISEASE
Objective
Explain an immunodeficiency disease.
25. Describe the following characteristics of an immunodeficiency disease. (1966)
a.
First evidence:
b.
Result of immunodeficient state:
c.
Two types:
d.
Factors that alter immune response:
11
111.
iv.
_______________
AUTOIMMUNE DISORDERS
Objectives
•
•
Discuss the cause of autoimmune disorders.
Explain plasmapheresis in the treatment of autoimmune diseases.
26. The patient has art autoimmune disorder. How will the nurse explain to him what could be the possible
causes of autoimmune disorders and how plasmapheresis treatment will be helpful? (1966)
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Chapter 55
Care of the Patient with an Immune Disorder
519
MULTIPLE CHOICE
27. Within 15 minutes of initiating a blood transfusion, the patient reports shortness of breath, chills, and
urticaria. After stopping the transfusion and notifying the physician, which laboratory test must be completed? (1965)
1. Urinalysis
2. Hematocrit
3. Hemoglobin
4. White blood cell count
28. The suppressed humoral immune response in older adults is associated with: (1966)
1. degeneration of the spleen.
2. reduction in the production of white blood cells.
3. reduction in effectiveness of white blood cells.
4. decreased immunoglobulin levels.
29. During plasmapheresis, the plasma may be replaced with which of the following? (Select all that apply)
(1967)
1.
2.
3.
4.
Normal saline
Lactated Ringer's solution
Albumin
Fresh-frozen plasma
30. The treatment protocol for anaphylaxis includes which of the following? (1960)
1. 1:10,000 epinephrine hydrochloride intramuscularly
2. 1:1000 epinephrine hydrochloride subcutaneously
3. 1:1000 epinephrine hydrochloride intradermally
4. 1:10,000 epinephrine hydrochloride subcutaneously
CRITICAL THINKING ACTIVITIES
Activity 1
31. A 22-year-old patient has just completed allergy testing. Her health care provider has prescribed a regimen of weekly allergy shots. (1960)
a.
What special precautions should be taken with the patient after the injection?
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Pr
Student Name
Date
chapter
Care of the Patient with
HIV/AIDS
Answer Key: Textbook page references are provided as a guide for answering these questions. A complete
answer key was provided for your instructor.
THE CAUSE OF HIV
Objectives
•
•
•
•
1.
Describe the agent that causes HIV disease.
Describe the definition of AIDS given in January 1993 by the Centers for Disease Control and
Prevention.
Explain the differences between HIV infection, HIV disease, and AIDS.
Define the nurse's role in the prevention of HIV infection.
The nurse is instructing a young male patient about human immunodeficiency virus (HIV) disease and
the differences among HIV infection, HIV disease, and acquired immunodeficiency syndrome (AIDS).
Develop information that the nurse will be able to share with him about this disease, including the definition of AIDS that the Centers for Disease Control and Prevention gave in January 1993. After developing this information, describe the nurse's role in the prevention of HIV infection. (2005-2006)
THE PATHOLOGY OF THE HIV INFECTION
Objectives
•
•
•
Discuss the pathophysiology of HIV disease.
List signs and symptoms that may be indicative of HIV disease.
Describe the progression of HIV infection.
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521
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Chapter 56
Care of the Patient with HIV/AIDS
Activity 1
2.
Label the significance of viral load in the blood and early time course (months) of the disease.
(1975)
Generalized virologic and immunologic course of HIV disease
Immune response
Months
Symptoms
Years
Symptoms
Activity 2
3.
The course of HIV disease varies. Discuss factors that may influenre the mortality and morbidity of the
disease. (1978)
4.
Discuss the patterns of progression associated with HIV disease. (1978) ______________________________
5.
When, in relation to exposure, does the process of seroconversion take place? (1981)
6.
Review the signs and symptomsthat may occur during the period of seroconversion. (1981)
___________________
___________
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Chapter 56
Care of the Patient with HV/AIDS
7.
How does a late diagnosis of HIV infection affect the progression of the disease? (1997)
8.
Discuss the relationship between viral set point and the HIV disease survival rate. (1981)
523
________________
DIAGNOSTIC TESTS
Objective
Discuss the laboratory and diagnostic tests related to HIV disease.
•
9.
Complete the following table about diagnostic tests used to determine the status of a patient with HIV
disease. (1983-1985)
Diagnostic Test
a.
Implications and Process
l-IIV antibody testing
11.
111.
iv.
V.
b.
CD4 cell monitoring
c.
Viral load monitoring
d.
Complete blood count
(CBC)
_________________________________________________
e.
Liver function
f.
Syphilis
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Chapter 56
Care of the Patient with HIV/AIDS
RISK FOR HIV
Objectives
o
°
•
Describe patients who are at risk for HIV infection.
Discuss the use of effective prevention messages in counseling patients.
Discuss how HIV is and is nOt transmitted.
Activity 1
10. Identify patients who are at risk for HIV infections in the column to the left. In the column on the right,
describe effective prevention messages. (1974)
Patients at Risk
Effective Prevention Messages
Activity 2
11. To what are nearly half of all new HIV infections in the United States attributed? (1973)
_______________
12. What factors are believed to be responsible for the reduction in pediatric HIV cases? (1975)
____________
13. List the five factors that HIV transmission is dependent upon. (1975)
a.
b.
c.
d.
e.
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Chapter 56
14. Identify four methods of HIV transmission.
Care of the Patient with HIV/AIDS
525
(1975-1976)
a.
b.
C.
d.
15. Identify populations associated with the highe
st rate of spread of HIV infection in the United State
s.
(1974-1985)
16. What are the three most common means of HIV
infec
tion transmission? (1974-1976)
a.
b.
c.
17. Discuss underlying factors that may increase the
risk of sexual transmission of the l-IIV virus.
(19761977)
18. Discuss the risk to health care providers with regar
d to HIV transmission. (1983 -1985)
_______________
__
19. Identify factors that increase the risk of transmission
of HP! infection to a baby during labor and delivery. (1983 -1985)
ISSUES WITH TESTING
Objective
Discuss the issues related to HIV antibody testhig.
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d.
Chapter 56
528
Care of the Patient with HIV/AIDS
23. List the opportunistic infections that the patient may develop because of advanced HIV disease. List the
infections under each system, and then list common symptoms that would alert the nurse to the possibility that the patient had an opportunistic infection. (1986-1988)
System
a.
Respiratory
b.
Integumentary
c.
Eye
d.
Gastrointestinal
e.
Neurologic
Opportunistic Infections
CARE PLAN
Objective
•
Implement a care plan for the patient with AIDS.
24. The nurse has been assigned to a patient who has AIDS. Since nursing care is complex and constant,
make a list of care that the nurse should give and goals that the nurse should promote. (1996, 2004)
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Chapter 56
Care of the Patient with HIV/AtDS
529
MULTIPLE CHOICE
25. A 32-year-old patient diagnosed with HIV reports she is looking into some alternative and complementary therapies to treat her disease. Which of the following is your best response? (1993)
1. "You should just use those medications prescribed by the doctor. Anything else might cause some
type of reaction."
2. "Be careful; there are so many unscrupulous people who are only after your money."
3. "Many patients in your position also look into alternative treatments. Please let me know what you
are considering."
4. "1 have heard several great things about these methods. Let me know how they work for you."
26. While caring for a known HI V-positive patient in the emergency department, the nurse notices the phiebotomist preparing to draw blood. What action by the nurse is correct? (1999)
1. Do nothing, because all patients should be treated with standard precautions.
2. Ask the technician if the nurse can see him before he completes the procedure.
3. Flag the chart to let all health care providers know the patient's status.
4. Discretely hand a second pair of gloves to the technician as a signal.
27. An HIV-positive patient voices concern about his reoccurring bouts with diarrhea. He asks for clarification about the cause. Based on the nurse's knowledge, which of the following is recognized to be true?
(Select all that apply) (1982)
1. Side effects from the medications
2. Infections of the gastrointestinal tract
3. Damage to the intestinal villi
4. Caused by the fluctuating white blood cell (WBC) coimt
28. A 34-year-old patient has recently been diagnosed with HIV-associated cognitive motor complex. He
asks questions about the complex. How does the nurse best respond? (2003)
1. "It is an unfortunate but expected complication of HIV."
2. "The symptoms may be treatable if the cause can be identified."
3. "It will fortunately be a short-term disorder."
4. "It is associated with end-stage HIV."
CRITICAL THINKING ACTIVITIES
29. A nursing student has just been stuck by a needle while providing care for a patient whose lifestyle has
placed him at high risk for HIV infection. After reporting to the clinic, she has questions. (1999-2000)
a.
What course of action should be taken initially?
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Chapter 56
530
Care of the Patient with HIV/AIDS
b.
What patient-based factors will affect her level of susceptibility?
c.
Upon hearing the recommendation for her to begin prophylactic drug therapy, she asks to wait
a
few days before beginning the medication regimen. How would you advise her?
d.
After a discussion of the need to begin the medications as soon as possible, she asks for an
explanation concerning the pros and cons of taking the drugs.
e.
List two nursing diagnoses for this patient.
11.
f.
The patient voices concerns about having contact with her husband and child. How will the nurse
respond to her concerns?
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reserved.