When the nurse gently pinches the skin over the sternum or forearm of a patient with hypovolemia, the fold stays raised instead of flattening, a finding called tenting.
Missing Word
tenting
Tenting shows poor skin turgor, meaning the skin has lost elasticity because tissue fluid is low. It is one sign of hypovolemia, read together with dry mucous membranes, thirst, low urine output and a rapid pulse; because skin loses elasticity with age, the other findings matter more in older adults.
Category: Fluid Volume Imbalances
Question 2
A high serum sodium level, called hypernatremia, pulls water out of cells and causes mainly neurologic changes such as confusion and lethargy.
Missing Word
hypernatremia
Hypernatremia makes the extracellular fluid concentrated, so water leaves the cells and they shrink. Causes include water loss, prolonged vomiting or diarrhea and high sodium intake, and correction must be gradual.
Category: Sodium and Potassium
Question 3
When the kidneys retain bicarbonate to offset a long-standing respiratory acidosis, the process is called compensation.
Missing Word
compensation
Compensation is the body's effort to return pH toward normal by having the system not causing the disorder adjust. The kidneys compensate for respiratory problems and the lungs compensate for metabolic problems.
Category: Acid-Base Imbalances
Question 4
Respiratory acidosis develops when hypoventilation, breathing too slowly or too shallowly, allows carbon dioxide to build up in the blood.
Missing Word
hypoventilation
Hypoventilation removes too little carbon dioxide, which raises the acid load and lowers the pH. Causes include oversedation, COPD, acute asthma and weak respiratory muscles, and treatment focuses on improving ventilation.
Category: Acid-Base Imbalances
Question 5
With the head of the bed raised, bulging jugular veins in the neck are a sign of fluid volume excess.
Missing Word
jugular
The jugular veins reflect pressure on the right side of the heart. When excess fluid fills the vascular space they stay distended even with the head raised, along with findings such as crackles, bounding pulses, edema and weight gain, while in hypovolemia the neck veins are flat.
Category: Fluid Volume Imbalances
Question 6
Breathing faster and deeper than the body needs, called hyperventilation, blows off carbon dioxide and can cause respiratory alkalosis during anxiety, pain or a panic attack.
Missing Word
hyperventilation
Hyperventilation removes carbon dioxide faster than the body makes it, so carbonic acid falls and the pH rises. The patient may report dizziness, chest tightness and tingling, and care includes calm reassurance, explaining the symptoms and treating the cause.
Category: Acid-Base Imbalances
Question 7
Low magnesium makes nerves and muscles more excitable, so tremors and hyperreflexia, abnormally brisk deep tendon reflexes, can develop.
Missing Word
hyperreflexia
Hyperreflexia means the deep tendon reflexes are exaggerated. Low magnesium increases neuromuscular irritability and can also cause tetany and dysrhythmias, so the nurse checks reflexes and keeps the patient on cardiac monitoring.
Category: Calcium, Magnesium, Phosphorus
Question 8
Chemical buffers, together with the lungs and kidneys, keep blood pH within a narrow range.
Missing Word
buffers
Buffers are substances that resist changes in pH by binding or releasing hydrogen ions. They act fastest, followed by the lungs, while the kidneys compensate most slowly.
Category: Acid-Base Imbalances
Question 9
Spasm of the muscles of the larynx, called laryngospasm, is a life-threatening airway complication of severe hypocalcemia.
Missing Word
laryngospasm
Laryngospasm narrows or closes the airway and can cause stridor and respiratory arrest. Because low calcium raises neuromuscular excitability, the nurse watches a patient with severe hypocalcemia for noisy breathing and keeps emergency airway equipment nearby.
Category: Calcium, Magnesium, Phosphorus
Question 10
Infusing large volumes of normal saline, which carries more chloride than plasma does, can raise the serum chloride level above normal, a condition called hyperchloremia.
Missing Word
hyperchloremia
Hyperchloremia is a high serum chloride level. Normal saline has a higher chloride concentration than plasma, so large infusions raise chloride and can push the patient toward metabolic acidosis, and the nurse monitors electrolytes during heavy fluid replacement.
Category: IV Fluid Therapy
Question 11
When noninvasive positive pressure ventilation fails to correct worsening respiratory acidosis, the patient needs intubation and mechanical ventilation.
Missing Word
intubation
Intubation places a tube in the trachea to secure the airway so a ventilator can remove carbon dioxide and oxygenate the patient. It follows less invasive measures such as clearing the airway, reversing oversedation and nebulizer treatments.
Category: Acid-Base Imbalances
Question 12
An arterial blood gas sample is most often drawn from the radial artery at the wrist.
Missing Word
radial
The radial artery is the usual site for arterial puncture because it is easy to reach. The sample measures pH, arterial oxygen and carbon dioxide, bicarbonate and oxygen saturation.
Category: Acid-Base Imbalances
Question 13
Carpopedal spasm and facial twitching are signs of tetany, the sustained involuntary muscle contraction caused by nerve and muscle excitability in acute hypocalcemia.
Missing Word
tetany
Tetany results when low calcium makes nerves fire too easily. Spasm of the hand and wrist when a blood pressure cuff is inflated and facial twitching when the facial nerve is tapped reveal it, and it can progress to airway spasm and seizures, so seizure precautions are part of care.
Category: Calcium, Magnesium, Phosphorus
Question 14
A low serum phosphorus level, called hypophosphatemia, can follow starvation, burns or alcohol abuse and in severe cases causes muscle weakness and seizures.
Missing Word
hypophosphatemia
Hypophosphatemia is often silent until it is severe, so the nurse compares serum levels with the patient's baseline and watches for muscle weakness, including weak respiratory muscles.
Category: Calcium, Magnesium, Phosphorus
Question 15
Before starting IV fluids, the nurse confirms catheter patency, an open and unobstructed line, by flushing it and checking for a blood return.
Missing Word
patency
Patency means the catheter is open and fluid can flow freely into the vein. A blocked or dislodged catheter cannot deliver fluid safely, so the nurse flushes the line, checks for blood return and inspects the site before and during an infusion.
Category: IV Fluid Therapy