Fluid Mechanics Quiz Part 2: Pressure And Flow

A spinach salad will have the greatest impact on the neurochemical activity of the person consuming it. Spinach is rich in nutrients such as folate, vitamin K, and antioxidants, which are known to support brain health and function. These nutrients can help improve cognitive function, memory, and overall brain health. Additionally, spinach contains high levels of magnesium, which plays a crucial role in regulating neurotransmitters and promoting healthy brain activity. Therefore, consuming a spinach salad can have a significant impact on neurochemical activity compared to the other food options listed.

A 42-year-old with severe diarrhea is most at risk for a fluid volume deficit because diarrhea can lead to excessive loss of fluids and electrolytes from the body. This can result in dehydration and imbalances in the body's fluid levels. The other clients mentioned may also be at risk for fluid volume deficit to some extent, but severe diarrhea poses the highest risk due to the rapid loss of fluids.

The client's symptoms of headache, nausea, and vomiting during a blood transfusion indicate a possible transfusion reaction. The most appropriate action for the nurse to take immediately is to stop the blood transfusion. This is to prevent any further complications or adverse reactions that the client may experience. The nurse should then assess the client's vital signs and notify the healthcare provider and blood bank personnel for further instructions and evaluation. Slowing down the rate of blood flow may not address the underlying issue and could potentially worsen the client's symptoms.

Lasix (furosemide) is a loop diuretic that helps the body get rid of excess water and salt. Digoxin is a medication used to treat heart failure and certain heart rhythm problems. Both Lasix and digoxin can affect the electrical conduction in the heart, increasing the risk of cardiac dysrhythmias or abnormal heart rhythms. Therefore, the nurse should be alert to the presence of cardiac dysrhythmias in the client taking these medications. Severe diarrhea, hyperactive reflexes, and peripheral cyanosis are not directly associated with Lasix and digoxin use.

The primary goal of prescribing a hypotonic solution like 0.45% sodium chloride is to move fluid into the cells. Hypotonic solutions have a lower concentration of solutes compared to the intracellular fluid, causing water to move into the cells to equalize the concentration. This helps to rehydrate the cells and restore their normal functioning. Expanding the volume of fluid in the vascular system, pulling fluid from the cells, and keeping protein levels normal are not the primary goals of prescribing a hypotonic solution.

Hyperkalemia is a condition characterized by high levels of potassium in the blood. Adrenal insufficiency can lead to hyperkalemia because the adrenal glands are responsible for producing hormones that regulate potassium levels. Increased anxiety is a common clinical assessment finding in clients with hyperkalemia as it is a symptom of the condition. The other options, such as dry, sticky tongue, nausea and vomiting, and decreased bowel sounds, are not typically associated with hyperkalemia.

A client with fluid volume excess will likely manifest increased blood pressure. This is because fluid volume excess causes an increase in the amount of fluid in the blood vessels, leading to increased pressure against the vessel walls. This can result in hypertension. The other options are not consistent with fluid volume excess. Increased urine specific gravity is more commonly associated with fluid volume deficit, while decreased body weight and decreased pulse strength are not specific manifestations of fluid volume excess.

Phlebitis is inflammation of the vein, while infiltration is the leakage of IV fluid into the surrounding tissue. The warmth of the integument surrounding the IV site indicates the presence of phlebitis because inflammation typically causes warmth in the affected area. Infiltration, on the other hand, would not cause warmth but may result in subcutaneous edema, skin discoloration, and pain of varying intensity. Therefore, the warmth of the integument is a specific indicator of phlebitis rather than infiltration.

Excess fluid volume refers to an abnormal increase in the amount of fluid in the body, which can lead to hypertension or high blood pressure. Hypertension is a common sign and symptom of excess fluid volume because the increased fluid puts extra pressure on the blood vessels, causing them to constrict and leading to higher blood pressure. Weak, thready pulse, dry mucous membranes, and flushed skin are not typically associated with excess fluid volume.

When a client's serum sodium level is 120 mEq/L, the priority nursing assessment is to monitor the status of the neurological system. This is because a low serum sodium level can indicate hyponatremia, which can lead to neurological symptoms such as confusion, seizures, and coma. Monitoring the neurological system is important to assess for any changes in mental status or neurological function that may require immediate intervention.

In hypernatremia, there is an excessive amount of sodium in the blood. Diabetes insipidus is a condition where the body is unable to properly regulate water balance, leading to excessive urination and dehydration. Dry, sticky tongue is a common symptom of dehydration, which is likely to occur in a client experiencing hypernatremia as a result of diabetes insipidus. Increased anxiety, nausea and vomiting, and decreased bowel sounds are not specific findings associated with hypernatremia or diabetes insipidus.

The normal range for calcium levels in the blood is 8.5-10.2 mg/dL or 2.1-2.6 mmol/L. A calcium level of 3.9 mEq/L is significantly lower than the normal range, indicating hypocalcemia. Hypocalcemia can have serious consequences, such as muscle cramps, numbness, and tingling, and can even lead to seizures or cardiac arrhythmias. Therefore, this unexpected value should be reported to the healthcare provider for further evaluation and intervention.

The nurse should closely monitor urine output because the increased secretion of aldosterone, glucocorticoids, and antidiuretic hormone (ADH) during the second to fifth postoperative day can cause fluid imbalances. Monitoring urine output will help the nurse assess the client's fluid status and ensure that the client is adequately hydrated. This is especially important in older adults who may be more susceptible to dehydration. Monitoring intake of sodium, activity level, and oxygen level are also important aspects of postoperative care, but they are not directly related to the fluid-balance changes caused by the stress response of surgery.

The correct answer is 0.45% normal saline (NS) because it is a hypotonic solution that will help replace the loss of intracellular fluid. Hypotonic solutions have a lower concentration of solutes compared to the intracellular fluid, causing water to move into the cells and rehydrate them. The other options, such as 10% dextrose, 5% dextrose in lactated Ringer's, and Dextrose 5% in NS, are not appropriate for replacing intracellular fluid loss as they are either hypertonic or do not contain electrolytes necessary for cellular function.

The nurse calculates the flow rate by dividing the total volume (1000 mL) by the total time (8 hours) and then multiplying it by the drop factor (15 gtt/mL). This gives a flow rate of 125 gtt/hour. To convert this to gtt/minute, the nurse divides 125 by 60 (minutes in an hour), which gives a flow rate of approximately 2.08 gtt/min. However, since the drop factor is given as 15 gtt/mL, the nurse needs to divide 2.08 by 15 to get the final flow rate of approximately 0.14 mL/min. To convert this to gtt/min, the nurse multiplies 0.14 by 15, which gives a flow rate of approximately 2.1 gtt/min. Rounded to the nearest whole number, the flow rate is 32 gtt/min.

When there is an excess of body fluid in the intravascular compartment, the hematocrit level is expected to be diluted, resulting in a lower concentration of red blood cells in the blood. Therefore, an elevated hematocrit level would not be expected in this scenario. The other signs mentioned, such as rales (abnormal lung sounds), a bounding pulse (strong and forceful pulse), and engorged peripheral veins (swollen veins), are all commonly associated with fluid overload.

The correct answer is "Pull fluid from the cells." A hypertonic solution has a higher concentration of solutes compared to the cells. When this solution is administered intravenously, it creates an osmotic gradient that causes water to move out of the cells and into the bloodstream, resulting in the pulling of fluid from the cells. This can be beneficial in certain conditions, such as when there is excess fluid in the cells or when there is a need to decrease swelling or edema.

A banana will have the greatest impact on the heart's conductivity of the person consuming it. Bananas are rich in potassium, which is an essential mineral for maintaining proper heart function. Potassium helps regulate the electrical impulses that control the heart's rhythm and conductivity. Consuming foods high in potassium, like bananas, can help prevent irregular heartbeats and maintain a healthy heart.

A pickle will have the greatest impact on the water balance of the person consuming it because pickles are typically high in sodium. Sodium is known to increase water retention in the body, leading to an imbalance in water levels. This can cause bloating and an increase in overall water weight.

Mashed potatoes would not be counted on the daily intake and output because they are not administered through the IV line. Intake and output refers to the measurement of fluids that are taken in and eliminated from the body, and in this case, only the IV fluids would be counted as intake. The cream of mushroom soup and gelatin may be counted as intake if they are consumed orally, and the IV fluids would be counted as both intake and output.

The client's symptoms of weakness, fatigue, nausea, and vomiting, along with the findings of decreased bowel sounds and ECG abnormalities such as flattened T wave and flattened ST segment, are consistent with hypokalemia. Furosemide is a loop diuretic that increases the excretion of potassium in the urine, leading to low potassium levels in the body. Hypokalemia can cause muscle weakness, fatigue, gastrointestinal disturbances, and ECG changes such as flattened T wave and flattened ST segment. Therefore, hypokalemia is the correct answer.

The 45-year-old woman with second-degree burns over 20% of her body is most at risk for fluid volume deficit. Burns can cause fluid loss through damaged skin, leading to dehydration and decreased blood volume. The extent of the burns (20% of her body) suggests a significant loss of fluids, making her more vulnerable to fluid volume deficit. The other clients may have their own health concerns, but they do not have the same level of fluid loss as the burn victim.

The primary goal of prescribing 0.9% sodium chloride (normal saline) as an intravenous therapy is to expand the volume of fluid in the vascular system. This solution has the same osmolarity as blood, which means it will not cause a shift of fluid into or out of the cells. Instead, it will increase the volume of fluid in the blood vessels, helping to restore or maintain adequate blood volume and blood pressure.

The client's arterial blood gas levels indicate a pH of 7.48, CO2 of 42 mm Hg, and HCO3 of 32 mEq/L. These values suggest that the client is experiencing metabolic alkalosis. Metabolic alkalosis occurs when there is an excess of bicarbonate (HCO3) in the blood, leading to an increase in pH. In this case, the elevated HCO3 level indicates a primary metabolic alkalosis.

The nurse should avoid selecting sites on the extremity away from a dialysis graft because these sites may have compromised blood flow and could potentially cause complications during the insertion of the intravenous infusion.

The child's symptoms of vomiting, fever, and lethargy, along with the history of a fever of unknown origin and a rectal temperature of 101.1°F, indicate that the child is likely dehydrated. Giving the child some juice to drink may not be sufficient to rehydrate her, especially if she is lethargic and unable to tolerate oral fluids. Therefore, the nurse should prepare to start an IV to administer fluids and rehydrate the child effectively.

Daily weight is the single best indicator of fluid status because it provides a direct measure of fluid balance. Changes in weight can indicate fluid retention or loss, which can be a sign of fluid overload or dehydration. Skin turgor, intake and output, and serum electrolyte levels can also provide valuable information, but they are not as reliable or immediate as daily weight measurements.

The nurse calculates the infusion rate as 125 gtt/min because the IV solution is to be infused over a 1-hour period and a microdrip infusion set will be used. A microdrip infusion set typically delivers 60 drops per minute, so the nurse can set the rate to 125 gtt/min to ensure that the full 125 mL is infused within the 1-hour timeframe.

The correct answer is pH 7.3, PaCO2 38 mm Hg, HCO3 19 mEq/L. This combination of arterial blood gas levels indicates metabolic acidosis. The pH is below the normal range, indicating acidosis. The PaCO2 is within the normal range, ruling out respiratory acidosis. The HCO3 is below the normal range, indicating a deficit of bicarbonate, which is a base, contributing to the acidosis. This is consistent with extremely poor nutrition, as malnutrition can lead to metabolic acidosis due to the accumulation of metabolic acids in the body.

The correct answer is respiratory acidosis because the child is exhibiting symptoms such as difficulty breathing, moist rales, and lethargy, which are indicative of respiratory distress. Respiratory acidosis occurs when there is an excess of carbon dioxide in the blood due to inadequate ventilation, leading to an increase in acidity.

Lactated Ringer's is an isotonic solution that is commonly used for fluid replacement. It contains a balanced combination of electrolytes, such as sodium, potassium, and calcium, which helps to restore the body's fluid and electrolyte balance. This solution is often used in situations where there is a need for volume expansion, such as in cases of dehydration or hypovolemia. Lactated Ringer's is preferred over other options listed because it closely resembles the electrolyte composition of plasma, making it an effective choice for fluid replacement.

The 79-year-old client with advanced Alzheimer's disease is at the greatest risk for dehydration because Alzheimer's disease can impair the individual's ability to recognize thirst and communicate their needs. Additionally, the client may have difficulty swallowing or may refuse to eat or drink, leading to inadequate fluid intake. Advanced age can also contribute to a higher risk of dehydration.

The nurse would want to obtain the client's serum calcium levels because the symptoms of right flank and lower back pain could be indicative of kidney stones or renal colic. Calcium imbalances can contribute to the formation of kidney stones, so checking the serum calcium levels would help determine if this is a possible cause for the client's pain.

The correct answer is "Every 72 hours". The nurse knows that the CDC recommends changing IV tubing every 72 hours to prevent the risk of infection. This is because IV tubing can become contaminated over time, increasing the risk of introducing bacteria into the client's bloodstream. By changing the tubing every 72 hours, the nurse can help maintain a sterile environment and reduce the risk of infection for the client.

The nurse should carefully adjust the roller clamp to see an increase in flow rate. This is because a decrease or absence of flow may indicate that the IV site is not patent, meaning that the catheter may be blocked or the vein may have collapsed. By adjusting the roller clamp, the nurse can determine if the issue is with the flow rate and take appropriate action to ensure the IV site is patent and the client is receiving the necessary fluids.

Hypokalemia refers to low levels of potassium in the blood. Potassium-wasting diuretics can cause excessive loss of potassium through urine, leading to hypokalemia. Decreased bowel sounds can be seen in hypokalemia as it affects the smooth muscle contractions in the gastrointestinal tract, leading to slowed or absent bowel sounds. Dry, sticky tongue is not a specific finding related to hypokalemia. Increased anxiety is not a common symptom of hypokalemia. Nausea and vomiting can be seen in hypokalemia, but decreased bowel sounds is a more specific finding.

In respiratory acidosis, there is an increase in carbon dioxide (CO2) levels in the blood, leading to a decrease in pH. To compensate for this, the kidneys retain bicarbonate (HCO3) to increase the pH level. By retaining HCO3, the kidneys help to neutralize the excess CO2 and restore the acid-base balance in the body. This compensating mechanism helps to increase the pH level and counteract the effects of respiratory acidosis.

Chvostek's sign is a clinical manifestation of hypocalcemia, which can occur as a result of citrated blood infusion. It is characterized by facial muscle twitching or spasm when the facial nerve is tapped. Therefore, the nurse should observe for Chvostek's sign as a potential complication of the rapid infusion of citrated blood. Diaphoresis, anxiety, and nausea and vomiting are not directly associated with this specific intervention.

A 15-year-old experiencing an asthmatic attack is at the greatest risk for insensible water loss. During an asthmatic attack, there is increased respiratory effort and rapid breathing, leading to increased water loss through respiration. This can result in significant dehydration if not properly managed.

The minimum gauge IV cannula necessary for administering a blood transfusion is 20 gauge. This is because blood transfusions require a larger diameter cannula to accommodate the flow rate of blood products. A larger gauge cannula allows for a faster and smoother administration of the transfusion, reducing the risk of complications such as clotting or hemolysis. A 20 gauge cannula is commonly used for blood transfusions, providing an appropriate balance between flow rate and patient comfort.

The nurse needs to hold pressure on the IV site for 5 to 10 minutes in order to prevent a hematoma. Holding pressure on the site helps to promote clotting and prevent bleeding. Since the client has been taking aspirin daily, which is a blood thinner, there is a higher risk of bleeding and a longer duration of pressure is needed to ensure proper clotting and prevent hematoma formation.

When the nurse notices that the tip of the cannula is missing, it is important to apply a tourniquet high on the extremity to prevent any potential bleeding or further complications. Applying pressure to the IV site may not be sufficient in this case, as the missing tip could cause bleeding that cannot be controlled by simple pressure. Notifying the health care provider and asking another nurse to double-check the cannula may be necessary steps, but the immediate priority is to apply a tourniquet to prevent any potential harm to the client.

The client's symptoms of tachycardia, chills, and low back pain are indicative of a transfusion reaction, specifically a hemolytic reaction. A hemolytic reaction occurs when there is a mismatch between the blood types of the donor and recipient, leading to the destruction of red blood cells. This can result in the release of hemoglobin into the bloodstream, which can then be filtered by the kidneys and excreted in the urine. Therefore, obtaining and sending a urine specimen to the laboratory would allow for further evaluation of the client's condition and confirmation of a hemolytic reaction.

A milkshake will have the greatest impact on the blood-clotting mechanism of the person consuming it. This is because milkshakes are often high in fat and sugar content, which can lead to increased blood clotting. Fat can cause an increase in blood viscosity, making it more likely for clots to form. Additionally, excessive sugar consumption can lead to inflammation and damage to blood vessels, further increasing the risk of blood clot formation.

Adrenal insufficiency, also known as Addison's disease, is characterized by the inadequate production of hormones by the adrenal glands. One of the main functions of these hormones is to regulate fluid and electrolyte balance in the body. In adrenal insufficiency, the lack of hormones can lead to decreased sodium and increased potassium levels, which can result in diarrhea. This is because the imbalance of electrolytes affects the absorption and movement of water in the intestines, leading to loose stools. Therefore, diarrhea is a common symptom in clients with adrenal insufficiency.

A client experiencing partial-thickness burns over 35% of the body as a result of hyponatremia is likely to experience nausea and vomiting. Hyponatremia refers to low levels of sodium in the blood, which can occur due to fluid loss from burns. Nausea and vomiting are common symptoms of hyponatremia as the body tries to eliminate excess fluid and restore electrolyte balance. The other options, including a dry, sticky tongue, increased anxiety, and decreased bowel sounds, are not specifically associated with hyponatremia.

A client experiencing acute congestive heart failure (CHF) is likely to present with bilateral crackles, +2 ankle edema bilaterally, history of a 5-pound weight gain in 3 days, and systemic blood pressure 15 mm Hg above usual baseline. These clinical signs are indicative of fluid overload and increased pressure in the heart and blood vessels. Bilateral crackles in the lungs suggest pulmonary congestion, while ankle edema and weight gain indicate fluid retention. The increase in systemic blood pressure is a compensatory mechanism to maintain perfusion. Flat neck veins and low urine output are not typically seen in acute CHF.

When a child ingests the remaining contents of an aspirin bottle, it can lead to toxicity and cause respiratory alkalosis. Aspirin overdose can stimulate the respiratory center in the brain, leading to hyperventilation and increased breathing rate. This results in excessive elimination of carbon dioxide from the body, leading to a decrease in carbonic acid levels and an increase in blood pH, causing respiratory alkalosis. Symptoms of respiratory alkalosis include rapid breathing, lightheadedness, numbness, and tingling in the extremities.

The nurse should notify the health care provider of the situation because the redness, edema, and pain at the IV insertion site may indicate an infection or infiltration. The health care provider needs to be informed so that appropriate interventions can be initiated, such as ordering a culture and sensitivity test, prescribing antibiotics if necessary, and evaluating the need for a new IV line. Discontinuing the IV line and removing the cannula may be necessary, but this should be done under the guidance of the health care provider. Applying cool or warm compresses may provide temporary relief, but it does not address the underlying issue and should not be the nurse's first action.

A client with partial-thickness burns over 40% of the body is likely to lose body fluid via several mechanisms. Firstly, water vapor is lost through the skin that is burned. Secondly, plasma and interstitial fluids are lost as burn exudate, which is the fluid that oozes from the burned area. Thirdly, there is blood leakage via damaged capillaries in the dermis, which further contributes to fluid loss. Additionally, plasma can leave the intravascular space and become trapped in blisters, leading to fluid loss. Lastly, there is a shift of sodium and water out of the vessels due to increased permeability, causing further fluid loss.