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Nursing exam quiz fluid and acid base balance case study

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Chapter 40, Fluid, Electrolyte, and Acid--Base Balance Case Study
You are a nurse in a nonsurgical cardiac unit caring for a 92-year-old patient who has two sons,
15 grandchildren, and 49 great-grandchildren. She lives in assisted living and has a history of
congestive heart failure (CHF). She consistently struggles with balancing her fluids and
electrolytes and has an affinity for dill pickles and sauerkraut. While hospitalized, she remains on
a fluid restriction---much to her chagrin, as she loves ice cream.
a. What within her history would indicate she was at risk for hypervolemia?
b. How would dill pickles and sauerkraut impact her fluid volume?
c. What body areas offer observational evidence of excessive interstitial extracellular fluid
(ECF)?
d. Why would your patient be on a strict fluid restriction while hospitalized?
e. Outline nursing interventions used while a patient is on fluid restriction. Chapter 40, Fluid,
Electrolyte, and Acid--Base Balance Case Study
Answer
a). The patient has a history of congestive heart failure, which makes her be at significant risk of
hypervolemia due to her increased cardiac output.
b). Dill pickles and sauerkraut are foods that are rich in sodium, which could cause
hypernatremia, thus resulting to increased fluid retention.

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c). The body areas that offer observational evidence of excessive interstitial extracellular fluid
includes ankles, fingers and feet. Lung crackles occurs if there is too much fluid that leaks into
the lungs, thus causing the crackling.
d). The main reason as to why the patient would be on fluid restriction while hospitalized is
prevent addition of more fluid volume, because the body is already holding excess fluids.
e). The nursing interventions used while a patient is on fluid restriction includes measuring the
patient weight on daily basis to determine the amount of excess fluid in the body, monitoring
fluid intake and output, positioning the patient in a position that facilitates the draining of fluids,
encouraging a low-intake diet, regulating the fluid intake and administering diuretics. This might
involve ensuring that the patient feeds on fluid restricted diet daily to prevent more fluid from
building up in the body.
Explanation
Hypervolemia is a condition in which there is too much fluid in the blood. Although the body
requires plenty of fluid in order to remain healthy, too much of it can cause a dangerous
imbalance. This is the main reason as to why a patient with hypervolemia is usually under fluid
restriction to avoid more fluid volume from accumulating on the blood. Congestive heart failure
is a condition in which the heart pumps inadequate blood to meet the needs of the body. When
the heart's blood pumping ability decreases, the kidneys do not work properly, thus leading to an
excess of fluid in the body. This is the reason as to why congestive heart failure contributes to
hypervolemia. When a patient has hypervolemia, he/she is supposed to be on fluid restriction to
avoid more accumulation of fluid in the body which would in turn cause health problems such as
long-term swelling, and tissue and blood vessel damage.

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Question: Chapter 40, Fluid, Electrolyte, and Acid--Base Balance Case Study You are a nurse in a nonsurgical cardiac unit caring for a 92-year-old patient who has two sons, 15 grandchildren, and 49 great-grandchildren. She lives in assisted living and has a history of congestive heart failure (CHF). She consistently struggles with balancing her fluids and electrolytes and has an affinity for dill pickles and sauerkraut. While hospitalized, she remains on a fluid restriction---much to her chagrin, as she loves ice cream. a. What within her history would indicate she was at risk for hypervolemia? b. How would dill pickles and sauerkraut impact her fluid volume? c. What body areas offer observational evidence of excessive interstitial extracellular fluid (ECF)? d. Why would your patient be on a strict fluid restriction while hospitalized? e. Outline nursing interventions used while ...
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