Chapter 29: Conditions That Produce Fluid and Electrolyte Imbalance

Chapter 29: Conditions That Produce Fluid and Electrolyte Imbalance

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which of the following types of diarrhea is associated with an inflammation of the mucosa and submucosa in the ileum and colon caused by infectious agents?

a.	Osmotic
b.	Secretory
c.	Cytotoxic
d.	Dysenteric

 

 

ANS:  D

Dysenteric diarrhea is associated with an inflammation of the mucosa and submucosa in the ileum and colon caused by infectious agents such as Campylobacter, Salmonella, or Shigella organisms. Edema, mucosal bleeding, and leukocyte infiltration occur. Osmotic diarrhea occurs when the intestine cannot absorb nutrients or electrolytes. It is commonly seen in malabsorption syndromes such as lactose intolerance. Secretory diarrhea is usually a result of bacterial enterotoxins that stimulate fluid and electrolyte secretion from the mucosal crypt cells, the principal secretory cells of the small intestine. Cytotoxic diarrhea is characterized by the viral destruction of the villi of the small intestine. This results in a smaller intestinal surface area, with a decreased capacity for fluid and electrolyte absorption.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 1092

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Physiological Integrity: Physiologic Adaptation

 

2. Which of the following conditions is often associated with severe diarrhea?

a.	Metabolic acidosis
b.	Metabolic alkalosis
c.	Respiratory acidosis
d.	Respiratory alkalosis

 

 

ANS:  A

Metabolic acidosis results from the increased absorption of short-chain fatty acids produced in the colon. There is an increase in lactic acid from tissue hypoxia secondary to hypovolemia. Bicarbonate is lost through the stool. Ketosis results from fat metabolism when glycogen stores are depleted. Metabolic alkalosis and respiratory alkalosis do not occur from severe diarrhea.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 1090

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Physiological Integrity: Physiologic Adaptation

 

3. Which of the following is a parasite that causes acute diarrhea?

a.	Shigella organisms
b.	Salmonella organisms
c.	Giardia lamblia
d.	Escherichia coli

 

 

ANS:  C

1. lamblia is a parasite that represents 10% of nondysenteric illness in the United States. Shigella, Salmonella, and E. coli are bacterial pathogens.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 1093

TOP:   Nursing Process: Assessment

MSC:  Client Needs: Physiological Integrity: Reduction of Risk Potential

 

4. A school-age child with diarrhea has been rehydrated. The nurse is discussing the child’s diet with the family. Which of the following may be tolerated the best?

a.	Clear fluids
b.	Carbonated drinks
c.	Applesauce and milk
d.	Easily digested foods

 

 

ANS:  D

Easily digested foods such as cereals, cooked vegetables, and meats should be provided for the child. Early reintroduction of nutrients is desirable. Continued feeding or reintroduction of a regular diet has no adverse effects and actually lessens the severity and duration of the illness. Clear fluids (such as fruit juices and gelatin) and carbonated drinks have high carbohydrate content and few electrolytes. Caffeinated beverages should be avoided because caffeine is a mild diuretic. In some children, lactose intolerance will develop with diarrhea, and cow’s milk should be avoided in the recovery stage.

 

DIF:    Cognitive Level: Application           REF:   p. 1095

TOP:   Integrated Process: Teaching/Learning

MSC:   Client Needs: Physiological Integrity: Physiologic Adaptation