PSA Fluid and Electrolyte Prescribing Flashcards
6 cards from real PSA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 PSA Fluid and Electrolyte Prescribing flashcards as text
A 70-year-old patient with congestive heart failure develops peripheral edema and shortness of breath with a weight gain of 4 kg over 2 days. Which fluid prescription change is most appropriate?
Answer: Prescribe IV furosemide and restrict fluid intake
Acute decompensated heart failure with fluid overload requires IV loop diuretics and fluid restriction to remove excess volume.
During calculation of maintenance fluid requirements using the Holliday-Segar method for a 25 kg child, what is the correct daily fluid requirement?
Answer: 1,500 mL/day
Using Holliday-Segar: 100 mL/kg for first 10 kg (1,000 mL) + 50 mL/kg for next 10 kg (500 mL) + 20 mL/kg for remaining 5 kg (100 mL) = 1,600 mL/day.
A patient with tumor lysis syndrome develops hypocalcemia (Ca2+ 6.8 mg/dL) with tetany. What is the most appropriate immediate treatment?
Answer: IV calcium gluconate infusion
Symptomatic hypocalcemia with tetany requires immediate IV calcium gluconate to prevent life-threatening laryngospasm or cardiac arrest.
A patient receiving total parenteral nutrition (TPN) develops hypophosphatemia (phosphate 1.5 mg/dL) on day 3 of therapy. What syndrome does this suggest?
Answer: Refeeding syndrome
Hypophosphatemia occurring early during nutritional support is the hallmark of refeeding syndrome, caused by a sudden cellular shift of phosphate.
A patient with adrenal insufficiency presents with hyponatremia and hyperkalemia. Which electrolyte replacement strategy is most important alongside corticosteroid replacement?
Answer: Administer IV sodium chloride to correct hyponatremia
Adrenal insufficiency causes sodium wasting and potassium retention due to aldosterone deficiency; IV saline corrects hyponatremia while steroid replacement addresses the underlying cause.
Which of the following IV fluid orders is UNSAFE and should be queried before administration?
Answer: IV potassium chloride 40 mEq undiluted by IV push
Concentrated potassium chloride must never be administered undiluted by IV push as it can cause fatal cardiac arrest; it must always be diluted and infused slowly.