SCTIMST Staff Nurse - 2015 (Set-B)
Medical & Surgical Nursing
Medium
The condition in which excessive fluid moves into the intracellular space and all body fluid compartments expand is:
Appeared in: SCTIMST Staff Nurse - 2015 (Set-B)
Explanation
- Hypotonic overhydration, or water intoxication, results from a gain of relatively more water than salt.
- This dilutes the extracellular fluid (ECF), making it hypotonic (lower osmolality) compared to the intracellular fluid (ICF).
- Due to osmosis, water moves from the diluted ECF into the more concentrated ICF to equalize solute concentration.
- This shift causes cells to swell and leads to an expansion of both the ECF and ICF compartments.
Why Other Options Were Wrong
- Option A: In isotonic overhydration, there is an excess of both water and sodium in equal proportions. The ECF expands, but since its tonicity is the same as the ICF, there is no significant osmotic shift of water into the cells.
- Option C: In hypertonic overhydration, there is an excess of solutes (like sodium) relative to water in the ECF. This makes the ECF hypertonic, causing water to be pulled out of the cells, leading to cellular shrinkage, not expansion.
- Option D: Hypertonic dehydration involves a loss of fluid, not an expansion. Specifically, more water is lost than sodium, making the ECF hypertonic and causing water to move out of cells, leading to cellular shrinkage and a decrease in both fluid compartments.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Fluid and Electrolyte Balance: Hypotonic Overhydration as background academic context rather than a clinical decision trigger.
- Hypotonic overhydration is a serious condition that can lead to cerebral edema, causing confusion, seizures, coma, and even death.
- Common causes include psychogenic polydipsia (compulsive water drinking), excessive administration of hypotonic IV fluids (like D5W), and the Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
- Nursing interventions focus on treating the underlying cause, restricting fluid intake, and, in severe cases, administering hypertonic saline to carefully correct the sodium level and pull fluid out of the swollen brain cells.
How to Approach the Question
- First, analyze the keywords in the question stem: 'excessive fluid' points to an 'overhydration' or 'expansion' state.
- Next, focus on the direction of fluid movement: 'moves into the intracellular space'. This is a critical clue.
- Recall the principles of osmosis: water moves from an area of lower solute concentration to an area of higher solute concentration.
- For water to move into cells, the fluid outside the cells (ECF) must be more dilute (hypotonic) than the fluid inside the cells (ICF).
- Combine these insights: 'excessive fluid' (overhydration) + 'fluid moving into cells' (due to a hypotonic ECF) = Hypotonic Overhydration.
- Evaluate the options based on this conclusion to confirm the correct answer.
Concept Tested & Keywords
- Concept Tested: Fluid and Electrolyte Balance: Hypotonic Overhydration
- Stem keywords: excessive fluid, intracellular space, body fluid compartments expand
- Lead-in keywords: The condition... is:
Question ID
Q8j7b1pYxiiQUS0HaHIu0A
Reference Book
E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 50-52
E6 Textbook of Biochemistry for medical StudentsDM Vasudevan Part 2 — Subpart A (pp 1-239 of 478) p. 91-93
E6 Pharmacology Nursing Lilley 11e Part 2 p. 160-162
Practise the full SCTIMST Staff Nurse - 2015 (Set-B)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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