Ch. 10 Fluid & Electrolytes

The nurse is caring for a client undergoing alcohol withdrawal. Which serum laboratory value should the nurse monitor most closely?

Magnesium

A client has been admitted to the hospital unit with signs and symptoms of hypovolemia; however, the client has not lost weight. The client exhibits a localized enlargement of her abdomen. What condition could the client be presenting? hypovolemia anasarca pitting edema third-spacing

third-spacing

The physician has prescribed a hypotonic IV solution for a patient. Which IV solution should the nurse administer?

0.45% sodium chloride

Which is considered an isotonic solution? 0.45% normal saline 3% NaCl Dextran in normal saline 0.9% normal saline

0.9% normal saline

The nurse should assess the patient for signs of lethargy, increasing intracranial pressure, and seizures when the serum sodium reaches what level? 115 mEq/L 160 mEq/L 145 mEq/L 130 mEq/L

115 mEq/L

A patient is admitted with severe vomiting for 24 hours as well as weakness and "feeling exhausted." The nurse observes flat T waves and ST-segment depression on the electrocardiogram. Which potassium level does the nurse observe when the laboratory studies are complete? 4.5 mEq/L 5.5 mEq/L 2.5 mEq/L 3.5 mEq/L

2.5 mEq/L

A patient's serum sodium concentration is within the normal range. What should the nurse estimate the serum osmolality to be? 350-544 mOsm/kg <136 mOsm/kg >408 mOsm/kg 275-300 mOsm/kg

275-300 mOsm/kg

A nurse can estimate serum osmolality at the bedside by using a formula. A patient who has a serum sodium level of 140 mEq/L would have a serum osmolality of:

280 mOsm/kg. Serum osmolality can be estimated by doubling the serum sodium or using the formula: Na × 2 = glucose/18 + BUN/3. Therefore, the nurse could estimate a serum osmolality of 280 mOsm/kg by doubling the serum sodium value of 140 mEq/L.

A nurse correctly identifies a urine specimen with a pH of 4.3 as being which type of solution? Acidic Basic Neutral Alkaline

Acidic

The nurse notes that a patient's urine osmolality is 980 mOsm/kg. What should the nurse assess as a possible cause of this finding?

Acidosis

The emergency department (ED) nurse is caring for a client with a possible acid-base imbalance. The physician has ordered an arterial blood gas (ABG). What is one of the most important indications of an acid-base imbalance that is shown in an ABG? Carbonic acid PaO2 PO2 Bicarbonate

Bicarbonate

A client reports tingling in the fingers as well as feeling depressed. The nurse assesses positive Trousseau's and Chvostek's signs. Which decreased laboratory results does the nurse observe when the client's laboratory work has returned? Calcium Iron Phosphorus Potassium

Calcium

A client presents with severe diarrhea and a history of chronic renal failure to the emergency department. Arterial blood gas results are as follows: pH 7.30 PaO2 97 PaCO2 37 HCO3 18 The nurse would expect which of the following sets of assessment findings?

Clammy skin, blood pressure 86/46, headache

The physician has prescribed 0.9% sodium chloride IV for a hospitalized client in metabolic alkalosis. Which nursing actions are required to manage this client? Select all that apply. Maintain intake and output records. Compare ABG findings with previous results. Suction the client's airway. Document presenting signs and symptoms. Administer IV bicarbonate.

Compare ABG findings with previous results. Maintain intake and output records. Document presenting signs and symptoms.

Which findings indicate that a client has developed water intoxication secondary to treatment for diabetes insipidus? Tetany and increased blood urea nitrogen (BUN) levels Confusion and seizures Sunken eyeballs and spasticity Flaccidity and thirst

Confusion and seizures

The nurse is caring for a 72-year-old client who has been admitted to the unit for a fluid volume imbalance. The nurse knows which of the following is the most common fluid imbalance in older adults? Dehydration Fluid volume excess Hypervolemia Hypovolemia

Dehydration

The nurse is caring for a client in heart failure with signs of hypervolemia. Which vital sign is indicative of the disease process? Elevated blood pressure Subnormal temperature Low heart rate Rapid respiration

Elevated blood pressure

A nurse is caring for a client with metastatic breast cancer who is extremely lethargic and very slow to respond to stimuli. The laboratory report indicates a serum calcium level of 12.0 mg/dl, a serum potassium level of 3.9 mEq/L, a serum chloride level of 101 mEq/L, and a serum sodium level of 140 mEq/L. Based on this information, the nurse determines that the client's symptoms are most likely associated with which electrolyte imbalance? Hypercalcemia Hypocalcemia Hypokalemia Hyperkalemia

Hypercalcemia

A nurse caring for a patient with metabolic alkalosis knows to assess for the primary, compensatory mechanism of: d. Decreased PaCO2. a. Increased serum HCO3. b. Increased PaCO2. c. Decreased serum HCO3.

Increased PaCO2.

Which intervention is most appropriate for a client with an arterial blood gas (ABG) of pH 7.5, a partial pressure of arterial carbon dioxide (PaCO2) of 26 mm Hg, oxygen (O2) saturation of 96%, bicarbonate (HCO3-) of 24 mEq/L, and a PaO2 of 94 mm Hg? Offer the client fluids frequently. Instruct the client to breathe into a paper bag. Administer an ordered decongestant. Administer ordered supplemental oxygen.

Instruct the client to breathe into a paper bag.

The nurse is caring for a client with an arterial blood pH of 7.48 and bicarbonate level of 29 mEq/L (29 mmol/L). Which treatment will the nurse expect to be prescribed for this client? Intravenous 0.9% normal saline Bronchodilator Oxygen through a rebreather mask Potassium supplements

Intravenous 0.9% normal saline

The nurse is caring for a patient with diabetes type I who is having severe vomiting and diarrhea. What condition that exhibits blood values with a low pH and a low plasma bicarbonate concentration should the nurse assess for?

Metabolic acidosis

A client has the following arterial blood gas (ABG) values: pH, 7.12; partial pressure of arterial carbon dioxide (PaCO2), 40 mm Hg; and bicarbonate (HCO3-), 15 mEq/L. These ABG values suggest which disorder? Respiratory alkalosis Metabolic alkalosis Metabolic acidosis Respiratory acidosis

Metabolic acidosis This client's pH value is below normal, indicating acidosis. The HCO3- value also is below normal, reflecting an overwhelming accumulation of acids or excessive loss of base, which suggests metabolic acidosis. The PaCO2 value is normal, indicating absence of respiratory compensation. These ABG values eliminate respiratory alkalosis, respiratory acidosis, and metabolic alkalosis.

A patient with abnormal sodium losses is receiving a regular diet. How can the nurse supplement the patient's diet to provide 1,600 mg of sodium daily? One beef cube and 16 oz of tomato juice Four beef cubes and 8 oz of tomato juice One beef cube and 12 oz of tomato juice One beef cube and 8 oz of tomato juice

One beef cube and 8 oz of tomato juice

The calcium concentration in the blood is regulated by which mechanism?

Parathyroid hormone (PTH)

A client is being treated in the ICU 24 hours after having a radical neck dissection completed. The client's serum calcium concentration is 7.6 mg/dL (1.9 mmol/L). Which physical examination finding is consistent with this electrolyte imbalance? Presence of Trousseau sign Slurred speech Muscle weakness Negative Chvostek sign

Presence of Trousseau sign

A client comes to the emergency department with status asthmaticus. His respiratory rate is 48 breaths/minute, and he is wheezing. An arterial blood gas analysis reveals a pH of 7.52, a partial pressure of arterial carbon dioxide (PaCO2) of 30 mm Hg, PaO2 of 70 mm Hg, and bicarbonate (HCO3??') of 26 mEq/L. What disorder is indicated by these findings?

Respiratory alkalosis

A nurse reviews the arterial blood gas (ABG) values of a client admitted with pneumonia: pH, 7.51; PaCO2, 28 mm Hg; PaO2, 70 mm Hg; and HCO3--, 24 mEq/L. What do these values indicate? Metabolic alkalosis Respiratory acidosis Metabolic acidosis Respiratory alkalosis

Respiratory alkalosis

Which of the following arterial blood gas results would be consistent with metabolic alkalosis? Serum bicarbonate of 28 mEq/L Serum bicarbonate of 21 mEq/L PaCO2 less than 35 mm Hg pH 7.26

Serum bicarbonate of 28 mEq/L

A nurse is conducting an initial assessment on a client with possible tuberculosis. Which assessment finding indicates a risk factor for tuberculosis?

The client had a liver transplant 2 years ago.

Treatment of FVE involves dietary restriction of sodium. Which of the following food choices would be part of a low-sodium diet, mild restriction (2 to 3 g/day)? Tomato juice, low-fat cottage cheese, and three slices of bacon A frozen, packaged low-fat dinner with a side salad Three ounces of light or dark meat chicken, 1 cup of spaghetti and a garden salad Three ounces of sliced ham, beets, and a salad

Three ounces of light or dark meat chicken, 1 cup of spaghetti and a garden salad

A client has a serum calcium level of 7.2 mg/dl (1.8 mmol/L). During the physical examination, the nurse expects to assess: Hegar's sign. Homans' sign. Goodell's sign. Trousseau's sign.

Trousseau's sign.

A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation? Urine pH of 3.0 Specific gravity of 1.02 Absence of glucose Absence of protein

Urine pH of 3.0

A nurse is providing client teaching about the body's plasma pH and the client asks the nurse what is the major chemical regulator of plasma pH. What is the best response by the nurse? renin-angiotensin-aldosterone system bicarbonate-carbonic acid buffer system sodium-potassium pump ADH-ANP buffer system

bicarbonate-carbonic acid buffer system

A client presents with anorexia, nausea and vomiting, deep bone pain, and constipation. The following are the client's laboratory values. sodium 137 mEq/L (137 mmol/L) potassium 4.6 mEq/L (4.6 mmol/L) chloride 94 mEq/L (94 mmol/L) calcium 12.9 mg/dL (3.2 mmol/L) What laboratory value is of highest concern to the nurse?

calcium 12.9 mg/dL (3.2 mmol/L)

A client with severe hypervolemia is prescribed a loop diuretic and the nurse is concerned with the client experiencing significant sodium and potassium losses. What drug was most likely prescribed?

furosemide

Fluid and electrolyte balance is maintained through the process of translocation. What specific process allows water to pass through a membrane from a dilute to a more concentrated area? evaporation osmosis filtration active transport

osmosis

When evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis? PaCO 36 HCO 21 mEq/L pH 7.48 O saturation 95%

pH 7.48

When evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis? pH 7.48 PaCO 36 HCO 21 mEq/L O saturation 95%

pH 7.48

Which set of arterial blood gas (ABG) results requires further investigation? pH 7.38, partial pressure of arterial carbon dioxide (PaCO2) 36 mm Hg, partial pressure of arterial oxygen (PaO2) 95 mm Hg, bicarbonate (HCO3-) 24 mEq/L pH 7.35, PaCO2 40 mm Hg, PaO2 91 mm Hg, and HCO3- 22 mEq/L pH 7.49, PaCO2 30 mm Hg, PaO2 89 mm Hg, and HCO3- 18 mEq/L pH 7.44, PaCO2 43 mm Hg, PaO2 99 mm Hg, and HCO3- 26 mEq/L

pH 7.49, PaCO2 30 mm Hg, PaO2 89 mm Hg, and HCO3- 18 mEq/L

A nurse is monitoring a client being evaluated who has a potassium level of 7 mEq/L (mmol/L). Which electrocardiogram changes will the client display? shortened PR interval elevated ST segment peaked T waves prolonged T waves

peaked T waves

A client admitted with acute anxiety has the following arterial blood gas (ABG) values: pH, 7.55; partial pressure of arterial oxygen (PaO2), 90 mm Hg; partial pressure of arterial carbon dioxide (PaCO2), 27 mm Hg; and bicarbonate (HCO3-), 24 mEq/L. Based on these values, the nurse suspects: respiratory alkalosis. metabolic alkalosis. metabolic acidosis. respiratory acidosis.

respiratory alkalosis.

A client is diagnosed with hypocalcemia and the nurse is teaching the client about symptoms. What symptom would the nurse include in the teaching?

tingling sensation in the fingers