CH 32: Fluid, Electrolytes, and Acid-Base

The health care provider is concerned that the client has hypokalemia. During the physical examination, which question should the nurse ask the client? "Have you been experiencing chest pain?" "Have you been experiencing muscle weakness or leg cramps?" "Have you been having diarrhea?" "Have you been experiencing difficulty breathing?"

"Have you been experiencing muscle weakness or leg cramps?"

A client admitted to the facility is diagnosed with metabolic alkalosis based on arterial blood gas values. When obtaining the client's history, which statement would the nurse interpret as a possible underlying cause? "I was breathing so fast because I was so anxious and in so much pain." "I've been taking antacids almost every 2 hours over the past several days." "I've had a fever for the past 3 days that just doesn't seem to go away." "I've had a GI virus for the past 3 days with severe diarrhea."

"I've been taking antacids almost every 2 hours over the past several days."

A client's intake and output is being measured and recorded each shift. The client has had the following intake:3 oz apple juice4 oz tea5 oz pureed chicken2 oz mashed potatoes4 oz orange gelatin2 oz vanilla ice creamCalculate the amount, in milliliters, the nurse documents as fluid on the intake sheet. Record your answer using a whole number.

390

What is the lab test commonly used in the assessment and treatment of acid-base balance? Complete blood count Basic metabolic panel Arterial blood gas Urinalysis

Arterial blood gas

A nurse is performing a venipuncture on an older client. The client has visible veins that appear to roll. What nursing technique is most appropriate? Avoid use of a tourniquet. Select a large-gauge needle. Consider venipuncture in the foot where veins are less visible. Use the client's nondominant hand to hold the vein in place.

Avoid use of a tourniquet.

The nurse is working with a colleague and observes the colleague changing the bag of a client's IV solution as pictured above. What is the nurse's most appropriate response? Observe the colleague and take no further action. Bring a pair of nonsterile gloves and give them to the colleague. Encourage the colleague to hang the bag on the IV pole before spiking it. Offer to double-check whether the bag has the prescribed solution.

Encourage the colleague to hang the bag on the IV pole before spiking it.

Because metabolism continually produces acids, maintenance of pH within these incredibly narrow limits depends on two processes: buffering and compensation. Which statement describes a function of buffering? It helps to prevent large changes in pH by absorbing or releasing H+ ions. The lungs, under the control of chemoreceptor areas in the brainstem respiratory center, are responsible for controlling the amount of carbon dioxide in the blood. The renal system excretes acids and bases from the body as needed. The kidneys influence the maintenance of the normal acid-base balance by changing the rate of excretion or retention of H+ and HCO3 ions.

It helps to prevent large changes in pH by absorbing or releasing H+ ions.

Potassium is essential for normal cardiac, neural, and muscle function and contractility of all muscles. Which is false about potassium? Insulin promotes the transfer of potassium from the extracellular fluid into skeletal muscle and liver cells. Aldosterone enhances renal excretion of potassium. A person loses approximately 30 mEq (30 mmol) of potassium. Normal serum potassium ranges from 5.5 to 6.0 mEq/L (5.5 to 6.0 mmol/L).

Normal serum potassium ranges from 5.5 to 6.0 mEq/L (5.5 to 6.0 mmol/L).

A group of nursing students is reviewing information about the body's electrolytes. The students demonstrate understanding of the material when they identify which electrolyte as having a reciprocal relationship with calcium? Sodium Potassium Phosphorus Magnesium

Phosphorus

The nurse is assessing an adult client who has presented to the emergency department with general weakness. The nurse reviews the client's health record to find there is no history of underlying health conditions. The nurse will begin preparing for the insertion of a peripheral intravenous line if which assessment finding(s) are present? Select all that apply. The client has experienced 24 hours of diarrhea. The client reports using laxative substances daily. The client has been vomiting for several days. The client is only willing to drink juices. The client has a serum potassium level of 2.0 mEq/l (2.0 mmol/l). The client has severe iron-deficiency anemia.

The client has been vomiting for several days. The client reports using laxative substances daily. The client has a serum potassium level of 2.0 mEq/l (2.0 mmol/l). The client has severe iron-deficiency anemia.

The nurse is assessing a client's intravenous line and notes small air bubbles within the tubing. What is the priority nursing action? Tighten the roller clamp to stop the infusion. Twist the tubing around a pencil. Tap the tubing below the air bubbles. Milk the air in the direction of the drip chamber.

Tighten the roller clamp to stop the infusion.

A nurse is caring for a postoperative client who reports feeling dizzy when getting up from bed. The nurse suspects extracellular fluid (ECF) volume deficit and assesses the effect that position change has on pulse rate and blood pressure. What would the nurse interpret as indicative of ECF volume deficit? a drop of more than 15 mmHg in systolic pressure a drop of more than 10 mmHg in diastolic pressure an increase in pulse rate of more than 20 beats per minute dizziness when standing up suddenly

an increase in pulse rate of more than 20 beats per minute

Which is a common anion? magnesium potassium chloride calcium

chloride

A client is taking a diuretic that increases urinary output. What nursing concern is appropriate to base an educational plan? altered skin integrity decreased fluid volume risk altered urinary elimination urinary retention

decreased fluid volume risk

A nurse who has diagnosed a client as having "fluid volume excess" related to compromised regulatory mechanism (kidneys) may have been alerted by what symptom? muscle twitching distended neck veins fingerprinting over sternum nausea and vomiting

distended neck veins

A client is admitted to the facility after experiencing uncontrolled diarrhea for the past several days. The client is exhibiting signs of a fluid volume deficit. When reviewing the client's laboratory test results, which electrolyte imbalance would the nurse likely to find? hyperphosphatemia hyperchloremia hypokalemia hypomagnesemia

hypokalemia

A nurse is reviewing the client's serum electrolyte levels which are as follows:Sodium: 138 mEq/L (138 mmol/L)Potassium: 3.2 mEq/L (3.2 mmol/L)Calcium: 10.0 mg/dL (2.5 mmol/L)Magnesium: 2.0 mEq/L (1.0 mmol/L)Chloride: 100 mEq/L (100 mmol/L)Phosphate: 4.5 mg/dL (2.6 mEq/L)Based on these levels, the nurse would identify which imbalance? hyponatremia hypokalemia hypercalcemia hypermagnesemia

hypokalemia

Mr. Jones is admitted to the nurse's unit from the emergency department with a diagnosis of hypocalcemia. His laboratory results show a serum calcium level of 8.2 mg/dL (2.05 mmol/L). For what assessment findings will the nurse be looking? muscle cramping and tetany nausea, vomiting, and constipation diminished cognitive ability and hypertension muscle weakness, fatigue, and constipation

muscle cramping and tetany

A nurse is preparing to measure jugular venous distention in a client. To ensure accuracy, the nurse would elevate the head of the client's bed to: 30 degrees 45 degrees 60 degrees 90 degrees

45 degrees