f&e prepu exam 5

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?

0.9% normal saline

The nursing instructor is talking with her junior nursing class about fluid and electrolyte balance. What would the instructor tell her students is the average daily fluid intake for an adult?

2500

The nurse is caring for four clients on a medical unit. The nurse is most correct to review which client's laboratory reports first for an electrolyte imbalance?

52 yr old with diarrhea

The nurse works at an agency that automatically places certain clients on intake and output (I&O). For which client will the nurse document all I&O?

55-year-old with congestive heart failure on furosemide

A client experiencing a severe anxiety attack and hyperventilating presents to the emergency department. The nurse would expect the client's pH value to be

7.50

A client with excess fluid volume and hyponatremia is in a comatose state. What are the nursing considerations concerning fluid replacement?

Administer small volumes of a hypertonic solution.

Which electrolyte is a major anion in body fluid?

Chloride

A client is taking spironolactone to control hypertension. The client's serum potassium level is 6 mEq/L. What is the nurse's priority during assessment?

ECG results

The nurse is caring for a client who is exhibiting symptoms of tachypnea and circumoral paresthesias. What should be the nurse's first course of action?

Find and correct the cause of tachypnea.

A priority nursing intervention for a client with hypervolemia involves which of the following?

Monitoring respiratory status for signs and symptoms of pulmonary complications.

A client with emphysema is at a greater risk for developing which acid-base imbalance?

Respiratory acidosis

A client with ulcerative colitis is scheduled for a bowel resection. The client is receiving parenteral nutrition prior to surgery. Which is the best explanation for the nurse to give the client about the need for parenteral nutrition?

The client has lost 15% of body weight and has prolonged diarrhea.

A client with hypervolemia asks the nurse by what mechanism the sodium-potassium pump will move the excess body fluid. What is the nurse's best answer?

active transport

Which nursing cocern will the nurse identify based on the effects of a fluid and electrolyte imbalance on human functioning?

acute confusion due to cerebral edema

Which is the most common cause of symptomatic hypomagnesemia?

alcoholism

The absorption of which electrolyte from the gastrointestinal (GI) tract is regulated by vitamin D ingested as part of the diet?

calcium

The nurse is caring for a client being treated with isotonic IV fluid for hypernatremia. What complication of hypernatremia should the nurse continuously monitor for?

cerebral edema

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

compare abgs with previous results maintain intake and output records document signs and symptoms

The nurse is caring for a client with laboratory values indicating dehydration. Which clinical symptom is consistent with the dehydration?

dark, concentrated urine

You are caring for a client with severe hypokalemia. The physician has ordered IV potassium to be administered at 10 mEq/hr. The client complains of burning along their vein. What should you do?

dilute the infusion

A client was admitted to the unit with a diagnosis of hypovolemia. When it is time to complete discharge teaching, which of the following will the nurse teach the client and family? Select all that apply.

drink at least 8 drinks of water drink water as an inexpensive way to meet fluid needs respond to thirst

A nurse reviews the results of an electrocardiogram (ECG) for a patient who is being assessed for hypokalemia. Which of the following would the nurse notice as the most significant diagnostic indicator?

elevated u wave

Which statement is an appropriate nursing concern for an 80-year-old client diagnosed with heart failure, with symptoms of edema, orthopnea, and confusion?

excess extracellular volume related to heart failure, manifested as edema and orthopnea

A nurse is caring for an adult client with numerous draining wounds from gunshots. The client's pulse rate has increased from 100 to 130 beats per minute over the last hour. The nurse should further assess the client for which of the following?

extracellular fluid volume deficit

A patient with a diagnosis of colon cancer has undergone a bowel resection with the creation of an ileostomy. The patient's ileostomy output has been unexpectedly high in the 2 days since surgery, and the patient's most recent blood work indicates a K+ level of 2.7 mEq/L. This potassium level should prompt the nurse to assess for which of the following physical manifestations?

fatigue, cramps, and weakness

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

Which medication is categorized as a loop diuretic?

furosemide

You are caring for a new client on your unit who is third-spacing fluid. You know to assess for what type of edema?

generalized

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?

hypocalcemia

The nurse is caring for a client who has been admitted with a possible clotting disorder. The client is complaining of excessive bleeding and bruising without cause. The nurse knows to take extra care to check for signs of bruising or bleeding in what condition?

hypocalcemia

A client reports muscle cramps in the calves and feeling "tired a lot." The client is taking ethacrynic acid (Edecrin) for hypertension. Based on these symptoms, the client will be evaluated for which electrolyte imbalance?

hypokalemia

A client presents with muscle weakness, tremors, slow muscle movements, and vertigo. The following are the client's laboratory values

hypomagnesemia

Clients diagnosed with esophageal varices are at risk for hemorrhagic shock. Which is a sign of potential hypovolemia?

hypotension

Clients diagnosed with hypervolemia should avoid sweet or dry food because it

increases the client's desire to consume fluid.

The nurse is assessing residents at a summer picnic at the nursing facility. The nurse expresses concern due to the high heat and humidity of the day. Although the facility is offering the residents plenty of fluids for fluid maintenance, the nurse is most concerned about which?

insensible fluid loss

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?

instruct the pt to breathe into a paper bag

The nurse is caring for a client with multiple organ failure and in metabolic acidosis. Which pair of organs is responsible for regulatory processes and compensation?

lungs and kidney

The nurse on a surgical unit is caring for a client recovering from recent surgery with the placement of a nasogastric tube to low continuous suction Which acid-base imbalance is most likely to occur?

metabolic alkalosis

A 64-year-old client is brought in to the clinic with thirsty, dry, sticky mucous membranes, decreased urine output, fever, a rough tongue, and lethargy. Serum sodium level is above 145 mEq/L. Should the nurse start salt tablets when caring for this client?

no sodium should be restricted

Which of the following would be appropriate nursing interventions for a client with hypokalemia? Select all that apply

offer a diet with fruit juices and citrus fruits monitor I's and o's

The nurse is adding the intake and output results for a client diagnosed with dehydration. The nurse notes a 24-hour intake of 1500 mL/day between oral fluids and intravenous solutions. The output total is calculated as 2800 mL/day from urine output, emesis, and Hemovac drainage. Which nursing action is best to maintain an acceptable fluid balance?

offer antiemetic medication (anti nausea)

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?

peaked t waves

When evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis?

ph 7.8

The nurse is reviewing client lab work for a critical lab value. Which value is called to the physician for additional orders?

potassium 5.8

A client with nausea, vomiting, and abdominal cramps and distention is admitted to the health care facility. Which test result is most significant?

potassium of 3

The nurse is analyzing the electrocardiographic (ECG) rhythm tracing of a client experiencing hypercalcemia. Which ECG change is typically associated with this electrolyte imbalance?

prolonged PR intervals

A nurse is caring for a client admitted with a diagnosis of exacerbation of myasthenia gravis. Upon assessment of the client, the nurse notes the client has severely depressed respirations. The nurse would expect to identify which acid-base disturbance?

respiratory acidosis

A patient in the ICU starts complaining of being "short of breath." An arterial blood gas (ABG) is drawn. The ABG has the following values: pH = 7.21, PaCO2 = 64 mm Hg, HCO3 = 24 mm Hg. What does the ABG reflect?

respiratory acidosis

Which of the following electrolytes is the primary determinant of extracellular fluid (ECF) osmolality?

sodium

Which medication does the nurse anticipate administering to antagonize the effects of potassium on the heart for a patient in severe metabolic acidosis?

sodium bicarbonate

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

An intravenous hypertonic solution containing dextrose, proteins, vitamins, and minerals is known as:

total parenteral nutrition.

A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation?

urine ph of 3.0