Fluid and Electrolytes

A client with chronic liver disease has ascites and is being treated with an albumin infusion. What should the nurse anticipate and monitor in this client? 1. Fluid volume excess 2. Cellular edema 3. Severe hypotension 4. Decreasing CVP

1 hypertonic solution which will pull fluid from the cells and into the vascular space, if there is too much pulled from the cells then there is FVE

A client is admitted following a severe burn. What changes related to fluid status would the nurse anticipate? 1. FVE 2. hypovolemia 3. third spacing 4. increased urine output 5. low CVP 6. increased urine specific gravity

2, 3, 5, 6 the fluid is shifting out of everything and you have dangerously low pressures so decreased perfusion to everything

A client is admitted to the cardiac floor in heart failure. The lung sounds reveal crackles bilaterally, and the BP is 160/98. The client has been on diuretics at home and the potassium level is 3.3 mEq/L (3.3 mmol/L). Which diuretic would the nurse anticipate being prescribed for this client to minimize potassium loss? 1. Spironolactone 2. Furosemide 3. Bumetanide 4. Hydrochlorothiazide

1 potassium sparing diuretic, all the others cause you to loss potassium

A client is admitted with hypocalcemia. Which treatment would the nurse anticipate for this client? 1. PO Calcium 2. Rapid IV Push Calcium 3. Vitamin D 4. Sevelamer hydrochloride 5. Phosphate supplements

1,3,4 Vitamin D helps to absorb calcium, 4 is a phosphate binder (they have an inverse relationship) NEVER push calcium because of the risk to the heart

A nurse has performed teaching with a client diagnosed with Cushing's disease. Which statement by the client would best indicate understanding of the teaching? 1. "The increased level of ADH will cause my potassium level to be too high" 2. "I will be retaining sodium and water due to the increased amount of aldosterone" 3. "I will be losing lots of fluids due to the hormonal imbalance I have" 4. I will feel jittery and nervous due to the elevated thyroxine levels"

2 Cushing's causes you to have too much aldosterone which will increase BP due to the retention of BOTH sodium and water

A client is admitted with prolonged nausea and vomiting. The client's admission sodium level is 149 mEq/L (149 mmol/L). What action by the nurse would be most appropriate at this time? 1. Administer 3% NS at 150 mL/hr 2. Perform neurological assessment 3. Increase oral intake of sodium 4. Decrease fluid intake

2 sodium=neuro! you don't want to give them anymore sodium and restricting their fluids will only make sodium levels go up more

The nurse is preparing a teaching plan for a client newly diagnosed with fluid retention and heart failure. What should the nurse advise the client to AVOID? 1. broiled, fresh fish 2. effervescent soluble medications 3. seasoning with lemon pepper 4. chicken noodle soup 5. deli-ham sandwiches

2, 4, 5 - want to avoid fluid volume excess/ water retention and anything that is processed

The nurse is preparing to administer magnesium sulfate IV to an alcoholic client with hypomagnesemia. Prior to the initiation of IV magnesium, which assessment data would be important for the nurse to document? 1. Liver function 2. Respiratory rate 3. Calcium levels 4. Deep Tendon Reflexes (DTRs) 5. Urinary output

2,4,5 Magnesium acts like a sedative so you need to watch anything that would be affected, mag is also nephrotoxic so you need to watch kidney status before, during, and after

A cleient was admitted with reports of prolonged diarrhea. The client's admission potassium level was 3.3 mEq/L (3.3 mmol/L) and is receiving an IV of D5 ½ NS with 20 mEq KCL at 125 mL/hr. The UAP reports an 8 hour urinary output of 200 mL. The previous 8 hour urinary output was 250 ml. What should be the nurse's priority action? 1. encourage the client to increase PO fluid intake. 2. administer a supplemental PO dose of potassium 3. stop the IV potassium infusion 4. administer polystyrene sulfonate PO

3 The potassium level is low and the decrease in urine output is showing that the kidneys are failing which will cause the patient to retain more potassium than is needed. Stop the infusion and notify the provider.

A client is admitted to the ICU with diabetes insipidus following a head injury. Which finding would the nurse anticipate in this client? 1. low serum hematocrit 2. high serum glucose 3. high urine protein 4. low urine specific gravity

4 DI makes you pee everything out so your blood will be super concentrated and your pee will be super dilute. You have to worry about hypovolemia with DI