Fluid and Electrolytes
Which laboratory finding can be seen in a patient with clinical dehydration?
Blood urea nitrogen (BUN) of 28 mg/dL Urine specific gravity of 1.150 Serum sodium level of 160 mEq/L
A patient had 200 mL of ice chips and 900 mL intravenous (IV) fluid during the nurse's shift. Which total intake would the nurse record?
1000mL
How much fluid does an adult lose through feces?
100ml
Which range is the normal value of phosphate in human blood?
2.7 to 4.5 mg/dL
Which range is the normal concentration of ionized calcium in human blood?
4.5 to 5.3 mg/dL
Which patient would the nurse expect to be at risk of developing dehydration?
A 78-year-old patient with dementia
Which acute condition will place the patient at a high risk of hyperkalemia?
Crush injuries
Which statement about antidiuretic hormone (ADH) leads the nurse to recognize that a patient with highly concentrated blood may have impaired renal function?
ADH circulates in the blood to the kidneys, where it acts on the collecting ducts
Which clinical finding would the nurse expect to find in a patient with chronic heart failure at risk of developing extracellular fluid volume (ECV) excess?
Ankle edema Overnight weight gain Neck veins full when upright
When a patient has an increased loss of sodium and water in the urine, which hormone does the nurse know is inhibiting the secretion of antidiuretic hormone (ADH)?
Atrial natriuretic peptide (ANP)
Which sign is true of hypokalemia?
Bilateral muscle weakness Signs of digoxin toxicity at normal digoxin levels
Which condition may lead to an extracellular fluid volume (ECV) deficit?
Burns Hemorrhage Adrenal insufficiency
Which electrolyte influences excitability of nerve and muscle cells and is necessary for muscle contraction?
Calcium (Ca2+)
Which laboratory finding is consistent with a diagnosis of milk-alkali syndrome?
Calcium level of 15 mg/dL
Which ion is an example of an anion?
Chloride
How might sepsis manifest?
Circulatory shock
After assessing a patient with gastroenteritis, the nurse suspects deficient fluid volume related to vomiting and diarrhea. Which symptom supports the nurse's suspicion?
Dark yellow urine Heart rate of 102 beats per minute
Which food item would the nurse include in the diet plan of a patient with magnesium deficiency?
Dark-green leafy vegetables
Which therapy would be prescribed for a patient with circulatory overload?
Oxygen Diuretics
Which donor would the nurse consider when choosing platelets for a patient with type O blood?
Donor should be of blood group O
Which statement is correct about active transport?
Energy is required to move electrolytes
Which effect is caused by respiratory acidosis?
Excessive carbonic acid in the blood
The nurse finds that a patient has sudden weight gain, confusion, edema in the dependent areas, and crackles in the lungs upon auscultation. Which condition does the nurse suspect?
Extracellular fluid volume (ECV) excess
For which reason would the nurse elevate a patient's extremity while receiving intravenous therapy?
Extravasation
Which transport mechanism is governed by oncotic and hydrostatic pressures?
Filtration
Patients should be taught to replace sweat, vomiting, or diarrhea fluid losses with which type of fluid?
Fluid that has sodium (salt) in it
Which symptom is caused by respiratory acidosis?
Headache
Which factor can be a risk of causing extracellular volume (ECV) deficit?
Hemorrhage
Which fluid electrolyte imbalance may develop in a patient who consumes spironolactone?
Hyperkalemia
A patient reports intense thirst, decreased alertness, and has a serum sodium level of 170 mEq/L. Which condition would the nurse document in the patient's medical chart?
Hypernatremia
Which condition is common in patients with chronic diarrhea?
Hypocalcemia Hypernatremia Hypomagnesemia
Which electrolyte abnormality is least likely to be caused by the use of laxatives?
Hyponatremia
Which electrolyte imbalance does syndrome of inappropriate antidiuretic hormone (SIADH) cause?
Hyponatremia
Which statement describes the cause of metabolic alkalosis?
Increase of carbonic acid ions in the blood
The nurse is learning about fluid, electrolyte, and acid-base balance. Which clinical finding would the nurse evaluate in a patient with hypomagnesemia?
Insomnia Muscle cramps Hyperactive deep tendon reflexes
Which organ's function is regularly observed in older-adult patients to monitor for metabolic acidosis?
Kidney
Which organ excretes carbonic acid?
Lungs
Which electrolyte controls the function of neuromuscular junctions?
Magnesium
Which activity related to intravenous (IV) therapy can the nurse delegate to assistive personnel (AP)?
Measuring oral intake and urine output Reporting an IV container that is low in fluid Reporting an electronic infusion device alarm
Which condition is characterized by severe hyperthyroidism, confusion, increased respiratory rate, and a pH of arterial blood gas below 7.35?
Metabolic acidosis
A health care provider prescribes carbenicillin for a patient with a urinary tract infection. Which acid-base imbalance is suspected in the patient?
Metabolic alkalosis
A patient who had an intravenous (IV) line reports purulent discharge at the catheter skin entry point. The nurse notices redness, localized warmth, and swelling at the catheter entry point. Which intervention would be beneficial for the patient?
Obtain drainage for culture. Cleanse the skin with alcohol. Apply a sterile dressing.
Which clinical symptom supports the nurse's documentation of grade 2 phlebitis?
Pain at the access site with erythema
Which buffer prevents urine from becoming too acidic?
Phosphate
Which electrolyte is necessary for the production of adenosine triphosphate?
Phosphate (PO43-)
Which substance is intravascular fluid?
Plasma
Which clinical finding can the nurse expect to document for a patient with suspected hypocalcemia? Select
Positive Chvostek's sign Positive Trousseau's sign Muscle twitching and cramping
Which drug can cause hypokalemia?
Prednisone Furosemide
Which condition in the patient can lead to respiratory alkalosis?
Psychological distress
A patient with cardiac failure is found to have excess extracellular fluid of normal tonicity. Which life-threatening complication is this patient likely to suffer?
Pulmonary edema
Which symptom can be seen in a patient with phlebitis?
Redness of the skin
Which condition can cause paresthesia?
Respiratory alkalosis
Which condition is characterized by metabolic acidosis with a high anion gap?
Severe hyperthyroidism
Which condition may result in excessive metabolic acids in the body of the patient?
Severe infection
Which ion is a cation?
Sodium Calcium Potassium
Which drug increases the risk of metabolic acidosis?
Spironolactone
Which condition places a patient at a higher risk of hypomagnesemia?
Steatorrhea Chronic alcoholism
A patient develops an acute intravascular hemolytic transfusion reaction after a transfusion with incompatible blood. Which treatment strategy should be included in the patient's management?
Stop the transfusion immediately. Maintain the blood pressure (BP) at the normal range. Administer diuretics. Insert an indwelling urinary catheter.
Which body fluid is a transcellular fluid?
Synovial fluid Peritoneal fluid Cerebrospinal fluid
Why are older adults prone to dehydration?
The ability of their kidneys to concentrate urine decreases
Which physical finding can be seen in a patient with extracellular fluid volume (ECV) deficit?
Thready pulse Postural hypotension Dry mucous membranes
Which body fluid is considered an intravascular fluid?
plasma of blood