Foundations PrepU: Chapter 39 Fluid/ Electrolytes

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." *Severe diarrhea is associated with metabolic acidosis.

The nursing instructor hears students discussing fluid and electrolyte balance. Which statement would warrant further instruction? -"The lungs remove water though exhalation." -"The heart circulates water and nutrients through the body." -"The lungs regulate metabolic acid-base disturbances by controlling carbon dioxide." -"The kidneys store and release antidiuretic hormone to increase water retention."

-"The kidneys store and release antidiuretic hormone to increase water retention." The pituitary glands store and release antidiuretic hormone rather than the kidneys. The other statements are correct regarding fluid and electrolyte balance.

The nurse is describing the role of antidiuretic hormone in the regulation of body fluids. What phenomenon takes place when antidiuretic hormone is present? -The client has a decreased sensation of thirst. -The renal system retains more water. -Urine becomes more diluted. -The frequency of voiding increases.

-The renal system retains more water. When antidiuretic hormone is present, the distal tubule of the nephron becomes more permeable to water. This causes the renal system to retain more water. A lack of antidiuretic hormone causes increased production of dilute urine. Antidiuretic hormone does not cause thirst.

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. The priority nursing action is to tighten the roller clamp on the tubing as this action prevents forward movement of air. All other options are appropriate to remove the air once the tubing has been clamped.

An infant is brought to the emergency room with dehydration due to vomiting. After several failed attempts to start an IV, the nurse observes a scalp vein. When accessing the scalp vein, the nurse should use: -an 18-gauge needle. -a winged infusion needle. -an intermittent infusion device. -a central venous access.

-a winged infusion needle. Winged infusion needles are short, beveled needles with plastic flaps or wings. They may be used for short-term therapy or when therapy is given to a child or infant.

The process of filtration begins at the: -glomerulus. -Loop of Henle. -Bowman's capsule. -collecting ducts.

-glomerulus.

The nurse is caring for Mrs. Roberts, an 86-year-old client, who fell at home and was not found for 2 days. Mrs. Roberts is severely dehydrated. The nurse is aware that older adults are at increased risk for fluid imbalance due to: -increase in muscle mass. -smaller stomach capacity. -decreased skin area. -increase in fat cells.

-increase in fat cells.

The passageways of the kidney permit the urine to flow to the bladder and: -act as a valve that covers the junction between the ureters and the bladder. -surround the Bowman's capsule, which is where the formation of urine begins. -selectively reabsorb or secrete substance to maintain fluids and electrolytes. -control external sphincter of the urethra and permit the control of urination.

-selectively reabsorb or secrete substance to maintain fluids and electrolytes. The capillaries of the glomerulus are porous, and, as the blood passes through the glomerular capillaries, some constituents of the blood are filtered out.

The physician writes an order for intravenous fluids to infuse at 150 mL per hour. If the drop factor of the tubing is 10, at how many drops per minute should the fluid infuse?

25

The physician writes an order for intravenous fluids to infuse at 150 mL per hour. If the drop factor of the tubing is 10, at how many drops per minute should the fluid infuse?

25 150/6

After surgery, a client is on IV therapy for the next 4 days. How often should the nurse change the IV tubing for this client? -every 12 hours -every 24 hours -every 36 hours -every 72 hours

-every 72 hours

A client has been admitted with fluid volume deficit. Which assessment data would the nurse anticipate? (Select all that apply.) -blood pressure 100/48 mm Hg -crackles in the lungs -distended neck veins -poor skin turgor -heart rate 128/bpm

-blood pressure 100/48 mm Hg -poor skin turgor -heart rate 128/bpm

Which nursing interventions would be appropriate for a client diagnosed with deficient fluid volume? Select all that apply. -Hypervolemia management -Fluid restriction -Intravenous therapy -Electrolyte management -Monitoring edema -Nutrition management

-Intravenous therapy -Electrolyte management -Nutrition management

When the nurse reviews the client's laboratory reports revealing sodium, 140 mEq/L (140 mmol/L); potassium, 4.1 mEq/L (4.1 mmol/L); calcium 7.9 mg/dL (1.975 mmol/L), and magnesium 1.9 mg/dL (0.781 mmol/L); the nurse should notify the physician of the client's: -low potassium. -low calcium. -high sodium. -high magnesium.

-low calcium. Normal total serum calcium levels range between 8.9 and 10.1 mg/dL (2.225 to 2.525 mmol/L).

A client with chronic anemia is admitted for the administration of blood. What would the nurse expect the physician to order? -Whole blood -Packed cells -White blood cells -Platelets -D5W 1000 mL

-Packed cells Packed cells are especially useful in the treatment of chronic anemia.

Which client is at a greater risk for fluid volume deficit related to the loss of total body fluid and extracellular fluid? -An infant age 4 months -An adolescent age 17 years -A woman age 45 years -A man age 50 years

-An infant age 4 months An infant has considerably more total-body fluid and extracellular fluid (ECF) than does an adult. Because ECF is more easily lost from the body than intracellular fluid, infants are more prone to fluid volume deficits. An adolescent at 17 years is considered to have an adult like body system similar to the 45 and 50 year old.

When caring for a client who is on intravenous therapy, the nurse observes that the client has developed redness, warmth, and discomfort along the vein. Which intervention should the nurse perform for this complication? -Elevate the client's head. -Apply a warm compress. -Position the client on the left side. -Apply antiseptic and a dressing.

-Apply a warm compress. Prolonged use of the same vein can cause phlebitis; the nurse should apply a warm compress after restarting the IV. The nurse need not elevate the client's head, position the client on the left side, or apply antiseptic and a dressing. The client's head is elevated if the client exhibits symptoms of circulatory overload. The client is positioned on the left side if exhibiting signs of air embolism. The nurse applies antiseptic and a dressing to an IV site in the event of an infection.

A client admitted with heart failure requires careful monitoring of his fluid status. Which method will provide the nurse with the best indication of the client's fluid status? -daily weights -daily BUN and serum creatinine monitoring -output measurements -daily electrolyte monitoring

-daily weights

After surgery, a client is on IV therapy for the next 4 days. How often should the nurse change the IV tubing for this client? -every 12 hours -every 24 hours -every 36 hours -every 72 hours

-every 72 hours IV tubings are generally changed every 72 hours or as per the facility's policy. Solutions are replaced when they finish infusing or every 24 hours, whichever occurs first. IV tubings are not replaced after every solution is over or after every 12, 24, or 36 hours.

A client is diagnosed with metabolic acidosis. The nurse develops a plan of care for this client based on the understanding that the body compensates for this condition by: -increasing ventilation through the lungs. -increasing the excretion of HCO into the urine. -increasing the excretion of H ion into the urine. -preventing excretion of acids into the urine.

-increasing ventilation through the lungs.

Which solution is a crystalloid solution that has the same osmotic pressure as that found within the cells of the body and is used to expand the intravascular volume? -Hypertonic -Colloid -Isotonic -Hypotonic

-Isotonic

A young man has developed gastric esophageal reflux disease. He is treating it with antacids. Which acid-base imbalance is he at risk for developing? -Respiratory alkalosis -Metabolic alkalosis -Respiratory acidosis -Metabolic acidosis

-Metabolic alkalosis

The nurse is caring for a client who was in a motor vehicle accident and has severe cerebral edema. Which fluid does the nurse anticipate infusing? -isotonic -hypotonic -hypertonic -hypotonic, followed by isotonic

-hypertonic

A client who is admitted to the health care facility has been diagnosed with cerebral edema. Which intravenous solution needs to be administered to this client? -hypertonic solution -hypotonic solution -isotonic solution -colloid solution

-hypertonic solution Hypertonic solutions are used in extreme cases when it is necessary to reduce cerebral edema or to expand the circulatory volume rapidly because it is more concentrated than body fluid and draws cellular and interstitial water into the intravascular compartment. Hypotonic solutions are administered to clients with fluid losses in excess of fluid intake, such as those who have diarrhea or vomiting. Isotonic solution is generally administered to maintain fluid balance in clients who may not be able to eat or drink for a short period. Colloid solutions are used to replace circulating blood volume because the suspended molecules pull fluid from other compartments. However, these solutions are not related to clients with cerebral edema.

The nurse is providing care to a client who has been experiencing emesis for 24 hours. Which fluid should the nurse anticipate incorporating into the client's plan of care? -isotonic -hypotonic -hypertonic -hypertonic, followed by isotonic

-hypotonic A hypotonic solution contains fewer dissolved substances than normally found in plasma. It is administered to clients with fluid losses in excess of fluid intake, such as those who have diarrhea or vomiting. The other fluids are not appropriate to administer.

The nurse is caring for a client with severe edema who has crackles in the lungs. Which nursing intervention is the priority for this client? -Increase oral intake to flush excess fluids. -Ask provider to order a low-salt diet. -Administer furosemide as ordered. -Treat the underlying condition that contributes to increased fluid volume.

-Administer furosemide as ordered. Control of edema, and thus restoration of fluid balance, can be accomplished by treating the disorder contributing to the increased fluid volume, restricting or limiting oral fluids, reducing salt consumption, discontinuing IV fluid infusions or reducing the infusing volume, and/or administering drugs that promote urine elimination. The priority is to administer the furosemide, as this will decrease the fluid volume and decrease the crackles in the lungs.

A nurse is caring for a client who is on total parenteral nutrition (TPN). Which clients are candidates for TPN? (Select all that apply.) -Clients who have not eaten for a day -Clients with major trauma or burns -Clients with liver and renal failure -Clients who are recovering from cataract surgery -Clients with inflammatory bowel disease

-Clients with major trauma or burns -Clients with liver and renal failure -Clients with inflammatory bowel disease

The nurse is caring for a client with "hyperkalemia related to decreased renal excretion secondary to potassium-conserving diuretic therapy." What is an appropriate expected outcome? -Bowel motility will be restored within 24 hours after beginning supplemental K+. -ECG will show no cardiac dysrhythmias within 48 hours after removing salt substitutes, coffee, tea, and other K+-rich foods from diet. -ECG will show no cardiac dysrhythmias within 24 hours after beginning supplemental K+. -Bowel motility will be restored within 24 hours after eliminating salt substitutes, coffee, tea, and other K+-rich foods from the diet.

-ECG will show no cardiac dysrhythmias within 48 hours after removing salt substitutes, coffee, tea, and other K+-rich foods from diet. If the client is taking a potassium-conserving diuretic, he must be mindful of the amount of potassium he is ingesting because the potassium level is more likely to elevate above normal. Cardiac dysrhythmias may result if hyperkalemia occurs. Supplemental potassium should not be added to the client's intake. Potassium does not have a direct impact on bowel motility.

The nurse, along with a nursing student, is caring for Mrs. Roper, who was admitted with dehydration. The student asks the nurse where most of the body fluid is located. The nurse should answer with which fluid compartment? -Interstitial -Extracellular -Intracellular -Intravascular

-Intracellular Intracellular is the fluid within cells, constituting about 70% of the total body water. Extracellular is all the fluid outside the cells, accounting for about 30% of the total body water. Interstitial fluid is part of the extracellular compartment. Intravascular is also part of the extracellular compartment.

A client is admitted to the unit with a diagnosis of intractable vomiting for 3 days. What acid-base imbalance related to the loss of stomach acid does the nurse observe on the arterial blood gas (ABG)? -Metabolic acidosis -Respiratory acidosis -Metabolic alkalosis -Respiratory alkalosis

-Metabolic alkalosis

The nurse is caring for a client whose blood type is B negative. Which donor blood type does the nurse confirm as compatible for this client? -B positive -O negative -A positive -AB negative

-O negative

A nurse is preparing a presentation for a group of older adults at a local senior center about the importance of fluid intake. As part of the presentation, the nurse plans to discuss how the intake and output of fluids is typically balanced each day. When describing the normal daily output of fluids, which component would the nurse identify as accounting for the smallest amount of fluid output? -Perspiration -Urine -Feces -Exhaled air

-Perspiration

A 50-year-old client with hypertension is being treated with a diuretic. The client reports muscle weakness and falls easily. The nurse should assess which electrolyte? -Sodium -Chloride -Phosphorous -Potassium

-Potassium

The nursing instructor is quizzing a group of students about fluid and electrolyte balance. Which statements made by the students indicate an understanding of the efforts of the organs to maintain fluid and electrolyte balance? Select all that apply. -"The kidneys regulate extracellular fluid volume by retention and excretion of body fluids." -"The kidneys react to hypovolemia by stimulating fluid retention." -"The kidneys regulate pH of extracellular fluid by excreting and retaining hydrogen ions." The adrenal glands regulate blood volume by secreting aldosterone." -"The nervous system regulates oral intake by sensing intracellular dehydration, which in turn stimulates thirst."

-"The kidneys regulate extracellular fluid volume by retention and excretion of body fluids." -"The kidneys regulate pH of extracellular fluid by excreting and retaining hydrogen ions." -"The adrenal glands regulate blood volume by secreting aldosterone." -"The nervous system regulates oral intake by sensing intracellular dehydration, which in turn stimulates thirst."

The student nurse asks, "What is intravascular fluid?" What is the appropriate nursing response? -"Fluid inside cells." -"Fluid outside cells." -"Fluid in the tissue space between and around cells." -"Watery plasma, or serum, portion of blood."

-"Watery plasma, or serum, portion of blood."

What commonly used intravenous solution is hypotonic? -0.45% NaCl -0.9% NaCl -Lactated Ringer's -5% dextrose in 0.45% NaCl

-0.45% NaCl 0.45% NaCl is hypotonic. Normal saline and Lactated Ringer's are isotonic. 5% dextrose in 0.45% NaCl is hypertonic.

The nurse is assessing a newly admitted client and finds that he has edema of his right ankle that is 2 mm and just perceptible. The nurse documents this at which grade? -1+ -2+ -3+ -4+

-1+ The edema in the client should be graded as 1+, which means that the edema is just perceptible and of 2 mm dimension. A measurement of 2+ or 3+ indicates moderate edema of 4 to 6 mm. A measurement of 4+ indicates severe edema of 8 mm or more.

The nurse is monitoring intake and output (I&O;) for a client who has diarrhea. What will the nurse document as input on the I&O;record? (Select all that apply.) -100 mL from melted ice chips -serving of jello -bowl of chili -infusion of intravenous solution -barbecue sandwich -cup of ice cream

-100 mL from melted ice chips -serving of jello -infusion of intravenous solution -cup of ice cream

A nurse identifies a client is experiencing excess fluid volume related to heart failure and has edema and weight gain. The nurse reviews the client's laboratory test results. Which plasma osmolality value would support the clients situation? -260 mOsm/kg -280 mOsm/kg -310 mOsm/kg -340 mOsm/kg

-260 mOsm/kg

A client with type AB blood has experienced a precipitous drop in hemoglobin levels due to a gastrointestinal bleed and now requires a blood transfusion. Which blood types may this client safely receive? (Select all that apply.) -A -B -AB -O

-A -B -AB -O

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: 3.89 mg/dL (1.6 mmol/L) Chloride: 100 mEq/L (100 mmol/L) Phosphate: 5.75 mg/dL (1.8 mEq/L) Based on these levels, the nurse would identify which imbalance? -Hyponatremia -Hypokalemia -Hypercalcemia -Hypermagnesemia

-Hypokalemia All of the levels listed are within normal ranges except for potassium, which is decreased (normal range is 3.5 to 5.3 mEq/L; 3.5 to 5.3 mmol/L). Therefore the client has hypokalemia.

During an assessment of an older adult client, the nurse notes an increase in pulse and respiration rates, and notes that the client has warm skin. The nurse also notes a decrease in the client's blood pressure. Which medical diagnosis may be responsible? -Hypervolemia -Hypovolemia -Edema -Circulatory overload

-Hypovolemia The nurse should recognize that hypovolemia, also known as dehydration, may be responsible. Additional indicators of dehydration in older adults include mental status changes; increases in pulse and respiration rates; decrease in blood pressure; dark, concentrated urine with a high specific gravity; dry mucous membranes; warm skin; furrowed tongue; low urine output; hardened stools; and elevated hematocrit, hemoglobin, serum sodium, and blood urea nitrogen (BUN). Hypervolemia means a higher-than-normal volume of water in the intravascular fluid compartment and is another example of a fluid imbalance that would manifest itself with different signs and symptoms. Edema develops when excess fluid is distributed to the interstitial space.

When providing chemotherapeutic agents, which catheter is accessed with a non-coring needle? -Hickman catheter -Groshong catheter -Implanted venous access catheter -Peripheral central catheter

-Implanted venous access catheter

A nurse selects the basilic vein as the intended site for the insertion of an IV catheter. The nurse understands that which bone would act as natural splints to allow the client greater freedom of movement? Select all that apply. -Radius -Ulna -Humerus -Carpal -Scaphoid

-Radius -Ulna When the basilic or cephalic vein is used, the ulna and radius act as natural splints, allowing the client greater freedom of movement. The humerus is the upper arm bone. The carpal and scaphoid bones are located in the wrist.

A nurse is caring for a client who is experiencing fluid volume deficit. Which signs should the nurse document as part of the assessment that correlates with a fluid volume deficit? Select all that apply. -Reduced skin turgor -Decreased blood pressure -Decreased urine output -Increased pulse rate -Increased respiratory rate

-Reduced skin turgor -Decreased blood pressure -Decreased urine output -Increased pulse rate Tachycardia or increased pulse rate is usually the earliest sign of decreased vascular volume associated with fluid volume deficit or dehydration. Pulse amplitude is decreased in fluid volume deficit. As a result of decreased vascular volume, the client would exhibit a decreased blood pressure, and the client would have a decrease in urine output. The client would exhibit a reduction in skin turgor due to lack of fluids in the skin and tissues. The respiratory rate is not affected by dehydration unless associated with respiratory acidosis or alkalosis.

A nurse is assessing for the presence of edema in a client who is confined to bed and who often lies supine. The nurse would pay particular attention to which area? -Sacral area -Face -Hands -Abdomen

-Sacral area The nurse should assess the sacral area in the client when determining the presence of edema. Edema is most noticeable in dependent areas of the body. The edema cannot be assessed in the face, hands and abdomen, as these are not dependent areas.

The nurse is educating a client about the function of sodium in the body. What education points would the nurse make? Select all that apply. -Sodium does not influence ICF volume. -Sodium is the primary regulator of ECF volume -The daily value of sodium cited on nutrition facts labels is 1,200 mg. -Sodium is normally maintained in the body within a relatively narrow range, and deviations quickly result in serious health problems. -The normal extracellular concentration of sodium is 85 to 95 mEq/L (85 to 95 mmol/L). -Sodium participates in the generation and transmission of nerve impulses.

-Sodium is the primary regulator of ECF volume -Sodium is normally maintained in the body within a relatively narrow range, and deviations quickly result in serious health problems. -Sodium participates in the generation and transmission of nerve impulses. Sodium primarily regulates extracellular fluid volume and plays a role in muscle contraction and transmission of nerve impulses. The range of serum sodium is 135 to 145 mEq/L (135 to 145 mmol/L). Sodium does influence ICF volume. The daily suggested intake of sodium is not more than 2,300 mg/day or no more than 1,500 mg/day for persons 51 years of age and older.

The nurse is monitoring a blood transfusion for a client with anemia. Five minutes after the transfusion begins, the client reports feeling short of breath and itchy. What is the priority nursing action? -Assess oxygen levels. -Stop the transfusion. -Assess for visible rash. -Call for assistance.

-Stop the transfusion. Life-threatening transfusion reactions generally occur within the first 5 to 15 minutes of the infusion, so the nurse or someone designated by the nurse usually remains with the client during this critical time. Whenever a transfusion reaction is suspected or identified, the nurse's first step is to stop the transfusion, thereby limiting the amount of blood to which the client is exposed. All other options should occur after the transfusion is stopped.

When the nurse is starting an intravenous infusion on a client who will be receiving multiple intravenous antibiotics, which guideline should the nurse follow? -Use veins of the lower extremities. -Use distal veins before proximal veins. -Use small veins before larger veins. -Use the brachial plexus vein.

-Use distal veins before proximal veins. Use larger veins and the distal portion of the vein, leaving the more proximal sites for later venipunctures.

Which statement most accurately describes the process of osmosis? -Water moves from an area of lower solute concentration to an area of higher solute concentration. -Solutes pass through semipermeable membranes to areas of lower concentration. -Water shifts from high-solute areas to areas of lower solute concentration. -Plasma proteins facilitate the reabsorption of fluids into the capillaries.

-Water moves from an area of lower solute concentration to an area of higher solute concentration.

Which client would be a candidate for total parenteral nutrition? -a client with diabetic ketoacidosis -a postoperative appendectomy client -a client with colitis and bloody diarrhea -a client receiving intravenous antibiotics

-a client with colitis and bloody diarrhea Total parenteral nutrition is indicated when there is interference with nutrient absorption from the gastrointestinal tract or when complete bowel rest is necessary for healing. A client with bloody diarrhea and colitis requires complete bowel rest.

The nurse is caring for a client who had a parathyroidectomy. Upon evaluation of the client's laboratory studies, the nurse would expect to see imbalances in which electrolytes related to the removal of the parathyroid gland? -calcium and phosphorus -potassium and sodium -chloride and magnesium -potassium and chloride

-calcium and phosphorus The parathyroid gland secretes parathyroid hormone, which regulates the level of calcium and phosphorus. Removal of the parathyroid gland will cause calcium and phosphorus imbalances. Sodium, chloride, and potassium are regulated by the kidneys and affected by fluid balance.

When an older adult client receiving a blood transfusion presents with an elevated blood pressure, distended neck veins, and shortness of breath, the client is most likely experiencing: -allergic reaction. -pulmonary embolism. -fluid overload. -anaphylaxis.

-fluid overload. Fluid overload can occur when blood components are infused too quickly or too voluminously. Symptoms include increased venous pressure, distended neck veins, dyspnea, coughing, and abnormal breath sounds.

A dialysis unit nurse caring for a client with renal failure will expect the client to exhibit which fluid and electrolyte imbalances? -fluid volume excess and acidosis -fluid volume deficit and alkalosis -fluid volume excess and alkalosis -fluid volume deficit and acidosis

-fluid volume excess and acidosis Fluid volume excess can be caused by malfunction of the kidneys (i.e., renal failure). The kidneys are also responsible for acid-base balance, and in the presence of renal failure, the kidneys cannot regulate hydrogen ions and bicarbonate ions, so the client develops metabolic acidosis.

During a blood transfusion, a client displays signs of immediate onset facial flushing, fever, chills, headache, low back pain, and shock. Which transfusion reaction should the nurse suspect? -allergic reaction: allergy to transfused blood -febrile reaction: fever develops during infusion -hemolytic transfusion reaction: incompatibility of blood product -bacterial reaction: bacteria present in the blood

-hemolytic transfusion reaction: incompatibility of blood product The symptoms of facial flushing, fever, chills, headache, low back pain, and shock occur when a blood product is incompatible and the client is experiencing a hemolytic transfusion reaction. Hives, itching, and anaphylaxis occur in allergic reactions; fever, chills, headache, and malaise occur in febrile reactions. In a bacterial reaction, fever, hypertension, dry, flushed skin, and abdominal pain occur.

When the nurse reviews the client's laboratory reports revealing sodium, 140 mEq/L (140 mmol/L); potassium, 4.1 mEq/L (4.1 mmol/L); calcium 7.9 mg/dL (1.975 mmol/L), and magnesium 1.9 mg/dL (0.781 mmol/L); the nurse should notify the physician of the client's: -low potassium. -low calcium. -high sodium. -high magnesium.

-low calcium.

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 Manifestations of hypocalcemia include numbness and tingling of fingers, mouth, or feet; tetany; muscle cramps; and seizures. Manifestations of hypercalcemia include nausea, vomiting, constipation, bone pain, excessive urination, thirst, confusion, lethargy, and slurred speech. Diminished cognitive ability and hypertension may result from hyperchloremia. Constipation is a sign of hypercalcemia.

A client with renal disease requires IV fluids. It is important for the nurse to: -catch the rate up when it falls behind. -place the fluids on an electronic device. -check the intravenous rate once a shift. -administer the fluids through the dialysis access.

-place the fluids on an electronic device. An IV electronic infusion device usefully and accurately regulates the infusion rate, especially if fluid administration must be watched very carefully, such as when infusing fluid to a renal client or when administering certain medications.

The nurse writes a nursing diagnosis of "Fluid Volume: Excess." for a client. What risk factor would the nurse assess in this client? -excessive use of laxatives -diaphoresis -renal failure -increased cardiac output

-renal failure Excess fluid volume may result from increased fluid intake or from decreased excretion, such as occurs with progressive renal disease. Excessive use of laxatives, diaphoresis, and increased cardiac output may lead to a fluid volume deficit.

A client is prescribed a diuretic as part of the treatment plan for heart failure. The nurse educates the client about the drug and dietary measures to prevent complications. What statement made by the client indicates that the education about increasing which substance in the diet? -spinach. -apricots. -orange juice. -carrots.

-spinach. The client needs to increase consumption of potassium-containing foods such as apricots, orange juice, and carrots. Spinach is high in calcium and magnesium but not potassium.