Fundamentals Ch 40

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

+1 edema

Moderate edema 4 to 6 mm

+2 or +3 edema

Severe edema of 8mm or more

+4 edema

What commonly used intravenous solution is hypotonic?

0.45% of NaCl

A client with a diagnosis of colon cancer has opted for a treatment plan that will include several rounds of chemotherapy. What vascular access device is most likely to meet the client's needs?

An implanted central venous access device (CVAD)

When a client is at great risk for fluid volume deficit related to the loss of total body fluid and extracellular fluid?

An infant age 4 months

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?

Apply a warm compress

A home care nurse is teaching a client and family about the importance of a balanced diet. The nurse determines that the education was successful when the client identifies which of the following as a rich source of potassium?

Apricots

A home care nurse is visiting a client with renal failure who is on fluid restriction. The client tells the nurse, "I get thirsty very often. What might help?" What would the nurse include as a suggestion for this client?

Avoid salty or excessively sweet fluids

A client's most recent blood work indicates a K+ level of 7.2 mEq/L, a finding that constitutes hyperkalemia. For what signs and symptoms should the nurse vaguely monitor?

Cardiac irregularities

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

The nurse reviews the laboratory tests results of a client and notes that the client's potassium level is elevated. What would the nurse expect to find when assessing the client's gastrointestinal system?

Diarrhea

A client losses consciousness after strenuous exercise and needs to be admitted to a health care facility. The client is diagnosed with dehydration. The nurse knows that the client needs restoration of:

Electrolytes

The nurse's morning assessment of a client who has heart failure reveals the presence of +2 pitting edema in the client's feet and ankles bilaterally. This assessment finding is suggestive of:

Fluid volume excess

5% dextrose in 0.45% NaCl

Hypertonic

A client age 80 years, who takes diuretics for management of hypertension informs the nurse that she takes laxatives daily to promote bowel movements. The nurse assess the client for possible symptoms of:

Hypokalemia

Endurance athletes who exercise for long periods of time and consume only water may experience a sodium deficit in their extracellular fluid. The electrolyte imbalance is known as:

Hyponatremia

Arterial blood gas reveals that a client's pH is 7.20. What physiologic process will contribute to a restoration of correct acid-base balance?

Increased respiratory rate

Normal Saline (0.9% NaCl) and Lactated Ringer's

Isotonic

A nurse monitoring a client's IV infusion auscultates the client's lung sounds and finds crackles in bases of the lungs that were previously clear. What would be the appropriate intervention in this situation?

Notify the primary care provider immediately for possible fluid overload

Upon assessment of a client's peripheral intravenous site, the nurse notices the area is red and warm. The client complains of pain when the nurse gently palpates the area. These signs and symptoms indicative of:

Phlebitis

Process Meat and Bread products

Provide Sodium

A woman age 58 years is suffering from food poisoning after eating at a local restaurant. She has had nausea, vomiting, and diarrhea for the past 12 hours. Her blood pressure is 88/50 and she is diaphoretic. She requires:

Replacement of fluids for those lost from vomiting and diarrhea

Dairy Products

Rich in Calcium

Potassium is needed for neural, muscle, and

cardiac function

A client who is NPO prior to surgery reports feeling thirsty. What is the physiologic process that drives the thirst factor?

decreased blood volume and intracellular dehydration

What food would the nurse provide for a client who has hypokalemia?

Bananas

The nurse is caring for a client who had 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

The nurse is caring for a male client who was diagnosed with heart failure. Today's laboratory results show a serum potassium of 3.2 mEq/L. For what complications should the nurse be aware, related to the potassium level

Cardiac Dysrhythmias

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

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