Hesi AQ F&E
A client is admitted with 50% of the body surface area burned after an industrial explosion and fire. The client's serum albumin is 1.5 g/dL (150 mg/dL), the hematocrit is 30%, the urine specific gravity is 1.025, and the serum globulin is 3 g/dL (300 mg/dL). When evaluating the client's response to fluid replacement, what determines when the nurse should prepare to administer a colloid?
Albumin is below 2 g/dL (200 mg/dL) Administration of a colloid is indicated when the serum albumin decreases below 2 g/dL (200 mg/dL); then, albumin must be administered to increase the level to the expected range of 3.5 to 5.5 g/dL (350 to 550 mg/dL). This increases the oncotic pressure and prevents the shift of fluid out of the intravascular compartment. A globulin of 3 g/dL (300 mg/dL) is within the expected parameters of 2.3 to 3.4 g/dL (230 to 430 mg/dL). A hematocrit level of 32% is low and indicates overhydration; administration of a colloid will increase this problem. The urine specific gravity is within the expected limits of 1.010 to 1.030.
A client admitted to the hospital with a diagnosis of malabsorption syndrome exhibits signs of tetany. The nurse concludes that the tetany was precipitated by the inadequate absorption of which electrolyte?
Calcium The muscle contraction-relaxation cycle requires an adequate serum calcium-phosphorus ratio; the reduction of the ionized serum calcium level associated with malabsorption syndrome causes tetany (spastic muscle spasms). Sodium is the major extracellular cation. Sodium's major route of excretion is the kidneys, under the control of aldosterone. Although it plays a part in neuromuscular transmission, potassium is not related to the development of tetany. Potassium is the major intracellular cation. Potassium is part of the sodium-potassium pump and helps to balance the response of nerves to stimulation. Potassium is not related to the development of tetany. Although phosphorus is closely related to calcium, because they exist in a specific ratio, phosphorus is not related to the development of tetany.
The mother of an adolescent reports that her child does not eat properly, performs strenuous physical exercise, and is very introverted. What nursing interventions would be appropriate? Select all that apply.
Correct1 Monitoring the adolescent's fluid and electrolyte status Correct2 Monitoring the adolescent for disturbances in family interactions 3 Counseling the adolescent about good personal hygiene and sanitation Correct4 Checking for evidence of self-induced vomiting Correct5 Developing a mutually agreeable targeted daily caloric intake goal Abnormal habits that involve not eating properly, performing strenuous physical exercise, and being introverted may be signs of anorexia. Adolescents with anorexia may have fluid and electrolyte imbalances due to a reduced intake of nutritious food, which may lead to cardiac problems. Disturbances in family interaction may result in an adolescent's introverted behavior. Self-induced vomiting is a characteristic feature of eating disorders. Because the adolescent may have a low nutrient intake, a mutually agreeable targeted daily caloric intake goal should be crafted. Personal hygiene and sanitation counseling is not appropriate in this case.
A nurse is teaching about the function of the loop of Henle. Which function should the nurse include?
Reabsorption of sodium in the ascending limb The reabsorption of sodium takes place in the ascending limb of the loop of Henle to maintain normal blood serum levels of sodium in the body. Ammonia is secreted from the distal tubule. The secretion of hydrogen occurs in the proximal and distal tubules of the nephron. Reabsorption of water is carried out in the descending limb of the loop of Henle.
While caring for a client who sustained a severe head injury in a motor vehicle accident, the nurse observes that the client is constantly passing urine and is dehydrated. What does the nurse suspect as the cause for the client's condition?
The client sustained a head injury in the accident; therefore the nurse suspects that the cause of constant water loss through urine could be because of decreased antidiuretic hormone related to the pituitary gland. Diabetes insipidus is a complication of traumatic brain injury where the posterior pituitary does not secrete antidiuretic hormone. In the absence of antidiuretic hormone, water is not reabsorbed from the tubules in the nephron and, therefore, gets eliminated as urine. Aldosterone is secreted by the adrenal cortex and mainly controls sodium-potassium levels. Parathyroid hormone helps regulate serum calcium levels in the body and is secreted by the parathyroid glands located in the neck. Atrial natriuretic peptide is secreted by the myocyte cells in the right atrium and work in opposition to aldosterone, causing increased urine output.
At 10 AM the nurse hangs a 1000-mL bag of D5W with 20 mEq of potassium chloride to be administered at 80 mL/hr. At noon the healthcare provider prescribes a stat infusion of an intravenous (IV) antibiotic of 100 mL to be administered via piggyback over 1 hour. How much longer than expected will it take the primary bag to empty if the nurse interrupts the primary infusion to use the circulatory access for the secondary infusion of the antibiotic?
1 hour An infusion of 1000 mL at 80 mL should take 12.5 hours. Because the primary infusion is interrupted for an hour while the antibiotic is infused, the primary bag will run an hour longer than if it were running uninterrupted. One quarter, half, and three quarters of an hour are incorrect calculations.
To minimize the side effects of the vincristine that a client is receiving, what does the nurse expect the dietary prescription to include?
A common side effect of vincristine is a paralytic ileus that results in constipation. Preventative measures include high-fiber foods and fluids that exceed minimum requirements. These will keep the stool bulky and soft, thereby promoting evacuation. Dietary plans that are low in fat, high in iron, and low in residue will not provide the roughage and fluids needed to minimize the constipation associated with vincristine.
To manage heart failure a client has been taking several medications, including furosemide 40 mg by mouth twice a day. The client develops severe muscle cramps and fatigue, and laboratory tests confirm the presence of hypokalemia. Potassium chloride intravenously (IV) and ECG monitoring have been prescribed. Which ECG change associated with hypokalemia should the nurse expect to observe?
A flattened T wave is associated with hypokalemia. A depressed T wave indicates a problem with ventricular repolarization, a process involved in muscle contraction. Adequate potassium levels are needed for efficient muscle contraction. P waves may peak in hypokalemia. In hypokalemia, U waves appear. ST segment is depressed in hypokalemia.
Which assessment finding in a client signifies a mild form of hypocalcemia?
A numbness or tingling sensation around the mouth or in the hands and feet indicates mild-to-moderate hypocalcemia. Seizures, hand spasms, and severe muscle cramps are associated with severe hypocalcemia.
A client has a permanent colostomy. During the first 24 hours there is no drainage from the colostomy. How should the nurse interpret this finding?
Absence of peristalsis is caused by manipulation of abdominal contents and the depressant effects of anesthetics and analgesics. Edema will not interfere with peristalsis; edema may cause peristalsis to be less effective, but some output will result. An absence of fiber has a greater effect on decreasing peristalsis than does decreasing fluids. A nasogastric tube decompresses the stomach; it does not cause cessation of peristalsis.
A client's extensive burns are being treated with silver nitrate 0.5% dressings. A week after treatment is begun, the nurse identifies that the client's sodium level is 135 mEq/L (135 mmol/L) and the potassium level is 3.0 mEq/L (3.0 mmol/L). The nurse notifies the primary healthcare provider. Which prescription should the nurse be prepared to administer?
Add potassium chloride (KCl) to the existing intravenous (IV) lactated Ringer solution. Silver nitrate can precipitate electrolyte imbalances; the client's potassium is below the expected range of 3.5 to 5.5 mEq/L (3.5 to 5.5 mmol/L) and should be supplemented by adding potassium chloride to the IV. The client's sodium level is within the expected range of 135 to 145 mEq/L (135 to 145 mmol/L); additional sodium chloride is not needed. Discontinuing the IV NaCl with 20 mEq KCl solution and replacing it with IV 5% D5W solution and discontinuing the IV 5% D5W with 40 mEq KCl solution and replacing it with IV 5% D5W solution will cause a further depletion of potassium.
Following surgery, a client asks the nurse to help with measuring intake and output. What is the best nursing response?
Assess the client's ability to measure the intake and output Clients should be allowed to maintain some control, depending on their ability to perform a given task; involve the client by allowing to measure intake and output after assessment of abilities. The client has already indicated willingness by the request. Determining the client's willingness to really help is immaterial. Able clients should be supported to perform self-care.
A client is diagnosed with esophageal varices and is admitted to the hospital. The healthcare provider prescribes a blood transfusion. Place the following nursing actions in the correct order.
Before obtaining the blood, it is important to have intravenous (IV) access because if there is difficulty establishing an IV after blood is obtained, the blood cannot be returned to the blood bank. Baseline vital signs should be obtained immediately before administering the blood product for future comparison purposes. Two licensed nurses should confirm the verifying data between the client and the blood product. The nurse should remain with and monitor the client's vital signs during the first 15 minutes of administration of the blood product and then follow the institution's protocol to monitor for a transfusion reaction or fluid overload. Vital signs must be taken immediately before the blood product infusion is begun for accurate future comparisons.
A nurse assesses a client who had a gastric resection. During the first 24 hours after surgery, what symptom should the nurse expect to identify?
Bloody nasogastric drainage Drainage is bright red initially and gradually becomes darker red during the first 24 hours. If the nasogastric tube is functioning correctly, secretions will be removed and vomiting will not occur. If the nasogastric tube is functioning correctly, gastric distention will not occur. Because the bowel was emptied before surgery and the client is now nothing by mouth, intestinal activity is not expected.
A client with anorexia nervosa is admitted to the critical care unit following a period of prolonged starvation. What signs or symptoms indicate to the nurse that the client may have hypokalemia? Select all that apply.
Correct1 Muscle weakness Correct3 Cardiac dysrhythmias Potassium is a component of the sodium-potassium pump that is essential for cellular functioning, especially muscle contraction; a deficiency of either potassium or sodium results in weakness. Potassium is important for muscle contraction; the heart is a muscle, and hypokalemia causes dysrhythmias. Decreased functioning of respiratory muscles may result in respiratory acidosis, not metabolic alkalosis. A serum potassium level of 5.5 mEq/L (5.5 mmol/L) is within the upper range of normal. A low respiratory rate, not a rapid one, would be expected because of the weakened respiratory muscles.
A nurse is caring for a 3-week-old infant with hypertrophic pyloric stenosis who is severely dehydrated. What finding does the nurse expect when assessing the infant?
Depressed fontanels related to decreased cerebral spinal fluid are a classic sign of fluid volume deficiency in infants. A 5% weight loss indicates mild dehydration; a severely dehydrated infant will have a 15% weight deficit. Dehydration is unrelated to allergic reactions. This specific gravity is within the expected limits of 1.005 to 1.020.
A nurse is caring for a client who is receiving an intravenous (IV) infusion. What should the nurse do first if the IV infusion infiltrates?
Discontinue the infusion When an IV infusion infiltrates, it should be removed to prevent edema and pain. Elevation does not change the position of the IV cannula; the infusion must be discontinued. Flushing the tubing will add to the infiltration of fluid. Soaks may be applied, if prescribed, after the IV cannula is removed.
A nurse identifies signs of electrolyte depletion in a client with heart failure who is receiving bumetanide and digoxin. What does the nurse determine is the cause of the depletion?
Diuretic therapy Diuretic therapy that affects the loop of Henle generally involves the use of drugs (e.g., bumetanide) that directly or indirectly increase urinary sodium, chloride, and potassium excretion. Sodium restriction does not necessarily accompany administration of bumetanide. Dyspnea does not directly result in a depletion of electrolytes. Unless otherwise prescribed, oral intake is unaffected.
A nurse is caring for a postoperative client who has a nasogastric (NG) tube set to low intermittent suction. The nurse recalls that the primary reason that an intravenous infusion of 5% dextrose with 0.45% sodium chloride and 20 mEq of potassium has been prescribed is to prevent which complication?
Electrolyte imbalance When clients do not receive nutrients or fluids by mouth and have loss of electrolytes through the removal of gastric secretions via an NG tube, then electrolyte imbalance is a primary concern. Constipation is usually not a concern in this type of situation. Although dehydration is a possible effect of an NG tube removing gastric secretions and fluid, electrolyte balance is still the priority. An NG tube set to low intermittent suction usually relieves nausea and vomiting.
The laboratory reports of a client reveal that the serum creatinine value is 7 mg/dL (618.8 mmol/L) and the blood urea nitrogen (BUN) value is 240 mg/dL (85.68 mmol/L). Which integumentary manifestations can be noticed in this client? Select all that apply.
Elevated serum creatinine and BUN levels indicate chronic kidney disease, the integumentary manifestations of which include pruritus, ecchymosis, uremic frost, decreased skin turgor, yellow-gray pallor, dry skin, purpura, and soft-tissue calcifications. Clubbing is the integumentary manifestation of heart and lung diseases from chronic hypoxia. Cyanosis is the manifestation of decreased peripheral circulation and deoxygenated blood.
The nurse is developing a postprocedure plan of care for a client with a continuous bladder irrigation after a transurethral vaporization of the prostate. What should the nurse include in the plan?
Exclude the amount of irrigant instilled from the output. The amount of irrigant instilled into the bladder must be deducted from the total output to determine the amount of urine produced. The client will have an indwelling catheter, and hourly measurements are not possible because the irrigant is mixing with the urine. Abnormal specific gravity values are not associated with this procedure and would be inaccurate because the irrigant is mixing with the urine. Because the bladder is being irrigated continuously no additional irrigations are needed.
A client is admitted to the hospital with a potential diagnosis of excess antidiuretic hormone. Which clinical indicator should the nurse identify when assessing this client?
Hyponatremia Antidiuretic hormone (ADH) causes increased resorption of water by renal tubules, which dilutes sodium levels, causing hyponatremia. ADH will decrease urine volume. ADH causes fluid retention. ADH does not alter glucose metabolism.
Which parts of the nephron are the sites for the regulation of water balance? Select all that apply.
Loop of Henle Descending limb (DL A loop of Henle is a part of a nephron that continues from the proximal convoluted tubule (PCT). It is permeable to water, sodium chloride, and urea and is a site for the regulation of water balance. The descending limb (DL) continues from the loop of Henle. It is permeable to water, sodium chloride, and urea and is a site for the regulation of water balance. The glomerulus is a site of glomerular filtration. The Bowman capsule (BC) is a site of the collection of glomerular filtrate. The proximal convoluted tubule (PCT) is a site for the reabsorption of sodium, chloride, glucose, water, amino acids, potassium, and calcium.
The nurse manager of the infection control service is teaching a class for nurses on the care of young children with viral infection-related diarrhea. What therapy should the nurse manager recommend?
Oral rehydration therapy (ORT) is important because the percentage of fluid to body mass is higher in young children than adults, and fluid and electrolyte imbalance with shock can occur quickly. The BRAT diet (bananas, rice, applesauce, and tea/toast) is no longer recommended. ORT and a regular diet should be encouraged. There are no antiviral agents for the treatment of viral infection-related diarrhea. Antidiarrheal agents, such as Kaopectate or Imodium, may be harmful because they slow the course of the disease by retaining the virus-containing stool in the intestine.
A nurse must establish and maintain an airway in a client who has experienced a near-drowning in the ocean. For which potential danger should the nurse assess the client?
Pulmonary edema Additional fluid from surrounding tissues will be drawn into the lung because of the high osmotic pressure exerted by the salt content of the aspirated ocean water; this results in pulmonary edema. Hypoxia and acidosis may occur after a near-drowning, not alkalosis. Renal failure is not a sequela of near-drowning. Hypovolemia occurs because fluid is drawn into the lungs by the hypertonic saltwater.
Which assessment finding is characteristic of a client with hypoparathyroidism?
Serum phosphorus of 5 mg/dL (1.61 mmol/L); serum magnesium of 0.9 mEq/L (0.9 mmol/L Hypoparathyroidism is manifested by increased serum phosphorus and decreased serum magnesium concentration. The normal level of serum phosphorus ranges from 3 to 4.5 mg/dL (0.97-1.45 mmol/L) and the normal serum magnesium level ranges from 1.3 to 2.1 mEq/L (1.3-2.1 mmol/L). A serum phosphorus concentration of 5 mg/dL (1.61 mmol/L) and a serum magnesium of 0.9 mEq/L (0.9 mmol/L) indicate hypoparathyroidism. Serum phosphorus levels of 3 and 4 are normal, while 2 mg is low (typical in hyperparathyroidism). Serum magnesium levels of 2.4, 3.3, and 4.1 are elevated levels associated with hyperparathyroidism.
A client has a paracentesis, and the healthcare provider removes 1500 mL of fluid. To monitor for a serious postprocedure complication, what should the nurse assess for?
Tachycardia Fluid may shift from the intravascular space to the abdomen as fluid is removed, leading to hypovolemia and compensatory tachycardia. Dry mouth may occur with dehydration, but it is not as vital or immediate as signs of shock. Dry mouth is a subjective symptom that cannot be measured objectively. The fluid shift can cause hypovolemia with resulting hypotension, not hypertension. A paracentesis decreases the degree of abdominal distention.
The nurse assesses a client for orthostatic hypotension. The results are: Lying heart rate = 70 beats/minute, BP = 110/70; Sitting heart rate = 78 beats/minute, BP = 106/66; Standing heart rate = 85 beats/minute, BP = 100/64. The nurse would expect which prescription from the primary healthcare provider?
The assessment findings do not indicate postural hypotension (decrease of more than 20 mm Hg of systolic pressure or more than 10 mm Hg of the diastolic pressure). There is no indication from the data that a prescription change is needed for this client. Increasing the furosemide or giving intravenous fluid to this client could result in a fluid imbalance.
A nurse notes that an infant with a diagnosis of failure to thrive who has been receiving tube feedings for 3 days has very dry skin and mucous membranes. The nurse verifies that all feedings have been retained, but the daily urine output is consistently 250 mL, and the infant has lost weight. What does the nurse conclude?
The infant is dehydrated, and the fluid intake needs to be increased. These are classic signs of dehydration; the healthcare provider should be notified because a prescription to increase fluids is needed. It is not common for the condition of an infant with failure to thrive to continue to deteriorate once therapy has been implemented. Although the infant may have a gastrointestinal problem, the classic signs of dehydration must be addressed before this conclusion is reached. These signs indicate dehydration, not undernutrition.
The blood urea nitrogen (BUN)/creatinine ratio of a client is 3. Which condition does the nurse suspect in the client?
The normal range of the blood urea nitrogen (BUN)/creatinine ratio is from 6 to 25. A decrease in the BUN/creatinine ratio indicates fluid volume excess. An increase in the BUN/creatinine ratio indicates obstructive uropathy. A decrease in the levels of blood urea nitrogen (BUN) indicates severe hepatic damage. An increase in the levels of blood urea nitrogen (BUN) indicates gastrointestinal (GI) bleeding.
A client with the diagnosis of bulimia nervosa, purging type, is admitted to the mental health unit after an acute episode of bingeing. Which clinical manifestation is most important for the nurse to assess?
The nurse should be alert for dehydration caused by fluid loss through vomiting in the binge-purge cycle. Weight gain is not expected because purging frequently follows a binge. Hyperactivity is not expected because many individuals with bulimia withdraw and vomit after a binge. Hyperglycemia is not expected because of the vomiting that follows a binge.
A client's serum albumin value is 2.8 g/dL (28 g/L). Which food selected by the client indicates that the nurse's dietary teaching is successful?
Turkey is high in protein; the client needs high protein intake. This client's serum albumin value indicates severe depletion of visceral protein stores; the expected range for serum albumin is 3.5 to 5.0 g/dL (35 to 50 g/L). Beef broth, fruit salad, and spinach salad do not contain as much protein as meat.
A nurse is evaluating a client's response to fluid replacement therapy. Which clinical finding indicates successful replacement?
Urinary output of 30 mL in an hour A urinary output rate of 30 mL/hour is considered adequate for perfusion of the kidneys, heart, and brain. A central venous pressure reading of 1.5 mm Hg indicates hypovolemia. A baseline pulse rate of 120 beats/min that decreases to 110 beats/min within a 15-minute period and a baseline blood pressure of 50/30 mm Hg that increases to 70/40 mm Hg within a 30-minute period indicate improvement but not necessarily adequate tissue perfusion.
A nurse is caring for an infant with gastroenteritis and diarrhea. What should the nurse evaluate to determine the magnitude of the infant's fluid loss?
Weight compared with prior weight Loss of weight is the most accurate measurement of the magnitude of fluid loss; 1 L of fluid weighs 2.2 lb. Tissue turgor is subjective measure of dehydration and not as accurate as a comparison with the pre-illness weight. Although an increased hematocrit and dry mucous membranes each indicate dehydration, neither is an effective tool for assessing the amount of fluid loss.
A student nurse is caring for a client with chronic kidney failure who is to be treated with continuous ambulatory peritoneal dialysis (CAPD). Which statement by the student nurse indicates to the primary nurse that the student nurse understands the purpose of this therapy?
"It uses the peritoneum as a semipermeable membrane to clear toxins by osmosis and diffusion." Diffusion [1] [2] moves particles from an area of greater concentration to an area of lesser concentration; osmosis moves fluid from an area of lesser to an area of greater concentration of particles, thereby removing waste products into the dialysate, which is then drained from the abdomen. The principle of ultrafiltration involves a pressure gradient, which is associated with hemodialysis, not peritoneal dialysis. Peritoneal dialysis uses the peritoneal membrane to indirectly cleanse the blood. Dialysate does not clear toxins in a short time; exchanges may occur four or five times a day.
The nurse is caring for a client scheduled to have a percutaneous liver biopsy. Which assessment findings warrant the postponement of the procedure? Select all that apply.
Correct2 Marked ascites Correct4 Hemoglobin of less than 9 g/dL (90 mmol/L) To do a liver biopsy when a client has marked ascites increases the risk of leakage of ascitic fluid. The liver biopsy should be postponed. A client with a hemoglobin of less than 9 g/dL (90 mmol/L) should not have a liver biopsy because the client cannot take the risk of the puncture of a hepatic blood vessel. Hemosiderosis is not a reason to postpone a liver biopsy, because it is done to detect the presence of hemosiderin. A diagnosis of hepatic cirrhosis is not a reason to postpone a liver biopsy, because it is done to detect the presence of hepatic cirrhosis. Although a platelet count of 150,000/mm3 (150 × 109/L) is within the low range of the expected platelet count for an adult, a liver biopsy is not contraindicated. A count of less than 50,000/mm3 (50 × 109/L) is critical and requires postponement of the test.
A client with hyperthyroidism is to receive potassium iodide solution before a subtotal thyroidectomy is performed. What action does the nurse include when providing teaching about this drug?
Decreases the size and vascularity of the thyroid gland Potassium iodide aids in decreasing the size and vascularity of the thyroid gland, which limits the risk of hemorrhage when surgery is performed; it should be given no longer than 10 to 14 days before surgery because its effect is temporary. Thyroid hormone substitutes regulate the body's metabolism. Maintaining the function of the parathyroids is not the therapeutic action of potassium iodine. The parathyroid glands help regulate adequate levels of calcium in the blood. When hypocalcemia occurs, the parathyroid glands increase the absorption of calcium from urine and the intestine and stimulate the breakdown of bone matrix, increasing the release of calcium from bone. Antithyroid drugs, not iodine, prevent the formation of thyroxine.
A client is admitted to the hospital with urinary retention, and an indwelling urinary catheter is prescribed by the primary healthcare provider. What should the nurse do to help prevent the client from developing a urinary tract infection?
Promoting hydration maintains urine production that flushes the bladder, thereby preventing urinary stasis and possible infection. Although assessing urine specific gravity may help identify a urinary tract infection, it will not prevent it. Although collecting a weekly urine specimen for culture and sensitivity may help identify a urinary tract infection, it will not prevent it. The collection bag is emptied once every shift unless the bag is full and needs to be emptied sooner.
A dehydrated older adult is admitted to the hospital from a nursing home. The transfer form documents a history of liquid fecal incontinence. Which intervention by the nurse promotes identification of the cause of this incontinence?
Fecal impaction is the primary cause of liquid fecal incontinence. A digital rectal examination will determine the presence of a fecal impaction. Abdominal percussion will not assist in the diagnosis of impaction. Urine culture and sensitivity test will identify urinary tract infection; urinary, not fecal, incontinence is associated with urinary tract infection. Pelvic and abdominal ultrasound might be done if earlier assessments are inconclusive and additional evaluations are required.
A client with a history of heart failure on daily weights has a 2-pound (0.9 kilogram) weight gain and pitting edema in lower extremities bilaterally. Which action should the nurse take next?
Perform a head-to-toe assessment, including vital signs. Performing a head-to-toe assessment, including vital signs, would indicate symptoms, such as jugular distention with right-sided heart failure, or pulmonary issues (crackles) associated with left-sided heart failure. Checking the record for code status is not a priority and should have been established and known on an elderly client. Increasing intake will make the problem of fluid retention worse. Continuing to monitor daily weights without an assessment may miss worsening symptoms.
A client with osteomyelitis is receiving antibiotic therapy via a central line. Trough blood levels were obtained immediately before a prescribed dose of antibiotics, and peak levels were obtained 30 minutes after the infusion was completed. The laboratory results reveal that the trough level is higher than the peak level. What does the nurse conclude that this finding probably indicates?
There was a problem with the obtaining of blood specimens. Peak levels will always be higher than trough levels; therefore this result indicates some mix-up in the drawn samples. Increasing the dose would be an appropriate action if the trough level were too low. Concluding that the dose in excess of the client's needs would be appropriate if the trough level were too high, but not exceeding the peak. There is not enough information to determine whether the antibiotic administered is adequate.
A client is receiving furosemide to relieve edema. The nurse will monitor the client for which responses? Select all that apply.
Weight loss Correct4 Excessive loss of potassium ions Each liter of fluid weighs 2.2 pounds (1 kilogram). Assessing weight loss is an objective measure of the effectiveness of the drug. Furosemide is a potent diuretic that is used to provide rapid diuresis in clients with pulmonary edema; it acts in the loop of Henle and causes depletion of electrolytes, such as potassium and sodium. A negative nitrogen balance drug does not affect protein metabolism. With increased fluid loss, the specific gravity is likely to be lowered. Furosemide inhibits the reabsorption of sodium.