Nurse 130 Final review
hyponatremia occurs due to
imbalance of water
A client is to receive hypotonic IV solution in order to provide free water replacement. Which solution does the nurse anticipate administering?
0.45% NaCl
Which solution is hypotonic?
0.45% NaCl
what is the normal range of urine specific gravity?
1.010-1.025
What is the average daily urinary output in an adult?
1.5L
Below which serum sodium concentration might convulsions or coma occur?
135 mEq/L (135 mmol/L)
IV magnesium sulfate must be administrated by an infusion pump not to exceed the rate of
150mg/min over 8 hours
What are normal serum potassium levels
3.5-5 mEq/L
Which is the most common cause of symptomatic hypomagnesemia?
Alcoholism
To evaluate a client for hypoxia, the physician is most likely to order which laboratory test?
Arterial blood gas (ABG) analysis
A patient complains of tingling in the fingers as well as feeling depressed. The nurse assesses positive Trousseau's and Chvostek's signs. Which decreased laboratory results does the nurse observe when the patient's laboratory work has returned?
Calcium
Air embolism is a potential complication of IV therapy. The nurse should be alert to which clinical manifestation associated with air embolism?
Chest pain
Calcium should be diluted in
D5W
What is a major indicator of extracellular FVD?
Drop in postural blood pressure
What foods can the nurse recommend for the patient with hypokalemia?
Fruits such as bananas and apricots
A patient with a diagnosis of colon cancer has undergone a bowel resection with the creation of an ileostomy. The patient's ileostomy output has been unexpectedly high in the 2 days since surgery, and the patient's most recent blood work indicates a K+ level of 2.7 mEq/L. This potassium level should prompt the nurse to assess for which of the following physical manifestations?
Fatigue, cramps, and weakness
potassium is never administered by
IV push or IM
The nurse is assessing residents at a summer picnic at the nursing facility. The nurse expresses concern due to the high heat and humidity of the day. Although the facility is offering the residents plenty of fluids for fluid maintenance, the nurse is most concerned about which?
Insensible fluid loss
A client has been diagnosed with an intestinal obstruction and has a nasogastric tube set to low continuous suction. Which acid-base disturbance is this client at risk for developing?
Metabolic alkalosis
A client with pancreatic cancer has the following blood chemistry profile: Glucose, fasting: 204 mg/dl; blood urea nitrogen (BUN): 12 mg/dl; Creatinine: 0.9 mg/dl; Sodium: 136 mEq/L; Potassium: 2.2 mEq/L; Chloride: 99 mEq/L; CO2: 33 mEq/L. Which result should the nurse identify as critical and report immediately?
Potassium
Which electrolyte is a major cation in body fluid?
Potassium
A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Laboratory results reveal serum sodium level 130 mEq/L and urine specific gravity 1.030. Which nursing intervention helps prevent complications associated with SIADH?
Restricting fluids to 800 ml/day
if the pH is greater than 7.4 then its
alkalosis
Hypokalemia may occur in patients with normal potassium store when
alkalosis is present
Treatment of FVE involves dietary restriction of sodium. Which of the following food choices would be part of a low-sodium diet, mild restriction (2 to 3 g/day)?
Three ounces of light or dark meat chicken, 1 cup of spaghetti and a garden salad
A patient is diagnosed with hypocalcemia. The nurse advises the patient and his family to immediately report the most characteristic manifestation. What is the most characteristic manifestation?
Tingling or twitching sensation in the fingers
Fluid volume excess (FVE), hypervolemia, is caused by
abnormal retention of water and sodium
When arterial pH decreases this is considered
acidosis
if the pH is less than 7.4 then its
acidosis
When arterial pH increases this is considered
alkalosis
Too rapid IV administration of calcium can cause
cardiac arrest preceded by bradycardia
When administrating fluids to patients with cardiovascular disease the nurse should assess for signs of
circulatory overload
respiratory acidosis is when
decrease in pH, increase or normal HCO3-, increase PaCO2 compensation increase renal aicd excretion increase PaCO3 and increase serum HCO3-
respiratory alkalosis is when
decrease in renal acid excretion decrease PaCo2 and decrease serum HCO3
hyponatremia
decrease osmolality, serum level less than 135 mEq/L
metabolic acidosis is when
decreased pH, decrease HCO3-, decrease or normal PaCO3 compensation hyperventilation with resulting decrease PaCO2 and decreased HCO3
A client is taking spironolactone (Aldactone) to control her hypertension. Her serum potassium level is 6 mEq/L. For this client, the nurse's priority should be to assess her:
electrocardiogram (ECG) results
T/F Osmosis is the movement of a substance from an area of higher concentration to one of lower concentration
false
diffusion
high concentration to low concentration
filtration is a type of passive transport that results from
hydrostatic pressure
hypernatremia
increase osmolality, serum level greater than 145 mEq/L
Metabolic alkalosis is when
increase pH, increase HCO3-, increase or normal PaCO3 compensation hypoventilation with resulting increase PaCO3, increase HCO3
Trousseau sign can be elicited by
inflating a blood pressure cuff on the upper arm, carpal spasm will occur
What are the organs of fluid loss?
kidney, skin, lungs, GI tract
Fluid volume deficit (FVD), hypovolemia, results from
loss of body fluid and decreased fluid intake
Osmosis
low concentration to high concentration
if the pH is equal to 7.4 then its
normal
Normal ranges for arterial blood gases
pH 7.35-7.45 PaCO3 35-45 mm Hg HCO3- 22-26 mEq/L
When evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis?
pH 7.48
Which set of arterial blood gas (ABG) results requires further investigation?
pH 7.49, PaCO2 30 mm Hg, PaO2 89 mm Hg, and HCO3- 18 mEq/L
When fluid balance is critical all routes of systemic gain and loss must be
recorded and all volumes compared
metabolic acidosis is most commonly due to
renal failure
potassium supplements are extremely dangerous for patients who have impaired
renal function
Urinary potassium excretion excedding 20mEq/day with hypokalemia suggest
renal potassium loss
oral potassium supplements can produce
small bowel lesions
filtration
the movement of water from a high hydrostatic pressure to low hydrostatic pressure
A client has been admitted to the hospital unit with signs and symptoms of hypovolemia; however, the client has not lost weight. The client exhibits a localized enlargement of her abdomen. What condition could the client be presenting?
third-spacing
T/F A highly hypertonic sodium solution should be administrated slowly
true
T/F A patient may have a total body calcium deficit such as osteoporosis, but a normal serum level
true
T/F The ECG change that is specific to hyperkalemia is a peaked T wave?
true
Chvostek sign consist of
twitching of muscles enervated by the facial nerve when region is tapped
