Pathophysiology 8 Disorders of Fluid and Electrolytes

A client is admitted after losing 44 lb (20 kg) over the past 3 months, largely due to frequent vomiting. What intervention should the nurse anticipate in the treatment of the client's resulting acid-base imbalance

Fluid replacement with an intravenous solution containing electrolytes as prescribed

A client tells the nurse that the client has been taking Alka-Seltzer (bicarbonate—antacid) four times a day for the past 2 weeks for an upset stomach. Upon assessment of the client, the nurse notes hyperactive reflexes, tetany, and mental confusion. Arterial blood gases reveal pH 7.55; serum HCO3− 37 mEq/L (37 mmol/L). The nurse suspects the client may be experiencing:

Metabolic alkalosis

In which client would the nurse be most likely to assess the signs and symptoms of an acid-base imbalance

A client with chronic obstructive pulmonary disease whose most recent arterial blood gases reveal a PCO2 of 51 mm Hg

A client has been diagnosed with metabolic acidosis. What assessment finding does the nurse expect

Decreased pH below 7.35

The nurse is aware that the major role of the kidneys in regulating acid-base balance is to increase the production of which chemical component

HCO3-

The nurse is caring for a client with ketoacidosis who is complaining of increasing lethargy and occasional confusion following several weeks of rigid adherence to a carbohydrate-free diet. The nurse understands which phenomenon is most likely occurring

In the absence of carbohydrate energy sources, her body is metabolizing fat and releasing ketoacids

A client with ethylene glycol toxicity is restless, and stating he has flank pain. What intervention should the nurse perform to minimize complications

Increase IV fluids

A nurse is caring for a client with a low sodium level and increased water retention. Hematocrit and blood urea nitrogen levels are decreased, urine osmolality is high, and serum osmolality is low. A chest x-ray shows a possible lung mass. Based on these findings, which problem could the client be diagnosed with

Syndrome of inappropriate antidiuretic hormone

A client with a long history of alcohol abuse has been admitted to the emergency department after several of days of heavy drinking. The nurse can best promote the restoration of the client's acid-base balance by

administering intravenous sodium bicarbonate as prescribed

When caring for a client with hypomagnesemia, the nurse prioritizes assessment of which body system?

cardiac

respiratory alkalosis

high pH, low CO2

A nurse observes peaked, narrow T waves on the electrocardiogram of a client suffering from renal failure. The nurse suspects that the client is experiencing which condition

hyperkalemia

A client who has just completed running a marathon reports muscle weakness, cramping, and general fatigue despite drinking adequate amounts of water. The nurse suspects which type of hypotonic hyponatremia

hypovolemic

Lymph fluid arises directly from which space

interstitial

Phorsphorus

inverse relationship with calcium, normally 2.5-4.5 mg/dL, helps with bone function

respiratory acidosis

low pH, high CO2

metabolic acidosis

low pH, low HCO3

Which unit of measure best describes the concentration of solute in a particular volume of fluid based on electrolyte equivalency?

mEq/L

Magnesium

normally 1.8-3.0 mg/dL, required for metabolism, nerve conduction, and ion transport

Calcium

normally 8.5-10.5 mg/dL, necessary for all muscle contraction

Hypothalamic sensory neurons that promote thirst when stimulated are called:

osmoreceptors

Water movement from the side of the membrane having a lesser number of particles and greater concentration of water to the side having a greater number of particles and lesser concentration of water is termed:

osmosis

The nurse is caring for a client with metabolic alkalosis. Which of these arterial blood gas results supports this diagnosis?

pH of 7.50 and HCO3 of 45 mEq/L

Which intravenous solution is appropriate to treat metabolic alkalosis that resulted from gastric suctioning

potassium chloride

When caring for the client with hyperkalemia, the nurse recognizes the body should respond in which of these ways

secrete potassium in the distal tubules for excretion

Which clinical manifestation would lead the nurse to suspect a client has developed fluid volume excess

weight gain

Which intervention is a priority for the nurse when caring for a client with hypokalemia

Initiating cardiac monitoring

A female client with a history of chronic renal failure has a total serum calcium level of 7.9 mg/dL (1.98 mmol/L). While performing an assessment, the nurse should focus on which clinical manifestation associated with this calcium level

Intermittent muscle spasms and reports of numbness around her mouth

The nurse is performing an assessment for a client who is experiencing shortness of breath. The nurse notes a full and bounding pulse, crackles in the lung fields, and jugular vein distention. The nurse recognizes symptoms of which problem

Isotonic fluid volume excess

A client has these arterial blood gas values: anion gap 20 mEq/L (20 mmol/L), pH 7.29, PCO2 37 mm Hg (4.92 mmol/L), HCO3- 11 mEq/L (11 mmol/L), base excess -6 mEq/L (-6 mmol/L). With what condition do these values correspond

Lactic acidosis

Vitamin D, officially classified as a vitamin, functions as a hormone in the body. What other hormone is necessary in the body for vitamin D to work

Parathyroid hormone

The renal control mechanism of restoring the acid-base balance is accomplished through which process

Reabsorption of HCO3 and excretion of H+ restores acid-base balance through the renal control mechanisms

metabolic alkalosis

high pH, high HCO3

A client is admitted to the emergency department with possible internal bleeding after being involved in an automobile accident. What type of isotonic intravenous (IV) solution does the nurse prepare to infuse

0.9% NaCl

Body weight consists of which percentage of body water

60%

Normal pH

7.35-7.45

The nurse is caring for the following group of clients. What is a sign of respiratory alkalosis.

A 26-year-old female with anxiety who has been hyperventilating

which client is at the highest risk for developing an acid-base imbalance?

A client who is being treated for acute kidney injury and who requires dialysis

Serum phosphorus level has a reciprocal relationship with which serum electrolyte

Calcium

The nurse is caring for a client with a tumor obstructing the lymphatic system. For which consequence does the nurse assess

Fluid accumulating in the interstitial spaces distal to the tumor

Which intravenous solution would be appropriate to treat metabolic acidosis

NaHCO3

In starvation, not enough amino acids are available for protein synthesis. This decreased protein level in the blood can lead to edema of the tissues. The underlying process that explains the edema is:

decreased capillary colloidal osmotic pressure