Unit 13: Nursing Support of Fluid, Electrolyte, & Acid-Base Balance

The student nurse asks the instructor how buffer systems work in the body to maintain the pH of the blood. The instructor explains the buffer systems to the students. Which buffer systems will be discussed by the instructor? Select all that apply.

Carbonic acid-sodium bicarbonate buffer system, is used by the body to maintain acid-base balance. Phosphate buffer system, is used by the body to maintain acid-base balance. The protein buffer system is used by the body to maintain acid-base balance. Potassium and respiratory are not buffer systems. Potassium and respiratory are not buffer systems.

The nurse is providing care to a client who has a serum potassium level of 5.2 mEq/L. Which findings would the nurse expect to assess? Select all that apply.

Cardiac dysrhythmia Diarrhea The client's potassium level suggests hyperkalemia, which is manifested by gastrointestinal hyperactivity (diarrhea and intestinal cramping). The client's potassium level suggests hyperkalemia, which is manifested by tall, peaked T waves on electrocardiogram; and cardiac dysrhythmias. Muscle weakness would be noted with hypokalemia. Polyuria would be noted with hypokalemia. Polydipsia would be noted with hypokalemia.

The term Electrolytes can be described as water moving from an area of lower solute concentration to an area of higher solute concentration.

False - Osmosis is the primary method of transporting body fluids, in which water moves from an area of lesser solute concentration and more water to an area of greater solute concentration and less water. Osmosis is the primary method of transporting body fluids, in which water moves from an area of lesser solute concentration and more water to an area of greater solute concentration and less water.

Which of the following are body functions with water? Select all that apply.

Help maintain normal body temperature Transport nutrients to cells and wastes from cells Act as a tissue lubricant Facilitate digestion

Match the type of access to the corresponding descriptive statement.

Implanted port - Type of long-term CVAD; which consists of a subcutaneous injection port attached to a catheter. The distal catheter tip dwells in the lower segment of the superior vena cava at or near the cavoatrial junction (CAJ), the point at which the superior vena cava meets and melds into the superior wall of the right atrium (INS, 2016b), and the proximal end or port is usually implanted in a subcutaneous pocket of the upper chest wall. Tunneled central venous catheter - Intended for long-term use, is implanted into the internal or external jugular or subclavian vein. The length of this catheter is >8 cm (approximately 90 cm, on average), depending on patient size, and is tunneled in subcutaneous tissue under the skin (usually the midchest area) for 3 to 6 in to its exit site. Midline Peripheral Catheter - Inserted peripherally into the upper arm into the basilic, cephalic, or brachial veins. Recommendations for dwell time at a particular insertion site vary from 1 to 4 weeks.

A nurse is providing care to a client who has been vomiting for the past two days. The nurse would assess this client for which imbalance? Select all that apply.

Respiratory acidosis Hypokalemia Metabolic alkalosis

Arterial blood gases reveal that a client's pH is 7.20. increased respiratory rate would be the physiologic process will contribute to a restoration of correct acid-base balance.

T/F? True

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.

The client would exhibit a reduction in skin turgor due to lack of fluids in the skin and tissues. As a result of decreased vascular volume, the client would exhibit a decreased blood pressure. As a result of decreased vascular volume, the client would exhibit a decrease in urine output. 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. The respiratory rate is not affected by dehydration unless associated with respiratory acidosis or alkalosis.

A nurse explains the homeostatic mechanisms involved in fluid homeostasis to a student nurse. Which statements accurately describe this process? Select all that apply.

The kidneys selectively retain electrolytes and water and excrete wastes and excesses according to the body's needs. The cardiovascular system is responsible for pumping and carrying nutrients and water throughout the body. The lungs regulate oxygen and carbon dioxide levels of the blood, which is especially crucial in maintaining acid-base balance. The parathyroid glands secrete parathyroid hormone, which regulates the level of calcium and phosphorus.

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. Osmosis is the primary method of transporting body fluids, in which water moves from an area of lesser solute concentration and more water to an area of greater solute concentration and less water. Osmosis is the primary method of transporting body fluids, in which water moves from an area of lesser solute concentration and more water to an area of greater solute concentration and less water.

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 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