vSim: Fundamentals Scenario Rashid Ahmed
What information should be included when documenting a change in the infusion rate of an IV solution? (Select all that apply.)
- Change made to flow rate - Date and time change was made - Nurse's initials - Patient's response to IV therapy
What pathology is responsible for metabolic acidosis?
A decrease in bicarbonate or an increase in hydrogen icons
Which diagnostic test serves as the basis for determining acid-base imbalances?
Arterial blood gas (ABG)
Which statement by Mr. Ahmed best reflects his ability to assume some responsibility in tracking his urinary output?
I will always use the calibrated urinal to measure my urine.
Considering Mr. Ahmed's diagnosis of dehydration and the possibility of neurological impairment, which nursing intervention is directed toward minimizing his risk for possible injury?
Implementing falls precaution
What information will the nurse provide to a patient to best assure minimizing the risk of side effects associated with sulfamethoxazole-trimethoprim therapy?
Increase fluid intake in order to remain well hydrated.
Reduced skin turgor is characteristically altered among which population?
Older adults
Which physical finding poses the greatest safety risk for a patient diagnosed with hyponatremia?
Orthostatic hypotension
Hypokalemia is confirmed by what serum blood result?
Potassium 3.0 mEq/L
In preparation for calculating the infusion rate for a newly ordered intravenous (IV) solution, the nurse must first secure what information?
The infusion set's drop factor
What determines the acidity of a substance like body fluids?
The number of existing H+ ions
Which statement by the nurse indicates a need for further education on the role of water as a body fluid?
Water is transported to cells when it is attached to electrolytes.
Calculate the IV infusion rate using the following provider's order: 1000 mL of NS over 8 hours. Infusion set has a drop rate of 10 drops/mL.
21 drops / minute
In addition to regular monitoring of serum potassium level, which intervention will the nurse implement to address the safety needs of a patient prescribed intravenous potassium chloride?
Securing electrocardiograms (ECG) regularly
Hyponatremia is associated with a decrease of which electrolyte?
Sodium
Which of Mr. Ahmed's lab results best supports his diagnosis of dehydration?
Sodium: 130 mEq/L
Which statement concerning fluid balance demonstrates a need for additional instruction concerning fluid intake and output?
The balance between fluid intake and output must be achieved each day to maintain homeostasis.
Which statement concerning the measurement of intake and output is true?
When possible, intake and output should be measured rather than estimated.
What is the initial step in assessing a patient for orthostatic hypotension?
After having the patient lie in a supine position for three to10 minutes, take and record blood pressure and pulse.