Adaptive Quiz 6 Study: Fluid and Electrolytes
Which serum laboratory values in a client with urinary problems may indicate the risk of developing muscle weakness and cardiac arrhythmias? Calcium of 9.5 mg/dL (2.375 mmol/L) Potassium of 7.02 mEq/L (7.02 mmol/L) Bicarbonate of 22.8 mEq/L (22.8 mmol/L) Phosphorus of 4.1 mg/dL (1.3243 mmol/L)
Potassium of 7.02 mEq/L (7.02 mmol/L) The normal level of serum potassium is between 3.5-5.0 mEq/L (3.5 and 5.0 mmol/L). Elevated potassium levels greater than 6 mEq/L (mmol/L) can lead to muscle weakness and cardiac arrhythmias. The normal levels of serum phosphorus are between 2.4-4.4 mg/dL (0.78 and 1.42 mmol/L). The normal levels of serum calcium are usually between 8.6-10.2 mg/dL (2.15 and 2.55 mmol/L). The normal level of serum bicarbonate is between 22 and 26 mEq/L or mmol/L. These findings are not associated with the risk of developing muscle weakness and cardiac arrhythmias.
The laboratory reports of a client reveal serum calcium levels of 8.1 mg/dL (.45 mmol/L). What is the order of events that occur in this client to correct the serum calcium levels?
1. Increase of parathyroid hormone (PTH) 2. Stimulation of osteoclastic activity 3. Release of calcium into the blood 4. Elevation of serum calcium levels When serum calcium levels are lowered, parathyroid hormone secretion increases and stimulates bones to promote osteoclastic activity. This activity releases calcium into the blood. PTH then reduces the renal excretion of calcium and facilitates the mineral's absorption from the intestines.
Which electrolyte deficiency triggers the secretion of renin? Sodium Calcium Chloride Potassium
Sodium Low sodium ion concentration causes decreased blood volume, thereby resulting in decreased perfusion. Decreased blood volume triggers the release of renin from the juxtaglomerular cells. Deficiencies of calcium, chloride, and potassium do not stimulate the secretion of renin.
The client is receiving high-flow intravenous (IV) fluid replacement therapy. Which nursing assessment findings are consistent with fluid volume overload? Select all that apply. Pulse quality Pulse pressure Bounding pulse Presence of dependent edema Neck vein distention in the upright position
Bounding pulse Presence of dependent edema Neck vein distention in the upright position Bounding pulse, presence of dependent edema, and neck vein distention in the upright position are all indicators of fluid overload, which should be reported by the nurse. Pulse quality and pulse pressure are indicators to monitor the client's response to fluid therapy.
The nurse is preparing a blood transfusion for a client with renal failure. Why does anemia often complicate renal failure? increase in blood pressure Decrease in erythropoietin Increase in serum phosphate levels Decrease in serum sodium concentration
Decrease in erythropoietin The hormone erythropoietin, produced by the kidneys, stimulates the bone marrow to produce red blood cells. In renal failure there is a deficiency of erythropoietin that often results in the client developing anemia. Therefore the nurse is instructed to administer blood. In renal failure, increased blood pressure is due to impairment of renal vasodilator factors and is not treated by administration of blood. Phosphate is retained in the body during renal failure, causing binding of calcium leading to done demineralization, not anemia. Increase in urinary sodium concentration and decrease in serum sodium concentration trigger the release of renin from the juxtaglomerular cells.
A client has non-pitting edema over the tibia. What could be the most possible cause of the client's condition? Endocrine imbalance Inflammatory response Fluid and electrolyte imbalance Venous and cardiac insufficiency
Endocrine imbalance Non-pitting edema occurs due to endocrine imbalance. Inflammatory response causes localized edema. Pitting edema occurs due to fluid and electrolyte imbalance and venous and cardiac insufficiency.
A client on antidepressant therapy develops hyponatremia. Which drug may be responsible for the client's electrolyte imbalance? Phenelzine Paroxetine Imipramine Amitriptyline
Paroxetine Paroxetine is a selective serotonin reuptake inhibitor; side effects include hyponatremia. Phenelzine is a monoamine oxidase inhibitor; side effects include orthostatic hypotension. Imipramine and amitriptyline are tricyclic antidepressants; side effects associated with these drugs include dry mouth and blurred vision.
The nurse is providing postoperative care to a kidney transplant recipient. What is the nurse's first priority during this period? Teaching signs of rejection to the client Maintaining fluid and electrolyte balance Providing emotional support to the recipient Advising the client to have frequent blood testing
Maintaining fluid and electrolyte balance The first priority while providing postoperative care for a kidney transplant recipient is maintaining fluid and electrolyte balance. The client is taught signs of rejection during the stay and when planning to discharge. Emotional support is provided to the donor and the recipient. The client is advised to have frequent blood tests after discharge.
A nurse is teaching about the function of the loop of Henle. Which function should the nurse include? Secretion of ammonia in the descending limb Secretion of hydrogen in the descending limb Reabsorption of sodium in the ascending limb Reabsorption of water in the ascending limb
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.
Which electrolyte concentration has the potential to precipitate dysrhythmias and cardiac arrest in a client? Serum sodium of 139 mEq/L (139 mmol/L) Serum chloride of 100 mEq/L (100 mmol/L) Serum calcium of 10.2 mg/dL (2.55 mmol/L) Serum potassium of 7.2 mEq/L (7.2 mmol/L)
Serum potassium of 7.2 mEq/L (7.2 mmol/L) Hyperkalemia causes dysrhythmias and cardiac arrest. The normal serum potassium concentration ranges between 3.5 and 5.0 mEq/L (3.5-5.0 mmol/L). A concentration of 7.2 mEq/L (7.2 mmol/L) indicates hyperkalemia. The normal concentration of sodium in the serum ranges between 135 and 145 mEq/L (135-145 mmol/L). The normal chloride concentration ranges between 96 and 106 mEq/L (96-106 mmol/L). The normal serum calcium level ranges between 9 and 10.5 mg/dL (2.25-2.625 mmol/L).