Fluid and electrolyte prepU
A client with marked oliguria is ordered a test dose of 0.2 g/kg of 15% mannitol solution intravenously over 5 minutes. The client weighs 132 lb (60 kg). How many grams would the nurse administer? Record your answer as a whole number.
12
A nurse is administering I.V. fluids to an infant. Infants receiving I.V. therapy are particularly vulnerable to:
Fluid overload
A client prescribed propranolol calls the clinic to report a weight gain of 3 lb (1.36 kg) within 2 days, shortness of breath, and swollen ankles. What is the nurse's best action?
Have the client come to the clinic in order to assess the lungs.
A nurse is caring for a client who had a thyroidectomy and is at risk for hypocalcemia. What should the nurse do?
Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes.
The nurse is conducting a postoperative assessment of a client on the first day after renal surgery. The nurse should report which finding to the health care provider (HCP)?
Urine output, 20 mL/hr
Which client is most likely to exhibit dehydration?
an 8-month-old infant with persistent diarrhea for 24 hours
A client is in hypovolemic shock. To determine the effectiveness of fluid replacement therapy, the nurse should monitor the client's
heart rate.
Which finding is a risk factor for hypovolemic shock?
hemorrhage
A nurse is caring for a client with multiple myeloma. Which laboratory value is the nurse most likely to see?
hypercalcemia
A client is admitted with acute pancreatitis. The nurse should monitor which laboratory values?
increased serum amylase and lipase levels
When caring for the neonate of a mother with gestational diabetes, which finding is most indicative of a hypoglycemic episode?
jitterness
A nurse administers furosemide to treat a client with heart failure. Which adverse effect must the nurse watch for most carefully?
low serum potassium level
What finding indicates that a child is receiving too much IV fluid too rapidly?
moist crackles in the lung fields
A client who has been taking furosemide has a serum potassium level of 3.2 mEq/L. Which assessment findings by the nurse would confirm an electrolyte imbalance?
muscle weakness and a weak, irregular pulse
A nurse is caring for a 12-month-old infant with dehydration with resulting metabolic acidosis. The infant exhibits lethargy and poor skin turgor. Which action by the nurse takes priority?
obtaining a patent intravenous site
A client with Addison's disease comes to the clinic for a follow-up visit. When assessing this client, the nurse should stay alert for signs and symptoms of
sodium and chloride abnormalities.
A client has been admitted with severe burns. Lactated Ringer's has been ordered to infuse via a pump. Why is this solution being used?
to prevent signs of hypovolemic shock and restore circulation
A client with heart failure is given a prescription for torsemide. Two days after the drug therapy is started, which sign indicates the drug is having the intended outcome? The client:
weighs 7 lb (3 kg) less than the client did 2 days ago.
An initial bolus of crystalloid fluid replacement for a child in shock is 20 ml/kg. The nurse is preparing to administer how many milliliters of fluid for a child weighing 30 kg?
600 mL
A nurse is caring for a client with bulimia nervosa. Strict management of the client's dietary intake is necessary. Which intervention is the most important?
Serve the client's menu choices in a supervised area and observe the client 1 hour after each meal.
A nurse is administering 50 mEq potassium chloride (KCl) in 250 mL 0.9 normal saline (NS) intravenously piggyback (I.V.PB) to a client with hypokalemia. Which action should the nurse take?
Provide continuous cardiac monitoring during the infusion
The nurse is assessing a client who is restless and agitated, has dry mucous membranes, and has intense thirst. The nurse should assess the client further for which electrolyte imbalance?
Hypernatremia
Which type of solution raises serum osmolarity and pulls fluid and electrolytes from the intracellular and interstitial compartments into the intravascular compartment?
Hypertonic Solution
A school-age child who has received burns over 60% of his body is to receive 2,000 mL of IV fluid over the next 8 hours. At what rate (in milliliters per hour) should the nurse set the infusion pump? Record your answer as a whole number.
250 ml/hr
A child, age 4, with a recent history of nausea, vomiting, and diarrhea is admitted to the pediatric unit with a diagnosis of gastroenteritis. During the physical examination, the nurse detects tenting. This finding supports a nursing diagnosis of
deficient fluid volume related to dehydration.
A client with Addison's disease has fluid and electrolyte loss due to inadequate fluid intake and to fluid loss secondary to inadequate adrenal hormone secretion. As the client's oral intake increases, which fluids would be most appropriate?
chicken broth and juice
A nurse is reviewing a client's laboratory test results. Which electrolyte is the major cation controlling a client's extracellular fluid (ECF) osmolality?
Sodium
A client with acute renal failure has a serum potassium level of 6.5 mEq/L (6.5 mmol/L). The nurse should monitor the client for which potential complication?
cardiac arrest
A nurse is reviewing a client's fluid intake and output record. Fluid intake and urine output should relate in which way?
Fluid intake should be about equal to the urine output.
A client who is 12 hours post total thyroidectomy reports tingling around the mouth. Which assessment is the priority?
calcium level
A nurse is caring for a client in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat:
hyperkalemia.
As a representative of the treatment team, a nurse is reviewing results of diagnostic studies with the family of an adolescent with anorexia nervosa. What explanation should the nurse give the family about the client's abnormal blood urea nitrogen (BUN) value?
"The BUN is elevated because your daughter is dehydrated."
Which serum electrolytes findings should the nurse expect to find in an infant with persistent vomiting?
K+, 3.2; Cl-, 92; Na+, 120
A client presents to the emergency department, reporting that they have been vomiting every 30 to 40 minutes for the past 8 hours. Frequent vomiting puts this client at risk for which imbalances?
Metabolic alkalosis and hypokalemia
The sudden onset of which sign indicates a potentially serious complication for the client receiving an IV infusion?
Noisy respirations
A newly admitted client reports taking digoxin and warfarin. Which statement would the nurse include in the discharge instructions?
Notify your healthcare provider if you experiences visual changes.
A primigravid with severe gestational hypertension has been receiving magnesium sulfate IV for 3 hours. The latest assessment reveals deep tendon reflexes (DTR) of +1, blood pressure of 150/100 mm Hg, a pulse of 92 beats/minute, a respiratory rate of 10 breaths/minute, and a urine output of 20 ml/hour. Which action should the nurse perform next?
Stop the magnesium sulfate infusion
The nurse notes that a client with acute pancreatitis occasionally experiences muscle twitching and jerking. How should the nurse interpret the significance of these symptoms?
The client may be developing hypocalcemia.
On the third day after a partial thyroidectomy, a client exhibits muscle twitching and hyperirritability of the nervous system. When questioned, the client reports numbness and tingling of the mouth and fingertips. Suspecting a life-threatening electrolyte disturbance, the nurse notifies the surgeon immediately. Which electrolyte disturbance most commonly follows thyroid surgery?
hypocalcemia
A client has had an exacerbation of ulcerative colitis with cramping and diarrhea persisting longer than 1 week. The nurse should assess the client for which complication?
hypokalemia
A child with diabetic ketoacidosis is being treated for a blood glucose level of 738 mg/dl (41.0 mmol/L). The nurse should anticipate an order for:
normal saline with regular insulin.
A nurse is planning to administer a sodium polystyrene sulfonate enema to a client with a potassium level of 6.2 mEq/L. Correct administration and the effects of this enema should include having the client
retain the enema for 30 minutes to allow for sodium exchange; afterward, the client should have diarrhea.
A client is to receive 1,000 mL of lactated Ringer's over 10 hours. The drip factor is 15 drops (gtt)/mL. How many gtt per minute should the client receive?
25 gtt/min
The client is to receive antibiotic intravenous (IV) therapy in the home. The nurse should develop a teaching plan to ensure that the client and family can manage the IV fluid and infusion correctly and avoid complications. What should the nurse instruct the client to do? Select all that apply.
A. Report signs of redness or inflammation at the siteD. Cleanse the port with alcohol.E. Call the health care provider for a temperature above 100 degrees F (37.8 degrees C).
The nurse is caring for a client with polydipsia and large amounts of urine with a specific gravity of 1.003. Which disorder is anticipated?
diabetes insipidus
A client is brought to the emergency department with abdominal trauma following an automobile accident. The vital signs are heart rate, 132 bpm; respirations, 28 breaths/min; blood pressure, 84/58 mm Hg; temperature, 97.0° F (36.1° C); oxygen saturation 89% on room air. Which prescription should the nurse implement first?
Administer 1 liter 0.9% saline IV.
A client is admitted with a diagnosis of viral gastroenteritis. The client has an elevated blood urea nitrogen and creatinine and is oliguric with a blood pressure of 74/30 mmHg. Which order from the healthcare provider should the nurse carry out first?
Administer intravenous fluids.
A client is diagnosed with left-sided heart failure. Which treatment should the nurse anticipate being prescribed to reduce this client's excess fluid?
diuretics
When administering IV replacement of 5% dextrose in water with potassium chloride, what should the nurse do first?
evaluating laboratory results for electrolytes
A client with cirrhosis begins to develop ascites. Spironolactone is prescribed to treat the ascites. The nurse should monitor the client closely for which drug-related adverse effect?
hyperkalemia
A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should anticipate which laboratory test result?
serum sodium level of 124 mEq/L
A physician orders a loop diuretic for a client. When administering this drug, the nurse anticipates that the client may develop which electrolyte imbalance?
hypokalemia
The nurse is reviewing the serum electrolyte levels of a client with heart failure who has been taking digoxin for 6 months. The nurse should report which finding from the lab report to the health care provider?
hypokalemia
