Fluid and Electrolytes, Acid-Base
A nurse is teaching a client who had an acute kidney injury about dietary sources of potassium. Which client statement needs clarification? "I will enjoy eating cantaloupe for my morning snack" "I can easily add baked potatoes to my diet" "Eating yogurt will be a new experience" "Adding pecans will be a change I can readily make"
"Adding pecans will be a change I can readily make"
What is the normal sodium level?
135-145
What is the normal potassium level?
3.5-5.0
What is the normal calcium level?
8.5-10.5
A nurse is assessing a client who has fluid volume deficit. The nurse should expect which of the following findings? 1) Decreased urine specific gravity 2) Decreased Hgb 3) Increased BUN 4) Increased urine ketones
Increased BUN
A nurse is caring for a client who has hypernatremia and requires IV fluid therapy due to his NPO status. Which of the following solutions should the nurse prepare to infuse for this client? Lactated Ringer's Dextrose 5% in 0.9% sodium chloride 0.45% sodium chloride Dextrose 10% in water
0.45% sodium chloride
1) Increased heart rate 2) Increase blood pressure 3) Increased respiratory rate 4) Increased hematocrit 5) Increased temperature A nurse is assessing a client who has fluid overload. Which of the following findings should the nurse expect? (Select all that apply.)
Increase blood pressure Increased heart rate Increased respiratory rate
What am I? Here is my ABG? pH 7.24, CO2 38, Bicarb 18
Metabolic acidosis
Who am I? pH 7.23, CO2 35, Bicarb 13
Metabolic acidosis
Who am I? pH 7.3, CO2 35, Bicarb 12
Metabolic acidosis
Client is using antacids for GERD, what are they at risk for? Respiratory alkalosis Respiratory acidosis Metabolic acidosis Metabolic alkalosis
Metabolic alkalosis
A nurse is assessing a client who has a Sodium level of 116. Which of the following should the nurse expect? Nausea and vomiting Extreme thirst Flushed skin Fever
Nausea and vomiting
A nurse is caring for a child who has acute gastroenteritis but is able to tolerate oral fluids. The nurse should anticipate providing which of the following types of fluid? 1) Broth 2) Water 3) Diluted apple juice 4) Oral rehydration solution
Oral rehydration solution
Client is in metabolic acidosis, assess which electrolyte? Potassium Calcium Sodium Magnesium
Potassium
A nurse is reviewing a client's lab results. Which of the following lab values should the nurse report to the provider? Sodium 126 Potassium 3.6 Magnesium 1.9 Chloride 99
Sodium 126
Client in metabolic alkalosis, breathing rate is 8/min. Most likely ABG finding? pH 7.32, CO2 28, Bicarb 24 pH 7.60, CO2 64, Bicarb 42 pH 7.28, CO2 52, Bicarb 32 pH 7.32, CO2 26, Bicarb 18
pH 7.60, CO2 64, Bicarb 42
When are you in alkalosis?
pH above 7.45
What would you find for a client in metabolic acidosis? pH below 7.35 HCO3 above 26 paO2 below 70 paCO2 above 45
pH below 7.35
What is the normal magnesium level?
1.5-2.5
A nurse is assessing four clients for fluid balance. The nurse should identify that which of the following clients is exhibiting manifestations of dehydration? 1) A client who has a urine specific gravity of 1.010. 2) A client who has a weight gain of 2.2 kg (2 lb) in 24 hr. 3) A client who has a hematocrit of 45% 4) A client who has a temperature of 39° C (102° F)
A client who has a temperature of 39 degrees Celsius or 102 Fahrenheit
Which client is at a greater risk for fluid volume deficit related to the loss of total body fluid and extracellular fluid? 1) an infant age 4 months 2) an adolescent age 17 years 3) a woman age 45 years 4) a man age 50 years
An infant age 4 months
A nurse is caring for a client with hypoparathyroidism. Which imbalance is a major concern for the client? Hypokalemia Hyponatremia Hypocalcemia Hypernatremia
Hypocalcemia
Client is in respiratory acidosis, if it progresses what intervention may need to take place? Mechanical ventilation Reducing supplemental O2 Resolution of underlying emotional cause Introduction of large muscle exercise
Mechanical ventilation
A nurse is making a home visit to a client who takes a daily diuretic for heart failure. What manifestation should the nurse identify as hypokalemia? Pitting edema Fatigue Dyspnea Oliguria
Fatigue
A client is brought to the ER with SOB. Assessments reveal a full, bounding pulse, severe edema, and audible crackles in lower lung fields bilaterally. Nurse orders Dr. to for which problem? Hyponatremia Fluid volume excess Hypocalcemia Hyperkalemia
Fluid volume excess
A nurse in a community clinic is assessing an older adult client for manifestations of dehydration. Which of the following findings should the nurse expect? 1) Hypothermia 2) Protruding eyeballs 3) Elevated blood pressure 4) Furrows in the tongue
Furrows in the tongue
The nurse is caring for a client who is one day post op for a thyroidectomy. Client complains of tingling of hands and feet and around his mouth. Manifestation of what electrolyte imbalance? Hyponatremia Hypocalcemia Hypercalcemia Hypophosphatemia
Hypocalcemia
A nurse is caring for a client with heart failure and a new prescription for furosemide. For which of the following adverse effects should the nurse monitor? Hypervolemia Hypertension Hypokalemia Hypoglycemia
Hypokalemia
A nurse is assessing a preschooler who has a calcium level of 8.0 mg/dL Which of the following findings should the nurse expect? Dry, sticky mucus membranes Polyuria Negative Chvostek's sign Muscle tremors
Muscle tremors
The nurse is assessing a client for early manifestations of hyponatremia. The nurse would assess the client for? Dry, sticky mucus membranes Tachycardia Muscle weakness Peaked T wave on the EKG
Muscle weakness
The nurse is administering a unit of packed red blood cells to a client and piggybacks the unit of blood through a solution of 0.9% NaCl. Blood cells placed in a solution of 0.9% saline will do which of the following? 1) Shrink 2) Swell 3) Neither shrink nor swell 4) Rupture
Neither shrink or swell
A nurse is caring for four hospitalized clients. Which of the following clients should the nurse identify as being at risk for fluid volume deficit? 1) The client who has been NPO since midnight for endoscopy. 2) The client who has left-sided heart failure and has a brain natriuretic peptide (BNP) level of 600 pg/mL. 3) The client who has end-stage renal failure and is scheduled for dialysis today. 4) The client who has gastroenteritis and is febrile.
The client who has gastroenteritis and is febrile
A nurse is admitting a 6-month-old infant who has dehydration. Which of the following amounts of urinary output should indicate to the nurse that the treatment has corrected the fluid imbalance? 1) 0.5 mL/kg/hr 2) 2 mL/kg/hr 3) 7.5 mL/kg/hr 4) 15 mL/kg/hr
2 mL/kg/hr
Of the following clients who would be the highest risk of hyperkalemia? A male admitted for acute renal failure following a drug overdose A client diagnosed with an ischemic stroke with multiple sensory and motor deficits An older adult client experiencing severe vomiting and diarrhea as a result of influenza A postsurgical client whose thyroidectomy resulted in the loss of some of the parathyroid glands
A male admitted for acute renal failure following a drug overdose
When do you have a metabolic ABG imbalance?
HCO3 is out of range
A nurse in an emergency department is caring for an infant who has a 2-day history of vomiting and an elevated temperature. Which of the following should the nurse recognize as the most reliable indicator of fluid loss? 1) Body weight 2) Skin integrity 3) Blood pressure 4) Respiratory rate
Body weight
A nurse is caring for a client who is 1 day postoperative following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should the nurse assess the client? Chvostek's sign Babinski's sign Brudzinski's sign Kernig's sign
Chvostek's sign
What client is at risk for metabolic acidosis? Client with diarrhea Client with vomiting Client taking a thiazide diuretic Client with salicylate intoxication
Client with diarrhea
A nurse is monitoring a client who is receiving a unit of packed RBCs following surgery. Which of the following assessments is an indication that the client might be experiencing circulatory overload? 1) Flushing 2) Dyspnea 3) Bradycardia 4) Vomiting
Dyspnea
A nurse is caring for a male client who reports nausea and vomiting and is receiving IV fluid therapy. His blood urea nitrogen (BUN) is 32 mg/dL, creatinine 1.1 mg/dL, and hematocrit 50%. Which of the following nursing interventions is appropriate? 1) Collect a urine specimen for culture and sensitivity. 2) Continue routine care because the results are within the expected reference range. 3) Decrease the IV fluid infusion rate and limit oral fluid intake. 4) Evaluate urine for amount and for specific gravity.
Evaluate urine for amount and for specific gravity
A nurse is admitting a client who has a serum calcium level of 12.3 mg/dL and initiates cardiac monitoring. Which of the following findings should the nurse expect during the initial assessment? Lethargy Hyperactive deep tendon reflexes Prolonged ST segment Hyperactive bowel sounds
Lethargy
Who am I? pH 7.48, CO2 38, Bicarb 28
Metabolic alkalosis
A nurse monitoring a client's IV infusion auscultates the client's lung sounds and detects crackles in the bases in lungs that were previously clear. What would be the most appropriate intervention in this situation? 1) Notify the primary care provider immediately because these are signs of speed shock. 2) Notify the primary care provider immediately for possible fluid overload. 3) Check all clamps on the tubing and check tubing for any kinking. 4) Place the client in the Trendelenburg position to keep the client's airway open.
Notify the primary care provider immediately for possible fluid overload
ABG pH 7.3 Bicarb 24 Carb 50
Respiratory acidosis
Post op client with shallow respirations at 9/min, what imbalance may the client develop?
Respiratory acidosis
Who am I? pH 7.28, CO2 48, Bicarb 24
Respiratory acidosis
Who am I? pH 7.3, CO2 55, Bicarb 24
Respiratory acidosis
Client reports fingers tingling, what acid-base imbalance can they be facing due to hyperventilation? Respiratory acidosis Respiratory alkalosis Metabolic acidosis Metabolic alkalosis
Respiratory alkalosis
Who am I? pH 7.5, CO2 26, Bicarb 22
Respiratory alkalosis
A nurse is reviewing the laboratory results of a client who has fluid volume deficit. The nurse would expect which of the following findings? 1) Urine specific gravity 1.035 2) Hematocrit 44% 3) BUN 19 mg/dL 4) Sodium 155 mEq/L
Urine specific gravity 1.035
When are you in acidosis?
pH is under 7.35
Someone with an acid-base imbalance is starting to compensate. What would you expect? Increased pH Decreased pH No alteration in ABG pH moves towards normal range
pH moves towards normal range
When do you have a respiratory ABG imbalance?
paCO2 is out of range
