Fluid/Electrolyte NUR 213

Respiratory acidosis

A nurse is admitting a client who has status asthmaticus. The client's ABG results are pH 7.32, PaO2 74mmHg, PaCO2 56mmHg, and HCO3- 26 mEq/L. The nurse should interpret these laboratory values as which of the following imbalances?

A nurse is assessing a client who has diabetes mellitus and reports feeling anxious. Which of the following findings should the nurse expect if the client is hypoglycemic?

Cool, clammy skin-- in addition hypoglycemia causes nervousness, tachycardia and confusion

Glucose-- cushing's syndrome causes elevated sugar levels

A nurse is caring for a client undergoing screening for primary Cushing's disease. The nurse should expect an elevation in which of the following laboratory findings?

Hypotension-- bradypnea, dysrhythmias, cold intolerance and cool dry skin are also findings of hypothyroidism

A home health nurse is assessing a client who requires lifelong hormone replacement therapy for the treatment of hypothyroidism. The client has not been taking his medication regularly. Which of the following findings should the nurse expect?

This test result is a good indicator of my average blood glucose levels-- average over the last 90 days (ATI says 120 days)

A nurse is teaching a client about glycosylated hemoglobin (HbA1c) testing. Which of the following statements should the nurse identify as an indication that the client understands the information about this test?

Reduction of the effects of thyroid hormone on the heart-- propranolol is a beta2-adrenergic blocking agent that decreases the rapid heart rate that excessive thyroid stimulation causes

A nurse has administered propranolol by IV bolus to a client who is having a thyroid storm. Which of the following findings indicates that the client is having a therapeutic response? a. Reduction of the effects of thyroid hormone on the heart b. Blockage of the release of thyroid hormone from the thyroid gland c. Increase of the uptake of thyroid hormone by the thyroid gland d. Increase of the heart's sensitivity to thyroid hormone

I will apply lotion to the dry areas of my feet, but not between my toes-- this area is prone to bacterial growt

A nurse in an outpatient clinic is teaching a client who has a diabetic foot ulcer about foot care. Which of the following statements should the nurse identify as an indication that the client understands the teaching?

Tremors-- hyperthyroidism also includes diaphoresis and insomnia

A nurse is admitting a client who has hyperthyroidism. When assessing the client, the nurse should expect which of the following findings?

0.9% sodium chloride with 10mEq/L of potassium chloride at 100mL/hr

A nurse is admitting a client who takes 40mg furosemide daily for heart failure and has experienced 3 days of vomiting. The nurses suspects hypokalemia. Which of the following medications should the nurse prepare to administer?

Hirsutism-- this is due to increased androgen production

A nurse is assessing a client who has a new diagnosis of Cushing's disease. Which of the following findings should the nurse expect?

Slow peripheral pulses

A nurse is assessing a client who has a phosphorus level of 2.4mg/dL. Which of the following findings should the nurse expect?

Calcium 12.8mg/dL-- adrenal insufficiency have excessive calcium

A nurse is assessing a client who has adrenal insufficiency. Which of the following findings should the nurse expect?

Increased hematocrit-- this is an expected finding resulting from dehydration

A nurse is assessing a client who has diabetes insipidus. The nurse should expect which of the following findings?

Sodium 110mEq/L-- clients retain fluids which cause dilutional hyponatremia

A nurse is assessing a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following findings should the nurse report to the provider?

Tingling and numbness of the hands and feet-- hypocalcemia can cause paresthesias usually starting in the hands and feet

A nurse is caring for a client following a thyroidectomy. The nurse should assess for which of the following findings as an indication of hypocalcemia?

Elevate the head of the client's bed-- this will help reduce blood pressure and abdominal pressure

A nurse is caring for a client who has a pheochromocytoma. Which of the following actions should the nurse take?

Monitor the temperature of bath water with a thermometer-- peripheral neuropathy makes it difficult to feel temp, or changes in the feet

A nurse is caring for a client who has diabetes mellitus and has developed peripheral neuropathy. Which of the following measures should the nurse recommend to prevent injuries to the client's feet?

Serum pH of 7.45-- a client who has HHS produces enough insulin to prevent ketosis, but not enough to prevent hyperglycemia. Therefore, the serum pH is within the expected reference range. Glucose will be above 600mg/dL

A nurse is caring for a client who has type 2 diabetes melliltus and has hyperglycemic-hyperosmolar state (HHS). Which of the following laboratory findings should the nurse expect?

Weight-- this med suppresses the production of the thyroid hormones and therefore, allows for weight gain. Excessive weight gain could indicate the dose is too high

A nurse is caring for a client who is taking propylthiouracil. The nurse should identify that the client has met the treatment goals when she reports an increase in which of the following manifestations?

Take this medication on an empty stomach-- to promote proper absorption, take 30-60 minutes before eating or drinking

A nurse is developing a teaching plan for a client who had a thyroidectomy and takes a thyroid hormone replacement. Which of the following instructions should the nurse plan to include?

Administer IV hydrocortisone sodium-- hydrocortisone sodium is necessary to replace the cortisol deficiency that occurs with adrenal insufficiency

A nurse is managing the care of a client who is postoperative and has acute adrenal insufficiency. Which of the following actions should the nurse take?

Laryngeal stridor-- harsh, high-pitched sound with inspiration that indicates respiratory obstruction

A nurse is monitoring a client's status 24 hours after a total thyroidectomy. Which of the following findings should the nurse report to the provider?

Fasting blood glucose 96mg/dL-- this is within an expected range for fasting blood sugar

A nurse is monitoring the laboratory values of a client who has diabetes mellitus and is taking insulin. Which of the following results indicates a therapeutic outcome of insulin therapy?

Ingest alcohol with food to reduce alcohol-induced hypoglycemia-- alcohol inhibits the liver from producing glucose, eating carbs while drinking helps prevent hypoglycemia

A nurse is planning teaching for a client who has type 1 diabetes mellitus. Which of the following instructions should the nurse include?

Report nocturia because it requires a dosage adjustment-- the dose will be adjusted until the patient no longer has nocturia

A nurse is preparing a teaching plan for a client who has diabetes insipidus and requires intranasal desmopressin. Which of the following information should the nurse include in the teaching plan?

Blow your nose gently prior to using the nasal spray-- this prevents dilution of the medication with nasal secretions

A nurse is providing discharge teaching for a client who has diabetes insipidus and has a new prescription for desmopressin nasal spray. Which of the following instructions should the nurse include in the teaching?

pH 7.32, PaCO2 36mmHg, HCO3 14mEq-- metabolic acidosis

A nurse is reviewing laboratory values for a client who has diabetic ketoacidosis (DKA). Which of the following results should the nurse expect?

Addison's disease-- this test measures the cortisol response to ACTH, the response is absent or decreased in clients who have primary adrenal insufficiency

A nurse is teaching a client about the adrenocorticotropic hormone (ACTH) stimulation test. The nurse should explain that the purpose of the test is to assess for which of the following disorders?

Osteoporosis-- due to the suppression of bone formation and acceleration of bone resorption Moon-shaped face-- can cause characteristics of iatrogenic Cushing's syndrome, also can include a potbelly, and buffalo hump Increased risk of infection-- suppresses the immune system

A nurse is teaching a client who has an autoimmune disease about the adverse effects of long-term corticosteroid therapy. Which of the following effects should the nurse include? (select all that apply)

Draw up the insulins into separate syringes-- insulin glargine isn't compatible with other insulins

A nurse is teaching a client who has diabetes mellitus about insulin injections. The client's prescription includes evening doses of insulin glargine and regular insulin. Which of the following instructions should the nurse include?

Blood glucose levels above 300mg/dL-- levels above 600mg/dL are an expected finding with hyperglycemic-hyperosmolar state

A nurse is teaching a client who has diabetes mellitus. Which of the following should the nurse include as an expected finding of diabetic ketoacidosis (DKA)?

I will call my doctor if my blood sugar is more than 250mg/dL-- during illness patient needs to call >250mg/dL glucose reading

A nurse is teaching a client who has type 1 diabetes mellitus about how to prevent complications during illness. Which of the following statements should the nurse identify as an indication that the client understands the teaching?

Restrict coffee intake 2 to 3 days prior to the test-- patients should avoid coffee, tea (even if they are decaffeinated), bananas, chocolate, and vanilla

To screen a client for pheochromocytoma, a nurse schedules a vanillylmandelic acid test. When teaching the client about this test, which of the following instructions should the nurse include?