Module 5 - Chapter 10: Fluid and Electrolytes: Balance and Disturbance

A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation? Absence of glucose Absence of protein Specific gravity of 1.02 Urine pH of 3.0

Urine pH of 3.0

A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation? Absence of glucose Absence of protein Urine pH of 3.0 Specific gravity of 1.02

Urine pH of 3.0

A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse informs the client that the physician will order diuretic therapy and restrict fluid and sodium intake to treat the disorder. If the client doesn't comply with the recommended treatment, which complication may arise? Hypovolemic shock Cerebral edema Severe hyperkalemia Tetany

cerebral edema

Early signs of hypervolemia include a decrease in blood pressure. increased breathing effort and weight gain. thirst. moist breath sounds.

increased breathing effort and weight gain.

A client with cancer is being treated on the oncology unit for bilateral breast cancer. The client is undergoing chemotherapy. The nurse notes the client's serum calcium concentration is 12.3 mg/dL (3.08 mmol/L). Given this laboratory finding, the nurse should suspect that the client has a history of alcohol abuse. malignancy is causing the electrolyte imbalance. client may be developing hyperaldosteronism. client's diet is lacking in calcium-rich food products.

malignancy is causing the lyte imbalance

Following a unilateral adrenalectomy, a nurse should assess for hyperkalemia as indicated by: diaphoresis. muscle weakness. tremors. constipation.

muscle weakness

Following a unilateral adrenalectomy, a nurse should assess for hyperkalemia as indicated by: diaphoresis. tremors. muscle weakness. constipation.

muscle weakness

Which is the preferred route of administration for potassium? IV (intravenous) push Subcutaneous Intramuscular Oral

oral

When evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis? PaCO 36 HCO 21 mEq/L pH 7.48 O saturation 95%

pH 7.48

Which arterial blood gas (ABG) result would the nurse anticipate for a client with a 3-day history of vomiting? pH: 7.55, PaCO2: 60 mm Hg, HCO3-: 28 pH: 7.34, PaCO2: 60 mm Hg, HCO3: 34 pH: 7.45, PaCO2: 32 mm Hg, HCO3-: 21 pH: 7.28, PaCO2: 25 mm Hg, HCO3: 15

pH: 7.55, PaCO2: 60 mm Hg, HCO3-: 28

The nurse is caring for a client diagnosed with bulimia. The client is being treated for a serum potassium concentration of 2.9 mEq/L (2.9 mmol/L). Which statement made by the client indicates the need for further teaching? "I will be sure to buy frozen vegetables when I grocery shop." "I will take a potassium supplement daily as prescribed." "I can use laxatives and enemas but only once a week." "A good breakfast for me will include milk and a couple of bananas."

"I can use laxatives and enemas but only once a week."

Which solution is hypotonic? 0.9% NaCl 5% NaCl 0.45% NaCl Lactated Ringer solution

0.45% NaCl

Which is considered an isotonic solution? 3% NaCl 0.9% normal saline 0.45% normal saline Dextran in normal saline

0.9% normal saline

A nurse is monitoring a client being evaluated who has a potassium level of 7 mEq/L (mmol/L). Which electrocardiogram changes will the client display? elevated ST segment prolonged T waves peaked T waves shortened PR interval

peaked T waves

At which serum sodium concentration might convulsions or coma occur? 142 mEq/L (142 mmol/L) 130 mEq/L (130 mmol/L) 140 mEq/L (140 mmol/L) 145 mEq/L (145 mmol/L)

130 mEq/L (130 mmol/L)

A client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should the nurse assess first? Blood pressure Temperature Respirations Pulse

pulse

A client has been admitted to the hospital unit with signs and symptoms of hypovolemia; however, the client has not lost weight. The client exhibits a localized enlargement of her abdomen. What condition could the client be presenting? third-spacing anasarca pitting edema hypovolemia

third-spacing

A client is diagnosed with hypocalcemia and the nurse is teaching the client about symptoms. What symptom would the nurse include in the teaching? tingling sensation in the fingers hypertension flank pain polyuria

tingling sensation in the fingers

A nurse is providing an afternoon shift report and relates morning assessment findings to the oncoming nurse. Which daily assessment data is necessary to determine changes in the client's hypervolemia status? edema weight intake and output vital signs

weight

The nurse is caring for a client in the intensive care unit (ICU) following a near-drowning event in saltwater. The client is restless, lethargic, and demonstrating tremors. Additional assessment findings include swollen and dry tongue, flushed skin, and peripheral edema. The nurse anticipates that the client's serum sodium value would be 155 mEq/L (155 mmol/L) 125 mEq/L (125 mmol/L) 145 mEq/L (145 mmol/L) 135 mEq/L (135 mmol/L)

155 mEq/L (155 mmol/L)

A client weighing 160.2 pounds (72.7 kg), who has been diagnosed with hypovolemia, is weighed every day. The health care provider asked to be notified if the client loses 1,000 mL of fluid in 24 hours. What weight would be consistent with this amount of fluid loss? 156.0 lbs (70.8 kg) 157.0 lbs (71.2 kg) 158.0 lbs (71.7 kg) 159.0 lbs (72.1 kg)

158.0 lbs (71.7 kg)

A patient's serum sodium concentration is within the normal range. What should the nurse estimate the serum osmolality to be? 275-300 mOsm/kg 350-544 mOsm/kg <136 mOsm/kg >408 mOsm/kg

275-300 mOsm/kg

A nurse can estimate serum osmolality at the bedside by using a formula. A patient who has a serum sodium level of 140 mEq/L would have a serum osmolality of: 230 mOsm/kg. 210 mOsm/kg. 250 mOsm/kg. 280 mOsm/kg.

280 mOsm/kg

A client experiencing a severe anxiety attack and hyperventilating presents to the emergency department. The nurse would expect the client's pH value to be 7.35 7.30 7.45 7.50

7.50

The nurse is caring for four clients on a medical unit. The nurse is most correct to review which client's laboratory reports first for an electrolyte imbalance? A 65-year-old with a myocardial infarction A 72-year-old with a total knee repair A 52-year-old with diarrhea A 7-year-old with a fracture tibia

A 52-year-old with diarrhea

Which of the following measurable urine outputs indicates the client is maintaining adequate fluid intake and balance? A patient with a minimal urine output of 30 mL/hour A patient with a minimal urine output of 50 mL/hour A patient with a minimal urine output of 10 mL/hour A patient with a minimal urine output of 20 mL/hour

A patient with a minimal urine output of 30 mL/hour

A nurse correctly identifies a urine specimen with a pH of 4.3 as being which type of solution? Neutral Alkaline Acidic Basic

Acidic

The nurse has been assigned to care for various clients. Which client is at the highest risk for a fluid and electrolyte imbalance? A 79-year-old client admitted with a diagnosis of pneumonia. A 45-year-old client who had a laparoscopic appendectomy 24 hours ago and is being advanced to a regular diet. A 66-year-old client who had an open cholecystectomy with a T-tube placed that is draining 125 mL of bile per shift. An 82-year-old client who receives all nutrition via tube feedings and whose medications include carvedilol and torsemide.

An 82-year-old client who receives all nutrition via tube feedings and whose medications include carvedilol and torsemide.

The emergency department (ED) nurse is caring for a client with a possible acid-base imbalance. The physician has ordered an arterial blood gas (ABG). What is one of the most important indications of an acid-base imbalance that is shown in an ABG? PaO2 Bicarbonate PO2 Carbonic acid

Bicarbonate

Which electrolyte is a major anion in body fluid? Chloride Sodium Potassium Calcium

Chloride

The nurse is caring for a client with a serum sodium concentration of 113 mEq/L (113 mmol/L). The nurse should monitor the client for the development of which condition? Confusion Nausea Hallucinations Headache

Confusion

Which findings indicate that a client has developed water intoxication secondary to treatment for diabetes insipidus? Confusion and seizures Sunken eyeballs and spasticity Flaccidity and thirst Tetany and increased blood urea nitrogen (BUN) levels

Confusion and seizures

A nurse caring for a patient who is receiving an IV solution via a central vein suspects the complication of an air embolism. Which of the following are signs and symptoms consistent with that diagnosis? Select all that apply. Cyanosis Crackles on auscultation Shoulder pain Tachycardia Hypertension Dyspnea

Cyanosis Shoulder pain Dyspnea Tachycardia

The nurse is caring for a 72-year-old client who has been admitted to the unit for a fluid volume imbalance. The nurse knows which of the following is the most common fluid imbalance in older adults? Fluid volume excess Dehydration Hypovolemia Hypervolemia

Dehydration

Which of the following is a clinical manifestation of fluid volume excess (FVE)? Select all that apply. Distended neck veins Shortness of breath Decreased blood pressure Crackles in the lung fields Bradycardia

Distended neck veins Crackles in the lung fields Shortness of breath

The physician has prescribed 0.9% sodium chloride IV for a hospitalized client in metabolic alkalosis. Which nursing actions are required to manage this client? Select all that apply. Compare ABG findings with previous results. Maintain intake and output records. Administer IV bicarbonate. Document presenting signs and symptoms. Suction the client's airway.

Document presenting signs and symptoms. Compare ABG findings with previous results. Maintain intake and output records.

A nurse reviews the results of an electrocardiogram (ECG) for a patient who is being assessed for hypokalemia. Which of the following would the nurse notice as the most significant diagnostic indicator? Flat P wave Peaked T wave Elevated U wave Widened QRS wave

Elevated U wave

The nurse is caring for a client in heart failure with signs of hypervolemia. Which vital sign is indicative of the disease process? Rapid respiration Low heart rate Elevated blood pressure Subnormal temperature

Elevated blood pressure

Before seeing a newly assigned client with respiratory alkalosis, a nurse quickly reviews the client's medical history. Which condition is a predisposing factor for respiratory alkalosis? Type 1 diabetes mellitus Myasthenia gravis Extreme anxiety Opioid overdose

Extreme anxiety

Which nerve is implicated in the Chvostek's sign? Facial Optic Hypoglossal Spinal accessory

Facial

A nurse is caring for a client with metastatic breast cancer who is extremely lethargic and very slow to respond to stimuli. The laboratory report indicates a serum calcium level of 12.0 mg/dl, a serum potassium level of 3.9 mEq/L, a serum chloride level of 101 mEq/L, and a serum sodium level of 140 mEq/L. Based on this information, the nurse determines that the client's symptoms are most likely associated with which electrolyte imbalance? Hyperkalemia Hypokalemia Hypercalcemia Hypocalcemia

Hypercalcemia

The nurse is assigned to care for a client with a serum phosphorus concentration of 5.0 mg/dL (1.61 mmol/L). The nurse anticipates that the client will also experience which electrolyte imbalance? Hypocalcemia Hyperchloremia Hyponatremia Hypermagnesemia

Hypocalcemia

A client reports muscle cramps in the calves and feeling "tired a lot." The client is taking ethacrynic acid (Edecrin) for hypertension. Based on these symptoms, the client will be evaluated for which electrolyte imbalance? hypocalcemia hypercalcemia hyperkalemia hypokalemia

Hypokalemia

An elderly client takes 40 mg of furosemide twice a day. Which electrolyte imbalance is the most serious adverse effect of diuretic use? Hypokalemia Hypernatremia Hyperkalemia Hypophosphatemia

Hypokalemia

An elderly client takes 40 mg of furosemide twice a day. Which electrolyte imbalance is the most serious adverse effect of diuretic use? Hypophosphatemia Hyperkalemia Hypokalemia Hypernatremia

Hypokalemia

A client has a respiratory rate of 38 breaths/min. What effect does breathing faster have on arterial pH level? Increases arterial pH Provides long-term pH regulation Decreases arterial pH No effect

Increases arterial pH

A client has a respiratory rate of 38 breaths/min. What effect does breathing faster have on arterial pH level? Increases arterial pH Provides long-term pH regulation No effect Decreases arterial pH

Increases arterial pH

A nurse is assessing a client with syndrome of inappropriate antidiuretic hormone. Which finding requires further action? Jugular vein distention Weight loss Tetanic contractions Polyuria

Jugular vein distention

A physician orders an isotonic I.V. solution for a client. Which solution should the nurse plan to administer? Lactated Ringer's solution 5% dextrose and normal saline solution Half-normal saline solution 10% dextrose in water

Lactated Ringer's solution

A client hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis? Headache or blurry vision Abdominal pain or diarrhea Light-headedness or paresthesia Hallucinations or tinnitus

Light-headedness or paresthesia

Your client has a diagnosis of hypervolemia. What would be an important intervention that you would initiate? Limit sodium and water intake. Assess for dehydration. Give medications that promote fluid retention. Teach client behaviors that decrease urination.

Limit sodium and water intake

A client has been diagnosed with an intestinal obstruction and has a nasogastric tube set to low continuous suction. Which acid-base disturbance is this client at risk for developing? Respiratory acidosis Respiratory alkalosis Metabolic acidosis Metabolic alkalosis

Metabolic alkalosis

A client who complains of an "acid stomach" has been taking baking soda (sodium bicarbonate) regularly as a self-treatment. This may place the client at risk for which acid-base imbalance? respiratory alkalosis metabolic alkalosis metabolic acidosis respiratory acidosis

Metabolic alkalosis

The nurse on a surgical unit is caring for a client recovering from recent surgery with the placement of a nasogastric tube to low continuous suction Which acid-base imbalance is most likely to occur? Respiratory alkalosis Metabolic alkalosis Metabolic acidosis Respiratory acidosis

Metabolic alkalosis

A priority nursing intervention for a client with hypervolemia involves which of the following? Encouraging the client to consume sodium-free fluids. Monitoring respiratory status for signs and symptoms of pulmonary complications. Drawing a blood sample for typing and crossmatching. Establishing I.V. access with a large-bore catheter

Monitoring respiratory status for signs and symptoms of pulmonary complications.

A patient with abnormal sodium losses is receiving a regular diet. How can the nurse supplement the patient's diet to provide 1,600 mg of sodium daily? Four beef cubes and 8 oz of tomato juice One beef cube and 8 oz of tomato juice One beef cube and 12 oz of tomato juice One beef cube and 16 oz of tomato juice

One beef cube and 8 oz of tomato juice

The nurse is teaching a group of student nurses about the function of calcitonin. The student nurse is correct in sharing which of the following? Select all that apply. Decreases urinary excretion of phosphate Increases deposition of calcium in bones Reduces bone resorption Increases urinary excretion of calcium Decreases deposition of phosphorous in bones

Reduces bone resorption Increases urinary excretion of calcium Increases deposition of calcium in bones

Which of the following arterial blood gas results would be consistent with metabolic alkalosis? PaCO2 less than 35 mm Hg Serum bicarbonate of 28 mEq/L Serum bicarbonate of 21 mEq/L pH 7.26

Serum bicarbonate of 28 mEq/L

A client with nausea, vomiting, and abdominal cramps and distention is admitted to the health care facility. Which test result is most significant? Urine specific gravity of 1.025 Serum sodium level of 132 mEq/L Blood urea nitrogen (BUN) level of 29 mg/dl Serum potassium level of 3 mEq/L

Serum potassium level of 3 mEq/L

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 Hematocrit of 52% Serum creatinine level of 0.4 mg/dl Serum blood urea nitrogen (BUN) level of 8.6 mg/dl

Serum sodium level of 124 mEq/L

A patient with diabetes insipidus presents to the emergency room for treatment of dehydration. The nurse knows to review serum laboratory results for which of the diagnostic indicators? Sodium level of 150 mEq/L Sodium level of 137 mEq/L Potassium level of 3.8 mEq/L Potassium level of 6 mEq/L

Sodium level of 150 mEq/L

Which of the following is a factor affecting an increase in urine osmolality? Fluid volume excess Syndrome of inappropriate antidiuretic hormone release (SIADH) Alkalosis Myocardial infarction

Syndrome of inappropriate antidiuretic hormone release (SIADH)

The nurse is caring for a client diagnosed with hyperchloremia. Which are signs and symptoms of hyperchloremia? Select all that apply. Dehydration Tachypnea Lethargy Hypotension Weakness

Tachypnea Weakness Lethargy

A client seeks medical attention for an acute onset of severe thirst, polyuria, muscle weakness, nausea, and bone pain. Which health history information will the nurse report to the health care provider? Ingests alcohol occasionally Takes high doses of vitamin D Works as a customer service representative Follows a high-fiber eating plan

Takes high doses of vitamin D

A nurse is conducting an initial assessment on a client with possible tuberculosis. Which assessment finding indicates a risk factor for tuberculosis? The client works in a health insurance office. The client had a liver transplant 2 years ago. The client sees the health care provider for a check-up yearly. The client has never traveled outside of the country.

The client had a liver transplant 2 years ago