Prep u fluid and electrolytes (exam 2 nurs 301)
How may mL are in 2.2 pds
1,000
Which is the preferred route of administration for potassium? a. Subcutaneous b. IV (intravenous) push c. Oral d. Intramuscular
c
What is FVE/ FVD?
fluid volume excess / deficiency
What is respiratory acidosis?
when the lungs cannot remove all of the carbon dioxide the body produces. This causes body fluids, especially the blood, to become too acidic.
What is hypervolemia?
when you have too much fluid in your body
What are the normal ranges for an ABG?
pH (7.35-7.45) PaO2 (75-100 mmHg) PaCO2 (35-45 mmHg) Hco3 (23-30)
A client presents with severe diarrhea and a history of chronic renal failure to the emergency department. Arterial blood gas results are as follows:pH 7.30PaO2 97PaCO2 37HCO3 18The nurse would expect which of the following sets of assessment findings? a. Confusion, respiratory rate 8 breaths/min, dry skin b. Blood pressure 188/120, nausea, vomiting c. Clammy skin, blood pressure 86/46, headache d. Headache, blood pressure 90/54, dry skin
a
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? a. hypokalemia b. hypocalcemia c. hypercalcemia d. hyperkalemia
a
What is hypoxia?
Having low oxygen levels in your blood
A nurse evaluates a client's laboratory results. What is a factor that may be affecting an increase in serum osmolality? a. free water loss b. overhydration c. hyponatremia d. diuretic use
a
The nurse is assigned a client with calcium level of 4.0 mg/dL. Which system assessment would the nurse ask detailed questions?
Neuro
What is jaundice?
Yellow skin caused by the buildup of bilirubin in the blood.
A client hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis? a. light-headedness or paresthesia b. headache or blurry vision c. abdominal pain or diarrhea d. hallucinations or tinnitus
a
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? a. Hypercalcemia b. Hyperkalemia c. Hypocalcemia d. Hypokalemia
a
A patient is admitted with severe vomiting for 24 hours as well as weakness and "feeling exhausted." The nurse observes flat T waves and ST-segment depression on the electrocardiogram. Which potassium level does the nurse observe when the laboratory studies are complete? a. 2.5 mEq/L b. 3.5 mEq/L c. 5.5 mEq/L d. 4.5 mEq/L
a
A physician orders an isotonic I.V. solution for a client. Which solution should the nurse plan to administer? a. 5% dextrose and normal saline solution b. 10% dextrose in water c. Lactated Ringer's solution d. Half-normal saline solution
a
Early signs of hypervolemia include a. increased breathing effort and weight gain. b. moist breath sounds. c. thirst. d. a decrease in blood pressure.
a
The nurse is correct to state that a client's body needs to have adequate nutrition to maintain energy. Which type of transport of dissolved substances requires adenosine triphosphate (ATP)? a. Active transport b. Osmosis c. Facilitated diffusion d. Passive diffusion
a
To evaluate a client for hypoxia, the physician is most likely to order which laboratory test? a. Arterial blood gas (ABG) analysis b. Total hemoglobin c. Sputum culture d. Red blood cell count
a
What does the nurse understand is the primary method by which fluid volume is regulated? a. Urine excretion b. Breathing c. Bowel elimination d. Perspiration
a
Which intervention is most appropriate for a client with an arterial blood gas (ABG) of pH 7.5, a partial pressure of arterial carbon dioxide (PaCO2) of 26 mm Hg, oxygen (O2) saturation of 96%, bicarbonate (HCO3-) of 24 mEq/L, and a PaO2 of 94 mm Hg? a. Instruct the client to breathe into a paper bag. b. Offer the client fluids frequently. c. Administer ordered supplemental oxygen. d. Administer an ordered decongestant.
a
Which of the following is the most common cause of symptomatic hypomagnesemia in the United States? a. Alcoholism b. Loss of gastric acid c. Intestinal resection d. Inflammatory bowel disease
a
A client in the emergency department reports that he has been vomiting excessively for the past 2 days. His arterial blood gas analysis shows a pH of 7.50, partial pressure of arterial carbon dioxide (PaCO2) of 43 mm Hg, partial pressure of arterial oxygen (PaO2) of 75 mm Hg, and bicarbonate (HCO3-) of 42 mEq/L. Based on these findings, the nurse documents that the client is experiencing which type of acid-base imbalance? a. Metabolic alkalosis b. Respiratory alkalosis c. Metabolic acidosis d. Respiratory acidosis
a - ph over 7.45
What is respiratory alkalosis?
a low level of carbon dioxide in the blood due to breathing excessively.
what is metabolic alkalosis and metabolic acidosis?
acidosis- buildup of body toxins, kidney failure, and ingestion of certain drugs or toxins, such as methanol or large doses of aspirin. It can be a rare complication of diabetes. alkalosis- when digestive issues disrupt the blood's acid-base balance. It can also be due to conditions affecting the liver, kidneys or heart
A client presents with anorexia, nausea and vomiting, deep bone pain, and constipation. The following are the client's laboratory values. sodium 137 mEq/L (137 mmol/L)potassium 4.6 mEq/L (4.6 mmol/L)chloride 94 mEq/L (94 mmol/L)calcium 12.9 mg/dL (3.2 mmol/L) What laboratory value is of highest concern to the nurse? a. chloride 94 mEq/L (94 mmol/L) b. calcium 12.9 mg/dL (3.2 mmol/L) c. sodium 137 mEq/L (137 mmol/L) d. potassium 4.6 mEq/L (4.6 mmol/L)
b
A nurse correctly identifies a urine specimen with a pH of 4.3 as being which type of solution? a. Alkaline b. Acidic c. Neutral d. Basic
b
A nurse is providing client teaching about the body's plasma pH and the client asks the nurse what is the major chemical regulator of plasma pH. What is the best response by the nurse? a. renin-angiotensin-aldosterone system b. bicarbonate-carbonic acid buffer system c. sodium-potassium pump d. ADH-ANP buffer system
b
The nurse is analyzing the arterial blood gas (ABG) results of a client diagnosed with severe pneumonia. Which of the following ABG results indicates respiratory acidosis? a. pH: 7.40, PaCO2: 40 mm Hg, HCO3-: 24 mEq /L b. pH: 7.20, PaCO2: 65 mm Hg, HCO3-: 26 mEq/L c. pH: 7.50, PaCO2: 30 mm Hg, HCO3-: 24 mEq/L d. pH: 7.32, PaCO2: 40 mm Hg, HCO3-: 18 mEq/L
b
The nurse is caring for a client with laboratory values indicating dehydration. Which clinical symptom is consistent with the dehydration? a. Crackles in the lung fields b. Dark, concentrated urine c. Distended jugular veins d. Cool and pale skin
b
What does the nurse recognize as one of the best indicators of the patient's renal function? a. Urine osmolality b. Serum creatinine c. Specific gravity d. Blood urea nitrogen
b
Which electrolyte is a major cation in body fluid? a. Phosphate b. Potassium c. Bicarbonate d. Chloride
b
Which solution is hypotonic? a. 5% NaCl b. 0.45% NaCl c. 0.9% NaCl d. Lactated Ringer solution
b
A client was admitted to the unit with a diagnosis of hypovolemia. When it is time to complete discharge teaching, which of the following will the nurse teach the client and family? Select all that apply. a. Drink carbonated beverages to help balance fluid volume. b. Drink at least eight glasses of fluid each day. c. Drink caffeinated beverages to retain fluid. d. Drink water as an inexpensive way to meet fluid needs. e. Respond to thirst
b, d, e
What is a pulmonary embolism?
is a blood clot that develops in a blood vessel in the body (often in the leg). It then travels to a lung artery where it suddenly blocks blood flow.
A nurse correctly identifies a urine specimen with a pH of 4.3 as being which type of solution? a. Alkaline b. Neutral c. Acidic d. Basic
c
A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation? a. Absence of glucose b. Absence of protein c. Urine pH of 3.0 d. Specific gravity of 1.02
c
Clients diagnosed with hypervolemia should avoid sweet or dry food because it a. can lead to weight gain. b. obstructs water elimination. c. increases the client's desire to consume fluid. d. can cause dehydration.
c
The nurse is analyzing the arterial blood gas (ABG) results of a client diagnosed with severe pneumonia. Which of the following ABG results indicates respiratory acidosis? a. pH: 7.40, PaCO2: 40 mm Hg, HCO3-: 24 mEq /L b. pH: 7.32, PaCO2: 40 mm Hg, HCO3-: 18 mEq/L c. pH: 7.20, PaCO2: 65 mm Hg, HCO3-: 26 mEq/L d. pH: 7.50, PaCO2: 30 mm Hg, HCO3-: 24 mEq/L
c
The nurse is assessing residents at a summer picnic at the nursing facility. The nurse expresses concern due to the high heat and humidity of the day. Although the facility is offering the residents plenty of fluids for fluid maintenance, the nurse is most concerned about which? a. Cardiovascular compromise b. Summer allergies c. Insensible fluid loss d. Lung function
c
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? a. "I will take a potassium supplement daily as prescribed." b. "A good breakfast for me will include milk and a couple of bananas." c. "I can use laxatives and enemas but only once a week." d. "I will be sure to buy frozen vegetables when I grocery shop."
c
Which nerve is implicated in the Chvostek's sign? a. Optic b. Hypoglossal c. Facial d. Spinal accessory
c
To confirm an acid-base imbalance, it is necessary to assess which findings from a client's arterial blood gas (ABG) results? Select all that apply. a. Na+ b. K+ c. PaCO2 d. pH e. Glucose f. HCO3
c, d, f
What are normal calcium, sodium, potassium and chloride levels?
calcium 8.5-10.2 sodium 134-145 potassium 3.5-5 chloride 96-106
What is hyponatremia?
condition where sodium levels in the blood are lower than normal
A client reports tingling in the fingers as well as feeling depressed. The nurse assesses positive Trousseau's and Chvostek's signs. Which decreased laboratory results does the nurse observe when the client's laboratory work has returned? a. Potassium b. Phosphorus c. Iron d. Calcium
d
A client with a suspected overdose of an unknown drug is admitted to the emergency department. Arterial blood gas values indicate respiratory acidosis. What should the nurse do first? a. Prepare for gastric lavage b. Monitor the client's heart rhythm c. Obtain a urine specimen for drug screening d. Prepare to assist with ventilation
d
A priority nursing intervention for a client with hypervolemia involves which of the following? a. Encouraging the client to consume sodium-free fluids. b. Establishing I.V. access with a large-bore catheter. c. Drawing a blood sample for typing and crossmatching. d. Monitoring respiratory status for signs and symptoms of pulmonary complications.
d
Fluid and electrolyte balance is maintained through the process of translocation. What specific process allows water to pass through a membrane from a dilute to a more concentrated area? a. filtration b. evaporation c. active transport d. osmosis
d
Oral intake is controlled by the thirst center, located in which of the following cerebral areas? a. Cerebellum b. Thalamus c. Brainstem d. Hypothalamus
d
The client's lab values are sodium 166 mEq/L, potassium 5.0 mEq/L, chloride 115 mEq/L, and bicarbonate 35 mEq/L. What condition is this client likely to have, judging by anion gap? a. Metabolic acidosis b. Respiratory alkalosis c. Respiratory acidosis d. Metabolic alkalosis
d
Treatment of FVE involves dietary restriction of sodium. Which of the following food choices would be part of a low-sodium diet, mild restriction (2 to 3 g/day)? a. Three ounces of sliced ham, beets, and a salad b. Tomato juice, low-fat cottage cheese, and three slices of bacon c. A frozen, packaged low-fat dinner with a side salad d. Three ounces of light or dark meat chicken, 1 cup of spaghetti and a garden salad
d
Which is considered an isotonic solution? a. 0.45% normal saline b. 3% c. Dextran in normal saline d. 0.9% normal saline
d
Which of the following electrolytes is the primary determinant of extracellular fluid (ECF) osmolality? a. Magnesium b. Potassium c. Calcium d. Sodium
d
Which of the following may be the first sign of respiratory acidosis in anesthetized patients? a. Increased pulse b. Dull headache c. Mental cloudiness d. Ventricular fibrillation
d
Your client has a diagnosis of hypervolemia. What would be an important intervention that you would initiate? a. Teach client behaviors that decrease urination. b. Give medications that promote fluid retention. c. Assess for dehydration. d. Limit sodium and water intake.
d
What is an air embolism?
is a blood vessel blockage caused by one or more bubbles of air or other gas in the circulatory system.
