AH I PrepU - Chapter 13: Fluid & Electrolytes
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 can use laxatives and enemas but only once a week."
The weight of a client with congestive heart failure is monitored daily and entered into the medical record. In a 24-hour period, the client's weight increased by 2 lb. How much fluid is this client retaining?
1 L
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:
280 mOsm/kg. Serum osmolality can be estimated by doubling the serum sodium or using the formula: Na × 2 = glucose/18 + BUN/3. Therefore, the nurse could estimate a serum osmolality of 280 mOsm/kg by doubling the serum sodium value of 140 mEq/L.
To evaluate a client for hypoxia, the physician is most likely to order which laboratory test?
Arterial blood gas (ABG) analysis
The nurse is caring for a client who was admitted with fluid volume excess (FVE). Which nursing assessments should the nurse include in the ongoing monitoring of the client? Select all that apply.
Blood pressure, heart rate, and rhythm Intake and output, urine volume, and color Skin assessment for edema and turgor
Which is an insensible mechanism of fluid loss?
Breathing
Air embolism is a potential complication of IV therapy. The nurse should be alert to which clinical manifestation associated with air embolism?
Chest pain
Hypokalemia can cause which symptom to occur?
Excessive thirst
You are caring for a 72-year-old client who has been admitted to your unit for a fluid volume imbalance. You know which of the following is the most common fluid imbalance in older adults?
Dehydration
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.
Document presenting signs and symptoms. Maintain intake and output records. Compare ABG findings with previous results.
Which factor increases blood urea nitrogen (BUN)?
Gastrointestinal bleeding
You are caring for a new client on your unit who is third-spacing fluid. You know to assess for what type of edema?
Generalized
What laboratory findings does the nurse determine are consistent with hypovolemia in a female patient? (Select all that apply.)
Hematocrit level of >47% Urine specific gravity of 1.027 Urine osmolality of >450 mOsm/kg
Which of the following electrolyte imbalances occur with adrenal insufficiency?
Hyperkalemia
A client presents with fatigue, nausea, vomiting, muscle weakness, and leg cramps. Laboratory values are as follows: Na + 147 mEq/L K + 3.0 mEq/L Cl - 112 mEq/L Mg ++ 2.3 mg/dL Ca ++ 1.5 mg/dL Which of the following is consistent with the client's findings?
Hypokalemia
A nurse is assessing a client with syndrome of inappropriate antidiuretic hormone. Which finding requires further action?
Jugular vein distention
The nurse is adding the intake and output results for a client diagnosed with dehydration. The nurse notes a 24-hour intake of 1500 mL/day between oral fluids and intravenous solutions. The output total is calculated as 2800 mL/day from urine output, emesis, and Hemovac drainage. Which nursing action is best to maintain an acceptable fluid balance?
Offer a prescribed antiemetic medication.
The calcium concentration in the blood is regulated by which mechanism?
Parathyroid hormone (PTH)
Which electrolyte is a major cation in body fluid?
Potassium
A nurse is caring for a client admitted with a diagnosis of exacerbation of myasthenia gravis. Upon assessment of the client, the nurse notes the client has severely depressed respirations. The nurse would expect to identify which acid-base disturbance?
Respiratory acidosis
What does the nurse recognize as one of the indicators of the patient's renal function?
Serum creatinine
A client with nausea, vomiting, and abdominal cramps and distention is admitted to the health care facility. Which test result is most significant?
Serum potassium level of 3 mEq/L
Which of the following electrolytes is the primary determinant of extracellular fluid (ECF) osmolality?
Sodium
To compensate for decreased fluid volume (hypovolemia), the nurse can anticipate which response by the body?
Tachycardia
The nurse is caring for a client diagnosed with chronic obstructive pulmonary disease (COPD) and experiencing respiratory acidosis. The client asks what is making the acidotic state. The nurse is most correct to identify which result of the disease process that causes the fall in pH?
The lungs are not able to blow off carbon dioxide.
A client reports muscle cramps in the calves and feeling "tired a lot." The client is taking ethacrynic acid (Edecrin) for hypotension. Based on these symptoms, the client will be evaluated for which electrolyte imbalance?
hypokalemia
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)?
Three ounces of light or dark meat chicken, 1 cup of spaghetti and a garden salad
A patient is diagnosed with hypocalcemia. The nurse advises the patient and his family to immediately report the most characteristic manifestation. What is the most characteristic manifestation?
Tingling or twitching sensation in the fingers
A client with emphysema is at a greater risk for developing which acid-base imbalance?
chronic respiratory acidosis
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
malignancy is causing the electrolyte imbalance.
Following a unilateral adrenalectomy, a nurse should assess for hyperkalemia as indicated by:
muscle weakness.
When evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis?
pH 7.48