Chapter 16 Fluid and electrolytes

The nurse is caring for a client with multiple organ failure and in metabolic acidosis. Which pair of organs is responsible for regulatory processes and compensation? A)Kidney and liver B)Heart and lungs C)Lungs and kidney D)Pancreas and stomach

C)Lungs and kidney

The nurse is assigned a client with calcium level of 4.0 mg/dL. Which system assessment would the nurse ask detailed questions? A)Endocrine system B)Gastrointestinal system C)Neurological system D)Musculoskeletal system

C)Neurological system

The nurse is reviewing client lab work for a critical lab value. Which value is called to the physician for additional orders? A) Potassium: 5.8 mEq/L B) Sodium: 138 mEq/L C) Magnesium: 2 mEq/L D) Calcium: 10 mg/dL

A) Potassium: 5.8 mEq/L

The nurse is reviewing lab work on a newly admitted client. Which of the following diagnostic studies confirm the nursing diagnosis of Deficient Fluid Volume? Select all that apply. A)An elevated hematocrit level B)A low urine specific gravity C)Electrolyte imbalance D)Low protein level in the urine E)Absence of ketones in urine

A)An elevated hematocrit level C)Electrolyte imbalance

Upon shift report, the nurse states the following laboratory values: pH, 7.44; PCO2, 30 mm Hg; and HCO3, 21 mEq/L for a client with noted acid-base disturbances. Which acid-base imbalance do both nurses agree is the client's current state? A)Compensated respiratory alkalosis B)Uncompensated respiratory alkalosis C)Compensated metabolic acidosis D)Compensated metabolic alkalosis

A)Compensated respiratory alkalosis

The nurse is documenting assessment findings of a client diagnosed with anasarca. Which nursing documentation best shows improvement in disease progression? A)Decreased abdominal girth B)Increased level of consciousness C)Weight maintenance D)Pulse rate decrease

A)Decreased abdominal girth

A client was admitted to your 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 his family? Select all that apply. A)Drink at least eight glasses of fluid each day. B)Drink caffeinated beverages to retain fluid. C)Drink carbonated beverages to help balance fluid volume. D)Drink water as an inexpensive way to meet fluid needs. E)Respond to thirst.

A)Drink at least eight glasses of fluid each day. D)Drink water as an inexpensive way to meet fluid needs. E)Respond to thirst.

The nurse is caring for a geriatric client in the home setting. Due to geriatric changes decreasing thirst, the nurse is likely to see a decrease in which fluid location which contains the most body water? A)Intracellular fluid B)Extracellular fluid C)Interstitial fluid D)Intravascular fluid

A)Intracellular fluid

Your clients 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)Metabolic alkalosis D)Respiratory acidosis

A)Metabolic acidosis

You are caring for a client with severe hypokalemia. The physician has ordered IV potassium to be administered at10 mEq/hr. The client complains of burning along his vein. What should you do? A)Seek a physicians order to dilute the infusion. B)Switch to an oral formulation. C)Increase the speed of transfusion. D)Change the electrolyte.

A)Seek a physicians order to dilute the infusion.

The nurse is conducting a lecture on the difference between hypovolemia and dehydration. When completing a verbal comparison, which point needs clarified? A)Similar causes are present in both conditions. B)Hypovolemia contains only low blood volume. C)In dehydration, only extracellular is depleted. D)Both conditions result in abnormal laboratory studies.

C)In dehydration, only extracellular is depleted.

The nursing instructor is talking with her junior nursing class about fluid and electrolyte balance. What would the instructor tell her students that the average daily fluid intake for an adult is? A)2000 mL B)2500 mL C)3000 mL D)3500 mL

B)2500 mL

The nurse is caring for a client with frequent dizziness. The nurse is evaluating the client for postural hypotension. Which of the following symptoms would indicate a potential diagnosis? A)A blood pressure elevation upon rising or activity B)A drop in systolic blood pressure (15 mmHg) upon rising C)A pulsating headache D)A drop in diastolic blood pressure (25 mm Hg) upon rising

B)A drop in systolic blood pressure (15 mmHg) upon rising

The nurse is instructing on the body's negative feedback loop to ensure homeostasis to a class of sixth graders. Which action by bases keeps the blood pH nearly neutral? A)Bases cast off acids. B)Bases bind with hydrogen. C)Bases hold acidic properties. D)Bases have no contact with acids.

B)Bases bind with hydrogen.

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

B)Elevated blood pressure

Which laboratory result does the nurse identify as a direct result of the client's hypovolemic status with hemoconcentration? A)Abnormal potassium level B)Elevated hematocrit level C)Low white blood count D)Low urine specific gravity

B)Elevated hematocrit level

Which nursing action is anticipated by the nurse to restore colloidal osmotic pressure to clients with third-spacing? A)Initiate an IV of an isotonic solution. B)Initiate an IV of albumin. C)Manage an infusion of plasma. D)Manage an infusion of total parenteral nutrition.

B)Initiate an IV of albumin.

A nursing instructor is teaching her class about burns. The instructor relates the following scenario: A nurse is caring for a severely burned client who now has elevated hematocrit and blood cell counts. What consequences should the nurse expect in this client? A)Slow heart rate B)Kidney stones and blood clots C)Imbalance in electrolytes D)Elevated central venous pressure (CVP)

B)Kidney stones and blood clots

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? A)Respiratory alkalosis B)Metabolic alkalosis C)Respiratory acidosis D)Metabolic acidosis

B)Metabolic alkalosis

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) A 7-year-old with a fracture tibia B) A 65-year-old with a myocardial infarction C) A 52-year-old with diarrhea D) A 72-year-old with a total knee repair

C) A 52-year-old with diarrhea

The nurse is caring for a client prescribed a low sodium diet. Which food, identified as a client favorite, will the nurse discourage? A)A grilled chicken sandwich with mayonnaise B)A natural fruit salad with nuts C)A hot dog with catsup D)A fresh grilled tuna entrée with fresh asparagus

C)A hot dog with catsup

The nurse receives report that a client's pH level is 7.4. Which nursing action would be most appropriate? A)Call the physician with the report. B)Encourage the client to deep breath. C)Complete a head-to-toe assessment. D)Obtain an ECG.

C)Complete a head-to-toe assessment.

A client is experiencing edema in the tissue. The nurse is correct in anticipating which tonicity of intravenous fluid? A)Isotonic fluid B)No intravenous solution C)Hypertonic solution D)Hypotonic solution

C)Hypertonic solution

You are caring for a client who has been admitted with a possible clotting disorder. The client is complaining of excessive bleeding and bruising without cause. You know that you should take extra care to check for signs of bruising or bleeding in what condition? A)Dehydration B)Hypokalemia C)Hypocalcemia D)Hypomagnesemia

C)Hypocalcemia

Which of the following conditions does the nurse need to confirm when he or she taps the facial nerve of a client who has dysphagia? A)Hypervolemia B)Hypercalcemia C)Hypomagnesemia D)Hypermagnesemia

C)Hypomagnesemia

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)Osmosis B)Passive diffusion C)Facilitated diffusion D)Active transport

D)Active transport

What is one process by which dissolved chemicals from one area of the body to another? A)Passive osmosis B)Free flow C)Passive elimination D)Active transport

D)Active transport

The nurse is providing nutritional instruction to the client diagnosed with hypovolemia. Which would the nurse emphasize as something to avoid? A)Eight to 10 glasses of water per day B)Foods high in sodium C)Potassium-rich fruit D)Beverages with alcohol or caffeine

D)Beverages with alcohol or caffeine

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? A)PaO2 B)PO2 C)Carbonic acid D)Bicarbonate

D)Bicarbonate

The nurse is caring for a client with laboratory values indicating dehydration. Which clinical symptom is consistent with the dehydration? A)Cool and pale skin B)Crackles in the lung fields C)Distended jugular veins D)Dark, concentrated urine

D)Dark, concentrated urine

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)Lung function B)Summer allergies C)Cardiovascular compromise D)Insensible fluid loss

D)Insensible fluid loss

A 64-year-old client is brought in to the clinic feeling thirsty with dry, sticky mucous membranes; decreased urine output; fever; a rough tongue; and is lethargic. Serum sodium level is above 145 mEq/L. Should the nurse start salt tablets when caring for this client? A)Yes, this will correct the sodium deficit. B)Yes, along with the hypotonic IV. C)No, start with the sodium chloride IV. D)No, sodium intake should be restricted.

D)No, sodium intake should be restricted.

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? A)Suggest a fluid restriction. B)Encourage oral fluids. C)Remove the Hemovac. D)Offer a prescribed antiemetic medication.

D)Offer a prescribed antiemetic medication.

. 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 rise in pH? A)The lungs are unable to breathe in sufficient oxygen. B)The lungs are unable to exchange oxygen and carbon dioxide. C)The lungs have ineffective cilia from years of smoking. D)The lungs are not able to blow off carbon dioxide.

D)The lungs are not able to blow off carbon dioxide.

The nurse is providing afternoon shift report and relates morning assessment findings to the oncoming nurse. Which daily assessment data is necessary to determine changes in hypervolemia status? A)Vital signs B)Edema C)Intake and output D)Weight

D)Weight