Fluid and electrolyte Test
NS 500ml to infuse in 3 hours. Set IV pump at? Answerml/hr. Round to nearest whole number (numbers only)
167
The nurse is viewing the rhythm strip of a patient on telemetry. The EKG strip below is consistent with which of the following electrolyte values? (EKG on the question)
K+ 6.0
pH 7.5 pCO2 35 HCO3 30 patient has been vomiting
Metabolic alkalosis
negatively charged ion
anion
hormone released by posterior pituitary that causes kidneys to hold on to sodium
antidiuretic hormone
Which client below is most likely experiencing excess fluid volume? (chart)
client D
pressure of proteins that pulls fluid back into vascular space from interstitial space; edema occurs if albumin levels are too low
colloid osmotic (oncotic) pressure
occurs when fluid is retained in the body
fluid volume excess
extracellular fluid surrounding the cells
interstitial space
fluid inside the cells - 2/3 of fluid in the body is located here, serves as a reservoir for fluid balance
intracellular space
extracellular fluid in the blood vessels, plasma
intravascular fluid
ntravascular fluid:
is the plasma within the blood
This solution 0.9% saline is_______________
isotonic
pH 7.13 pCOX 46 HCO3 12
metabolic acidosis
pH 7.35 pCO2 40 HCO3 24
normal ABG
ADH (antidiuretic hormone) is produced in the:
pituitary gland
What is a main source of Sodium?
pork
pH 7.10 pCO2 79 HCO3 21 - patient has emphysema and CO2 retention
respiratory acidosis
The nurse needs to draw an arterial blood gas. She will perform Allen's test to
verify collateral circulation
The daughter of a client with Dementia calls and reports that the client has not been drinking for 24 hours. Which instruction by the nurse is most appropriate? Hint: use your nursing process.
Ask the daughter about the presence of other symptoms.
A client has a nursing diagnosis of fluid volume deficit (FVD). Which vital sign, if decreased, supports this nursing diagnosis.
blood pressure
positivity charged ion
cation
ion has electrical charge (produces electrocity) in solution
electrolyte
serum blood levels are falsely decreased in fluid volume excess
hemodilution
pushes fluids from the vascular space into the interstitial space; edema occurs if too high
hydrostatic pressure
When a client's serum sodium level is 120 mEq/L, the priority nursing assessment is to monitor the status of which body system?
neurological
released by the kidneys when blood pressure or blood volume is low
renin-angiotensin-aldosterone
Order: Give 300 ml of IV fluids over 3 hr. gtt factor 20 gtts/ml. Calculate the gtts/min. Round to nearest whole number. Numbers only.
33
Of all of the followingclients, the nurse recognizes that the individual who is most at risk for a fluid volume deficit is:
42 year old with diarrhea x 3 days
Factors that can influence the flow rate of an IV solution include: (check all that apply)
a. placement in the vein b. condition of the catheter and tubing c. height of the solution e. blood pressure
energy is needed to move particles across the cell membrane
active trasport
occurs when fluid is lost from the body
dehydration or fluid volume deficit
fluid inside the blood vessels and surrounding the cells 1/2 of body fluid is located here
extracellular space
Normal osmolality is 280-300 mOsm. Your patient's glucose level is 400 *(normal 70-100). His blood tonicity would be described as
hypertonic
This solution, Dextrose 10% is
hypertonic
Normal osmolality is 280-300 mOsm. Your patient's sodium level is 115. His blood tonicity would be described as
hypotonic
This solution, D5% and 0.45% saline is
hypotonic
Which body organ is the principle regulator of fluid and electrolyte balance?
kidneys
An elderly client is transported to the emergency department from a local nursing home with a serum calcium level of 3.9 mEq/L. The client's family is upset and says "This is the second time this has happened since she got admitted to that home!" The nurse knows that this might have been caused by
lack of exposure to sunlight or vitamin D
A/An_________________ delivers 10 to 20 drops per milliliter of solution. Often selected for adult transfusions.
macrodrip
pH 7.10 pCO2 38 HCO3 16 - patient has renal disease and diabetic ketoacidosis
matabolic acidosis
pH 7.29 PCO2 43 HCO3 16 - patient took overdose of acetylsalacylic acid (aspirin)
metabolic acidosis
name for fluid in the intravascular space
plasma
pH 7.13 pCO2 79 HCO3 24
respiratory acidosis
patient is hypoventilating post surgery
respiratory acidosis
pH 7.5 pCO2 28 HCO2 27 - patient has been hyperventilating
respiratory alkalosis
pH 7.50 pCOs 25 HCO3 26
respiratory alkalosis
patient is anxious
respiratory alkalosis
Which findings suggest that interventions for a 90 year old with hypernatremia have been INEFFECTIVE?
restlessness and confusion
The morning labs for Mr R are as follows: K+ 4.0 Na+ 120 HCO3 24 Glucose 98. Which of the following should the nurse remove from the dinner tray/bedside table?
water pitcher
75 year old LP has been admitted for dehydration. His AM labs are as follows: Na 125 K+ 4.0 Cl 97 Glucose 96. He has been ordered IV fluid to treat his dehydration. Which of the following IV fluids would be inappropriate for LP?
0.45% saline
1000ml fluid is to infuse over 10 hours. Set the pump at Answer ml/hr (numbers only)
100
Order: Ancef 1 gm 100ml. Give over 30 minutes. gtt factor 15gtts/ml. Calculate the gtts/min. Numbers only. Round to nearest whole number.
50
1000ml Lactated Ringers hung at 1000. Pump is running at 80ml/hour. How many ml is left in bag at 1600? (numbers only)
520
The nurse hangs a1-liter bag of D5W for a diabetic patient going to surgery at 0530. The pump is set for 100ml/hr. How many ml of fluid is left in the bag at 0730 when the oncoming nurse makes rounds? (numbers only)
800
A 70 year old client with a history of coronary artery disease is admitted with FVE (fluid volume excess). Bumex ( a diuretic) is given and the client's serum potassium level drops to 3.0. IV potassium replacement is ordered. Which factor should the nurse consider when preparing to administer the IV potassium replacement?
Ice or warm packs may be needed to reduce vein irritation
The nurse is aware that the compensating mechanism that is most likely to occur in the presence of respiratory acidosis is
Retention of HCO3 by the kidneys to increase the pH level
Your patient's Na is 120. Select all of the following that is true related to this finding
a. The patient has had multiple tap water enemas b. The nurses have been using hypotonic saline to irrigate his NG tube for 2 days c. This condition could be caused by excessive secretion of ADH - Syndrome of Inappropriate ADH) in which the body holds onto move water than salt. d.The patient has fluid replacement for diarrhea and vomiting with only water, no salt
Body fluids perform several important functions such as
a. Transport material to and from cell b. Maintain blood volume d. Regulate body temperature e. Serve as a medium for cellular metabolism
Your patient's K+ is 6.6. Select all of the following that are true related to this condition.
a. Your patient may have renal disease and it is time for hemodialysis. b. expect weakness, and abnormal finding in the GI systemd. c. the doctor may order kayexlate which will cause diarrhea where the K+ will excreted in the feces thus lowering the levelf. d. monitor the EKG for peaked T wave and cardiac arrhythmias e. the doctor may order lasix to lower the level f. Your patient may have renal disease and has been using over the counter salt substitutes with KCl
Dehydration characteristics include
a. excessive fluid loss from the body b. shifting of fluid between the compartments c. decreased intake of fluids
After a subtotal thyroidectomy, the nurse sees a response in the patient's face below. The nurse should request an order to check _____________ levels.
calcium
Which electrolyte is responsible for bone health and neuromuscular and cardiac function?
calcium
A client is hypokalemic and the physician leaves an order for the nurse to infuse a bolus of 40 mEq of potassium in 100 ml of NS over 15 minutes. The most appropriate action by the nurse is to
clarify the order
RW has been placed on a 2000ml fluid restriction. The nurse should distribute the fluid over 24 hours. Which of the following would be the appropriate schedule?
d. 7-3 shift 1000 ml 3-11 shift 700 ml 11-7 shift 300ml
A patient with fluid volume deficit can be expected to have a slightly _______________ temperature.
elevated
When an excess of body fluid exists in the intravascular compartment, all of the following signs can be expected except:
elevated hematocrit
A small child is hospitalized with severe metabolic acidosis after ingesting a whole bottle of baby aspirin about 24 hours ago. The nursing care for this patient is geared toward reassuring the patient and:
frequent assessment of mental and neurological status
serum blood levels are fasely elevated in dehydration
hemoconcentration
pH 7.58 pCO2 35 HCO3 35
metabolic acidosis
patient has diabetes with blood sugar of 440
metabolic acidosis
patient has renal disease and liver is breaking down fatty acids
metabolic acidosis
patient is vomiting
metabolic alkalosis
A client with a pulmonary embolism has blood gases that show alkalosis. Which of the findings below support this diagnosis?
pH 7.54 pCO2 25 HCO3 24