Fluid and Electrolytes (1st year nursing/nclex)

a client is in a state of uncompensated acidosis. What approximate arterial blood pH does the nurse expect the client to have? 1. 7.20 2. 7.35 3. 7.45 4. 7.48

1. 7.20 normal range is 7.35- 7.45

a rn is reviewing a client's serum electrolyte laboratory report. what is a comparison between blood plasma and interstitial fluid? 1. they both contain the same kinds of ions 2. plasma exerts lower osmotic pressure than does interstitial fluid 3. plasma contains more of each kind of ion than does interstitial fluid 4. sodium is higher is plasma whereas potassium is higher in interstitial fluid

1. blood plasma and interstitial fluid are both part of the extracellular fluid and are of the same ionic composition

a nurse is evaluating the effectiveness of treatment for a client with excessive fluid volume. what clinical finding indicates that treatment has been successful? 1. clear breath sounds 2. positive pedal pulses 3. normal potassium level 4. increased urine specific gravity

1. excess fluid can move into the lungs; causing crackles. clear breath sounds support that treatment was effective.

Magnesium levels

1.5 - 2.5

Sodium levels

135-145

what complication is prevented when a nurse addresses the needs of a client who is hyperventilating? 1. cardiac arrest 2. carbonic acid deficit 3. reduction in serum pH 4. excess oxygen saturation

2. hyperventilation causes excessive loss of carbon dioxide, leading to carbonic acid deficit and respiratory alkalosis

a nurse is analyzing how a hyperglycemic client's blood glucose can be lowered. the nurse considers that the chemical that buffers the client's excessive acetoacetic acid is: 1. potassium 2. bicarbonate 3. carbon dioxide 4. sodium chloride

2. sodium bicarbonate is a base and one of the major buffers in the body

in reviewing lab of a client with a tentative DX of kidney failure; what mechanism does the nurse expect to be maintained when ammonia is excreted by healthy kidneys? 1. osmotic pressure of the blood 2. acid-base balance of the body 3. low bacterial levels in the urine 4. normal red blood cell production

2. the excreted ammonia combines with hydrogen ions in the globular filtrate to form ammonium ions, which are excreted by the body. this mechanism helps rid the body of excess hydrogen, maintaining acid-balance.

a client's serum potassium level has increased to 5.8. what action should the nurse implement first: 1. call lab and repeat test 2. take vitals and notify PCP 3. inform the cardiac arrest team and place them on alert 4. take an electrocardiogram and have lidocaine available.

2. vital signs monitor cardiorespiratory status; hyperkalemia causes cardiac dysrhythmias. the pcp should be notified because medical intervention may be necessary

Phosphate levels

2.5-4.5

what clinical indicators should the nurse expect a client with hyperkalemia to exhibit? Select all that apply 1. tetany 2. seizures 3. diarrhea 4. weakness 5. dysrhythmias

3, 4 and 5 tetany = hypocalcemia seizures = electrolyte imbalances with low calcium or sodium levels

an arterial blood gas report indicates the client's pH s 7.25, PCO2 is 35 and HCO3 is 20. which disturbance should the nurse identify based on these results? 1. metabolic acidosis 2. metabolic alkalosis 3. respiratory acidosis 4. respiratory alkalosis

3. metabolic acidosis

a nurse adds 20mEq of potassium chloride to the IV solution of a client with diabetic ketoacidosis. what is the primary purpose for administering this drug? 1. treat hyperpnea 2. prevent flaccid paralysis 3. replace excessive losses 4. treat cardiac dysrhythmias

3. once treatment with insulin for diabetic ketoacidosis is begun, potassium ions reenter the cell, causing hypokalemia; therefore, potassium along with the replacement fluids are needed.

a nurse is concerned that a client is at risk for developing hyperkalemia. which disease does the client have that has caused this concern? 1. chrohn 2. cushing 3. end-stage renal 4. gastroesophageal reflux

3. one of the kidneys' functions is to eliminate potassium from the body; diseases of the kidneys often interfere with this function, and hyperkalemia may develop, necessitating dialysis

a client is admitted with metabolic acidosis. the RN considers that 2 body systems interact with the bicarbonate buffer system to preserve healthy body pH. what 2 body systems should the nurse assess for compensatory changes? a. skeletal and nervous b. circulatory and urinary c. respiratory and urinary d. muscular and endocrine

3. respiratory and urinary

a nurse is caring for a client with ascites. what does the nurse consider to be the cause of ascites? 1. portal hypotension 2. kidney malfunction 3. diminished plasma protein level 4. decreased production of potassium

3. the liver manufactures albumin, the major plasma protein. a deficit of this protein lowers the osmotic (oncotic) pressure in the intravascular space, leading to a fluid shift.

Potassium levels

3.5-5

a nurse caring for a client with albuminuria resulting in edema. what pressure change does the nurse demonstrate as the cause of the edema? 1. decrease in tissue hydrostatic pressure 2. increase in plasma hydrostatic pressure 3. increase in tissue colloid osmotic pressure 4. decrease in plasma colloid oncontic pressure

4. because the plasma colloidal oncotic pressure (COP) is the major force drawing fluid from the interstitial spaces back into the capillaries, a drop in COP caused by albuminuria results in edema.

a client's arterial blood gas report indicates pH 7.52 PCO2 32 HC03 24. what does the nurse identify as a possible cause of these results? 1. airway obstruction 2. inadequate nutrition 3. prolonged gastric suction 4. excessive mechanical ventilation

4. respiratory alkalosis, which can be caused by mechanical ventilation that is too aggressive

a nurse assesses a client's serum electrolyte levels in the lab report. what electrolyte in intracellular fluid should the nurse consider most important? 1. sodium 2. calcium 3. chloride 4. potassium

4. the concentration of potassium is greater inside the cell and is important in establishing a membrane potential, a critical factor in the cell's ability to function

Calcium levels

8.5-10.5

Chloride levels

95-108