Fluid and Electrolyte Checkpoint

Edema is caused by:

- heart failure - low serum protein - blockage of lymphatics

An older woman was admitted to the medical unit with GI bleeding and fluid volume deficit. Clinical manifestations of this problem are (select all that apply)

- weight loss - dry oral mucosa - decreased central venous pressure.

When monitoring the daily weight of a patient with fluid volume deficit (FVD), the nurse is aware that fluid loss may be considered when weight loss begins to exceed:

0.5 lbs

The nurse evaluates which of the following clients to be at risk for developing hypernatremia?

39-year-old with diarrhea and vomiting

Which patient is at greatest risk for developing hypermagnesemia?

42-year-old woman with systemic lupus erythematosus and renal failure - (involved with kidney failure)

The nurse is caring for a client with heart failure. On assessment, the nurse notes that the client is dyspneic, and crackles are audible on auscultation. What additional manifestations would the nurse expect to note in this client if excess fluid volume is present?

An increase in blood pressure and increased respirations

Which of the following pressure changes would result in decreased fluid movement into the interstitium?

An increase in interstitial osmotic pressure.

The nurse is reviewing laboratory results and notes that a client's serum sodium level is 150 mEq/L (150 mmol/L). The nurse reports the serum sodium level to the health care provider (HCP) and the HCP prescribes dietary instructions based on the sodium level. Which acceptable food items does the nurse instruct to avoid eating?

Cheese

The nurse reviews a client's laboratory report and notes that the client's serum phosphorus (phosphate) level is 1.8 mg/dL (0.45 mmol/L). Which condition most likely caused this serum phosphorus level?

Hyperparathyroidism

The nurse is reading a health care provider's (HCP's) progress notes in the client's record and reads that the HCP has documented "insensible fluid loss of approximately 800 mL daily." The nurse makes a notation that insensible fluid loss occurs through which type of excretion?

Integumentary output (i.e. sweating)

The nurse assesses a client and notes puffy eyelids, swollen ankles, and crackles at both lung bases. The nurse understands that these clinical findings are most specifically associated with fluid excess in which of the following compartments?

Interstitial compartment

Magnesium reabsorption is controlled by:

Loop of Henle

The nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which clinical manifestation would the nurse expect to note in the client?

Muscle cramping

The nurse is caring for a client with heart failure who is receiving high doses of a diuretic. On assessment, the nurse notes that the client has flat neck veins, generalized muscle weakness, and diminished deep tendon reflexes. The nurse suspects hyponatremia. What additional signs would the nurse expect to note in a client with hyponatremia?

Muscle weakness, spasms or cramps

During administration of a hypertonic IV solution, the mechanism involved in equalizing the fluid concentration between ECF and the cells is

Osmosis

The nurse prepares to administer intravenous albumin to a client with severe liver disease who has a low serum albumin level of 1.5 g/dL (15 g/L). Which characteristic finding associated with hypoalbuminemia should the nurse anticipate assessing?

Pitting Edema

Why does fluid re-enter the capillary from the interstitium at the venule end of the capillary bed?

Pressure is greater at the arterial end of the capillary

The nurse is caring for a client who has been in good health up to the present and is admitted with cellulitis of the hand. The client's serum potassium level was 4.5 mEq/L yesterday. Today the level is 7 mEq/L. Which of the following is the next appropriate nursing action?

Question the results and redraw the specimen

The nurse is preparing to care for a client with a potassium deficit. The nurse reviews the client's record and determines that the client is at risk for developing the potassium deficit because of which situation?

Requires nasogastric suction

Which client is at risk for the development of a hyperkalemia?

The client who has sustained a traumatic burn

The nurse administers serum albumin to a client to assist in?

The development of osmotic pressure

What is osmotic pressure

The minimum pressure which needs to be applied to a solution to prevent the inward flow of its pure solvent across a semipermeable membrane.

The nurse should be alert for which manifestations in a patient receiving a loop diuretic?

Weak, irregular pulse and poor muscle tone

The nurse caring for a client who has been receiving intravenous (IV) diuretics suspects that the client is experiencing a fluid volume deficit. Which assessment finding would the nurse note in a client with this condition?

Weight loss and poor skin turgor

What is the main regulator of colloidal osmotic (oncotic) pressure?

albumin

When assessing a patient for signs of fluid overload, the nurse would expect to observe:

bounding pulse

Which of the following conditions is associated with elevated serum chloride levels?

eclampsia

An excessive accumulation of interstitial fluid is termed:

edema

Mr. Miyazaki who is diagnosed of bipolar disorder has been drinking copious amounts of water and voiding frequently. The patient is experiencing muscle cramps, twitching, and is reporting dizziness. the nurse checks lab work for:

electrolytes, particularly the serum sodium

A rise in arterial pressure causes the baroreceptors and stretch receptors to signal an inhibition of the sympathetic nervous system, resulting in:

increased urine output

Which of the following conditions is an equal decrease of extracellular fluid (ECF) solute and water volume?

isotonic fluid volume deficit

Etiologies associated with hypocalcemia may include all of the following except:

metastatic bone lesions

The difference in net pressure in artery and vein part of capillary causes:

net fluid loss

During the postoperative care of a 76-year-old patient, the nurse monitors the patient's intake and output carefully, knowing that the patient is at risk for fluid and electrolyte imbalances primarily because

older adults have an impaired thirst mechanism and need reminding to drink fluids.

A patient experiencing multisystem fluid volume deficit, has the symptoms of tachycardia, pale, cool skin, & decreased urine output. The nurse realizes these findings are most likely a direct result of which of the following?

pharmacological effects of a diuretic

Disease of which of the following structures is most likely to affect electrolyte reabsorption?

renal tubules

In renal regulation of water balance, the functions of angiotensin II include:

selectively constricting portions of the arteriole in the nephron

Which of the following findings would the nurse expect to asses in hypercalcemia?

urinary calculi