FLUID AND ELECTROLYTE TICKET TO TEST
The nurse is instructing a client with recurrent hyperkalemia about following a potassium-restricted diet. Which statement by the client indicates the need for additional instruction?
"I will not salt my food; instead I'll use salt substitute."
Which solution is hypotonic?
0.45% NaCl
Which is considered an isotonic solution? 0.9% normal saline 0.45% normal saline Dextran in normal saline 3% NaCl
0.9% normal saline
The nurse knows which is the normal serum value for potassium?
3.5-5.0
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 nurse is caring for a client admitted with a diagnosis of acute kidney injury. When reviewing the client's most recent laboratory reports, the nurse notes that the client's magnesium levels are high. The nurse should prioritize assessment for what health problem?
Diminished deep tendon reflexes
The nurse is assessing the client for the presence of a Chvostek sign. What electrolyte imbalance would a positive Chvostek sign indicate?
Hypocalcemia
An elderly client takes 40 mg of furosemide twice a day. Which electrolyte imbalance is the most serious adverse effect of diuretic use?
Hypokalemia
The nurse is working on a burns unit and an acutely ill client is exhibiting signs and symptoms of third spacing. Based on this change in status, the nurse should expect the client to exhibit signs and symptoms of what imbalance?
Hypovolemia
The nurse is performing an admission assessment on an older adult client newly admitted for end-stage liver disease. What principle should guide the nurse's assessment of the client's skin turgor?
Inelastic skin turgor is a normal part of aging.
When caring for a client who has risk factors for fluid and electrolyte imbalances, which assessment finding is the highest priority for the nurse to follow up? Mild confusion Weight loss of 4 lb Irregular heart rate Blood pressure 96/53 mm Hg
Irregular heart rate
Your client has a diagnosis of hypervolemia. What would be an important intervention that you would initiate?
Limit sodium and water intake.
Which of the following would be appropriate nursing interventions for a client with hypokalemia? Select all that apply. Monitor intake and output every shift. Administer the ordered Kayexalate enema. Administer the ordered potassium 40 mg IV push. Offer a diet with fruit juices and citrus fruits. Administer the ordered furosemide 60 mg po.
Monitor intake and output every shift., Offer a diet with fruit juices and citrus fruits.
A 64-year-old client is brought in to the clinic with thirsty, dry, sticky mucous membranes, decreased urine output, fever, a rough tongue, and lethargy. Serum sodium level is above 145 mEq/L. Should the nurse start salt tablets when caring for this client?
No, sodium intake should be restricted.
A client is being treated in the ICU 24 hours after having a radical neck dissection completed. The client's serum calcium concentration is 7.6 mg/dL (1.9 mmol/L). Which physical examination finding is consistent with this electrolyte imbalance?
Presence of Trousseau sign
A client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should the nurse assess first?
Pulse
A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Laboratory results reveal serum sodium level 130 mEq/L and urine specific gravity 1.030. Which nursing intervention helps prevent complications associated with SIADH?
Restricting fluids to 800 ml/day
A client has a serum calcium level of 7.2 mg/dl (1.8 mmol/L). During the physical examination, the nurse expects to assess:
Trousseau's sign.
Which is an insensible mechanism of fluid loss?
breathing
The nurse is caring for a client with laboratory values indicating dehydration. Which clinical symptom is consistent with the dehydration?
dark concentrated urine
Early signs of hypervolemia include
increased breathing effort and weight gain.
Which is a correct route of administration for potassium?
oral
Which electrolyte is a major cation in body fluid?
potassium
A physician orders an isotonic I.V. solution for a client. Which solution should the nurse plan to administer?
Lactated Ringer's solution
The nurse is caring for a client in heart failure with signs of hypervolemia. Which vital sign is indicative of the disease process?
Elevated blood pressure
Which is the most common cause of symptomatic hypomagnesemia?
alcoholism
Which of the following is the most common cause of symptomatic hypomagnesemia in the United States?
alcoholism
A client is taking spironolactone to control hypertension. The client's serum potassium level is 6 mEq/L. What is the nurse's priority during assessment?
electrocardiogram (ECG) results
Which nerve is implicated in the Chvostek's sign?
facial
A client reports muscle cramps in the calves and feeling "tired a lot." The client is taking ethacrynic acid (Edecrin) for hypertension. Based on these symptoms, the client will be evaluated for which electrolyte imbalance?
hypokalemia
Clients diagnosed with hypervolemia should avoid sweet or dry food because it
increases the client's desire to consume fluid.
The nurse is caring for a client undergoing alcohol withdrawal. Which serum laboratory value should the nurse monitor most closely?
magnesium
A client is diagnosed with hypocalcemia and the nurse is teaching the client about symptoms. What symptom would the nurse include in the teaching?
tingling sensation in the fingers
What does the nurse understand is the primary method by which fluid volume is regulated?
urine exertion
The community health nurse is performing a home visit to an older client recovering from hip surgery. The nurse notes that the client seems uncharacteristically confused and has dry mucous membranes. When asked about fluid intake, the client states, "I stop drinking water early in the day because it is just too difficult to get up during the night to go to the bathroom." What would be the nurse's best response?
"Limiting your fluids can create imbalances in your body that can result in confusion. Maybe we need to adjust the timing of your fluids."
A client is to receive hypotonic IV solution in order to provide free water replacement. Which solution does the nurse anticipate administering?
0.45% NaCl
The physician has prescribed a hypotonic IV solution for a patient. Which IV solution should the nurse administer?
0.45% sodium chloride
While assessing a client's peripheral IV site, the nurse observes edema around the insertion site. How should the nurse document this complication related to IV therapy?
Infiltration
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?
Insensible fluid loss
The nurse is reviewing client lab work for a critical lab value. Which value is called to the physician for additional orders? Potassium: 5.8 mEq/L Calcium: 10 mg/dL Sodium: 138 mEq/L Magnesium:2 mEq/L
Potassium: 5.8 mEq/L
Which of the following electrolytes is the primary determinant of extracellular fluid (ECF) osmolality? Sodium Magnesium Potassium Calcium
Sodium
A nurse is monitoring a client being evaluated who has a potassium level of 7 mEq/L (mmol/L). Which electrocardiogram changes will the client display?
peaked T waves
The nurse is caring for a client in the intensive care unit (ICU) following a near-drowning event in saltwater. The client is restless, lethargic, and demonstrating tremors. Additional assessment findings include swollen and dry tongue, flushed skin, and peripheral edema. The nurse anticipates that the client's serum sodium value would be
155 mEq/L (155 mmol/L)
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?
1L
A patient is admitted with severe vomiting for 24 hours as well as weakness and "feeling exhausted." The nurse observes flat T waves and ST-segment depression on the electrocardiogram. Which potassium level does the nurse observe when the laboratory studies are complete?
2.5 mEq/L
A nurse is providing an afternoon shift report and relates morning assessment findings to the oncoming nurse. Which daily assessment data is necessary to determine changes in the client's hypervolemia status?
WEIGHT
A client's most recent laboratory results show a slight decrease in potassium. The physician has opted to forego drug therapy but has suggested increasing the client's dietary intake of potassium. What should the nurse recommend?
bananas
A client was admitted to the hospital unit after 2 days of vomiting and diarrhea. The client's spouse became alarmed when the client demonstrated confusion and elevated temperature, and reported "dry mouth." The nurse suspects the client is experiencing which condition?
dehydration
A client with severe hypervolemia is prescribed a loop diuretic and the nurse is concerned with the client experiencing significant sodium and potassium losses. What drug was most likely prescribed?
furosemide
Oral intake is controlled by the thirst center, located in which of the following cerebral areas?
hypothalamus
