Fluid + Electrolyte Quiz

A nurse is reviewing a client's lab results. Which of the following lab values should the nurse report to the provider? A. Sodium 126 mEq/L B. Potassium 3.6 mEq/L C. Magnesium 1.9 mEq/L D. Chloride 99 mEq/L

Sodium 126 mEq/L Rationale: Therapeutic sodium level is 136 to 145 mEq/L. Low sodium values can be seen with dehydration, use of diuretics, adrenal insufficiency, and water toxicity. Sodium is essential for maintaining acid-base balance and conduction of nerve and muscles tissue. Hyponatremia is a net gain of water or loss of sodium that results in a sodium level less than 136 mEq/L. Manifestations of hyponatremia include headache, confusion, lethargy, muscle weakness, fatigue, decreased deep-tendon reflexes, and seizures.

A nurse is caring for a client who sustained blood loss. Which of the following is a manifestation of hypovolemia? A. Decreased heart rate B. Dyspnea C. Increased blood pressure D. Weak pulse

Weak pulse Rationale: A decreased volume of circulating blood and less pressure within the vessels results in weak peripheral pulses (rated as +1), which can be described as thready.

A nurse in the emergency department is caring for a client who collapsed after playing football on a hot day. After reviewing the admission laboratory findings, the nurse recognizes that these findings are consistent with which of the following conditions? Sodium 152 mEq/L Glucose 102mg/dL Potassium 3.6 mEq/L BUN 18 mg/dL Chloride 105 mEq/L Creatinine 0.7 mg/dL A. Renal failure B. Low-protein diet C. Dehydration D. Syndrome of inappropriate antidiuretic hormone (SIADH)

Dehydration Rationale: Hypernatremic (hypertonic) dehydration occurs with excessive fluid losses due to perspiration, respiration, and inadequate fluid intake. The nurse should note that the client's sodium is above the accepted reference range, while glucose, potassium, BUN, chloride, and creatinine are within the accepted reference ranges. The client's history, collapsing after activity on a hot day, and the sodium findings are consistent with dehydration due to water deficit.

A nurse is preparing to administer potassium chloride (KCL) to a client who is receiving diuretic therapy. The nurse reviews the client's serum potassium level results and discovers the client's potassium level is 3.2 mEq/L. Which of the following actions should the nurse take? A. Give the ordered KCL as prescribed. B. Omit the KCL dose and document that it was not given. C. Hold the prescribed dose and notify the provider of the serum potassium level. D. Call the lab to verify the client's results.

Give the ordered KCL as prescribed. Rationale: The client's serum potassium level is below the recommended reference range. The nurse should administer the KCL as prescribed.

A nurse is admitting a client who has a serum calcium level of 12.3 mg/dL and initiates cardiac monitoring. Which of the following findings should the nurse expect during the initial assessment? A. Lethargy B. Hyperactive deep tendon reflexes C. Prolonged ST segment D. Hyperactive bowel sounds

Lethargy Rationale: A serum calcium level of 12.3 mg/dL is above the expected reference range. The nurse should monitor the client for lethargy, generalized weakness, and confusion. B. Hyperactive deep tendon reflexes

A nurse is assessing a client who has a sodium level of 116 mEq/L. Which of the following findings should the nurse expect? A. Nausea and vomiting B. Extreme thirst C. Flushed skin D. Fever

Nausea and vomiting Rationale: A sodium level of 116 mEq/L is a critical value indicating hyponatremia. Nausea and vomiting are expected findings for a client with this sodium level.

A nurse is caring for a client who has a new prescription for a low-sodium diet. The client's family has requested to bring in some of the client's favorite foods. Which of the following food items should the nurse tell the family members to omit? A. Boiled rice B. Flat bread C. Broiled fish fillet D. Pickled vegetables

Pickled vegetables Rationale: Due to the pickling brine, pickled vegetables are high in sodium. The family should not bring this food item to the client.

A nurse is reviewing the laboratory results of a client who has fluid volume deficit. The nurse would expect which of the following findings? A. Urine specific gravity 1.035 B. Hematocrit 44% C. BUN 19 mg/dL D. Sodium 155 mEq/L

Urine specific gravity 1.035 Rationale: A client experiencing fluid volume deficit would manifest an increased urine specific gravity greater than 1.030

A nurse is reviewing the medical record of a client who has a potassium level of 3.0 mEq/L. Which of the following findings should the nurse recognize as a potential causative factor? A. Client is currently prescribed spironolactone. B. Client has a history of alcohol abuse disorder. C. Client reports drinking 3.5 to 4 L of water each day. D. Client has an NG tube to gastric suction.

Client has an NG tube to gastric suction Rationale: The client who has an NG tube to gastric suction is at risk for developing hypokalemia due to the gastrointestinal loss of potassium.

A nurse is preparing to administer 40 mEq of potassium chloride in 45% sodium chloride (NaCl) 500 mL IV to infuse 10 mEq/hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) ______ mL/hr

125 mL/hr

A nurse is preparing to administer potassium chloride 20 mEq suspension PO daily. The amount available is potassium chloride suspension 10 mEq/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)

2 mL

A nurse is caring for a client who has a prescription for potassium chloride (KCL) 20 mEq PO daily. The nurse reviews the client's most recent laboratory results and finds the client's potassium level is 5.2 mEq/L. Which of the following actions should the nurse take? A. Give the ordered KCL as prescribed. B. Omit the KCL dose and document it was not given. C. Call the prescribing physician and inform her of the client's serum potassium level results. D. Call the lab to verify the client's results.

Call the prescribing physician and inform her of the client's serum potassium level results. Rationale: As a potassium level of 5.2 mEq/L is above the expected reference range, the nurse should hold the medication and notify the provider of the client's serum potassium level. D. Call the lab to verify the client's results.

A nurse is instructing a group of clients regarding calcium rich foods. Which of the following foods should the nurse include in the teaching as the best source of calcium? A. ½ cup ice cream B. 1 ounce swiss cheese C. 1 cup milk D. 1 cup cottage cheese

1 cup milk Rationale: Of the four choices, milk contains the most calcium per serving.Milk c ontains 276 mg calcium per one cup serving.

A nurse is reviewing the laboratory results of a client who is dehydrated. Which of the following BUN lab values should the nurse report to the provider? A. 25 mg/dL B. 13 mg/dL C. 10 mg/dL D. 18 mg/dL

25 mg/dL Rationale: The expected reference range for BUN values is 10 to 20 mg/dL. If the BUN is above this range, the kidneys might be having difficulty excreting urea and nitrogen. Elevation can be seen in dehydration and might require the use of intravenous fluids.

A nurse is caring for a 3-year-old child who was admitted with acute diarrhea and dehydration. Which of the following findings indicates that oral rehydration therapy has been effective? A. Heart rate 130/min B. Respiratory rate 24/min C. Urine specific gravity 1.015 D. Capillary refill greater than 3 seconds

Urine specific gravity 1.015 Rationale: The expected reference range for urine specific gravity is 1.010 to 1.025. A result of 1.015 indicates the child is hydrated. A result greater than 1.025 indicates dehydration. Dehydration results when the total output of fluid exceeds the total intake. Infants and children who have diarrhea and dehydration should be treated first with oral rehydration therapy, such as Pedialyte and Infalyte. After rehydration, oral rehydration therapy can be alternated with a low-sodium solution, such as water, breast milk, lactose-free formula, or half-strength lactose-containing formula.