Fluids and Electrolytes
The nurse is caring for a client whose blood pressure is 90/49 mm Hg. This client's kidneys will compensate by secreting which substance?
renin
A patient is admitted for renal dysfunction. The nurse knows that the kidneys receive 20%-25% of the total cardiac output. This means that all of the body's blood circulates through the kidneys how many times an hour?
12
The nurse is caring for a client who is being monitored for hypercalcemia. The nurse understands that what calcium level is considered a medical emergency?
12 mg?dL
After receiving the results of blood work for a client with dehydration, the nurse knows which sodium level is indicative of hyponatremia?
129
An elderly client postoperative hip replacement is experiencing signs of hyponatremia. The nurse checks the client's electrolyte levels. Which of the following serum sodium levels confirms this diagnosis?
130 mEq/L
A client consumed the 6-ounce cup of orange juice that was on the breakfast tray. The nurse should document what volume of fluid intake on the client's fluid balance sheet.
180 ml
The nurse is conducting a first aid class and informs the class that in the case of acute, nonspecific diarrhea in adults where fluid losses are not severe, clients usually need only simple replacement of fluids and electrolytes lost in the stool. The nurse instructs the class to drink how much fluid during the first 24 hours?
2 -3 L of clear liquids
The nurse is providing health promotion education to a client regarding proper hydration. How much urine will the nurse indicate an adequately hydrated adult produces each day?
2 L/ d
A client is receiving digoxin and a potassium supplement. When monitoring daily laboratory values, what should the potassium level be for this client?
3.5 to 5.0 mEq/L
A client with renal impairment has been receiving hydrochlorothiazide, and lately it has been less effective than usual. The nurse knows that thiazide drugs become ineffective when the GFR is less than what level?
30 mL/min
A clinic nurse has been assigned to follow up with a group of patients on hydrochlorothiazide therapy. Which patient will the nurse most closely monitor for hyponatremia?
71 yo female who has advanced arteriosclerosis
Nonspecific therapy of diarrhea includes:
Adequate fluid and electrolyte replacement.
What is the most prevalent mineralocorticoid that regulates fluid balance?
Aldosterone
A client, treated successfully for diarrhea, has had only one loose bowel movement during the day. Which food should be introduced back into the diet first?
BAKED POTATO
A client is taking prednisone 10 mg per day. Which laboratory study does the nurse identify as directly correlated with the use of this medication?
Calcium level of 6.2 mg Normal serum calcium is 8.5 to 10.5 mg/dL. A low calcium level directly corresponds to the chronic use of corticosteroids; steroids decrease the absorption of calcium and place the client at risk for the development of osteoporosis. Potassium, sodium, and phosphorus levels are within normal range.
Calcium participates in many metabolic processes, including the regulation of which of the following? Choose all that apply.
Cell membrane permeability and function Nerve-cell excitability and transmission of impulses Contraction of cardiac, skeletal, and smooth muscle
The nurse is caring for a client receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which will alert the nurse that the client may be experiencing nephrotoxicity ?
DECREASE IN URINE OUTPUT
Which of the following nursing diagnoses is a priority for a client who is 89 years old and has frequent liquid stools?
Deficient fluid volume related to excessive losses in liquid stools
A nurse is caring for a client who is to receive IV potassium. Which action would be appropriate?
Ensure that potassium infuses in no less than 4 hours.
A client who has been admitted to the healthcare center has been diagnosed with emphysema. The arterial blood gas results reveal respiratory acidosis. Based on this information, what should the nurse explain to the client that is the cause of the respiratory acidosis?
Excess carbon dioxide in the blood if a person has a breathing disorder, carbon dioxide an build up in the body, dangerously lowing blood pH
A client has edema of the lower extremities with crackles in the lung bases. What diuretic is most likely to be prescribed for a client assessed with lower extremity edema and bilateral lung crackles?
Furosemide
A male client has cirrhosis of the liver that has caused ascites. The nurse knows that what condition may occur if diuretics are used to reduce the ascites?
Hepatic encephalopathy
A patient is diagnosed with hypercalcemia. The nurse knows that which statement regarding hypercalcemia is correct?
Hypercalcemia can lead to calcium deposits that damage the kidneys.
The nurse is providing education to a client with diabetes mellitus who has been prescribed captopril. What potential adverse effect will the nurse include in the teaching?
Hyperkalemia
You are preparing to administer a saline cathartic when the patient mentions that they have CHF. You know that saline cathartics are contraindicated for clients with congestive heart failure due to what adverse effect?
Hypernatremia
A patient is diagnosed with hypocalcemia. The nurse knows that which statement regarding hypocalcemia is correct?
Hypocalcemia can be accompanied by hyperphosphatemia.
A client required several doses of furosemide and now has developed hypokalemia. What medication will be prescribed to treat this adverse effect?
POTASSIUM CHLORIDE
The nurse is caring for a client with severe hypercalcemia. The nurse knows that hypercalcemic syndrome may develop and expects the health care provider to order which intervention?
IV sodium chloride and a diuretic medication
A client diagnosed with hyperkalemia has been prescribed treatment with intravenous insulin and glucose. What is the action by which these substances address the disorder?
Insulin and glucose drive potassium into the cells.
A client who is taking chemotherapeutic drugs for treatment of a malignant cancer has repeated bouts of vomiting. Electrolytes are administered to maintain the serum electrolyte balance. However, the client cannot absorb electrolytes taken orally. Which is the preferred route of electrolyte administration in such a case?
Intravenous
A client is diagnosed with hyponatremia and hypoglycemia and is currently experiencing lactic acidosis. What condition is most consistent with this clinical presentation?
Myxedema coma
Which of the following is a correct route of administration for potassium?
ORAL
A 15-year-old client is brought to the emergency department by his friends. He reports visual changes, drowsiness, and tinnitus. He is confused and hyperventilating. These symptoms may be attributable to which condition?
Salicylate intoxication
A female client presents to the emergency department with symptoms and laboratory values indicative of hypercalcemia. What IV solutions would the health care provider order to treat the hypercalcemia?
Sodium chloride (0.9%)Sodium chloride (0.9%) injection (normal saline) is an IV solution that contains water, sodium, and chloride. It is included here because it is the treatment of choice for hypercalcemia and is usually effective. The sodium contained in the solution inhibits the reabsorption of calcium in renal tubules and thereby increases urinary excretion of calcium.
A nurse is preparing to administer a diuretic that antagonizes the action of aldosterone. Which drug would the nurse likely administer?
Spironolactone
A nurse is caring for a client with acute renal failure. The health care provider has prescribed a diuretic therapy for the client to promote dieresis. What intervention should the nurse perform to prevent the inconvenience caused by increased urination?
administer the drug early in the day
A patient with chronic renal failure receiving epoetin alfa will be having a total left hip arthroplasty. What supplementation should the patient receive prior to surgery?
an iron supplement
What food should the nurse encourage a patient taking Lasik to consume to prevent a low potassium (K+) level?
bananas
An older adult client has been diagnosed with Paget's disease. Which serum electrolyte is altered in this disease process?
calcium
You are caring for a patient in hypovolemic shock. What is a priority nursing action for this client?
check blood pressure and pulse
The nurse is assessing a client being treated for Cushing's disease. Which assessment suggests that medication therapy is therapeutic?
decreased peripheral edema
The pharmacology instructor is discussing the various diuretic agents and their sites of action in the nephron. In what part of the nephron do thiazide diuretics act?
distal tubule
The patient with chronic renal failure requires an agent to increase red blood cell production. What drug does the nurse anticipate administering?
epoiten alfa
Which would a nurse identify as responsible for causing the release of antidiuretic hormone?
falling blood volume
A client who is taking an estrogen reports swelling and weight gain. The nurse notes some peripheral edema. Which nursing diagnosis would the nurse identify as the priority?
fluid volume excess
The nurse is providing education to a 72-year-old client who has been discharged home on a diuretic. What should the nurse include in the discharge instructions?
how to properly weigh themselves at home
A client is admitted to a medical-surgical unit with a diagnosis of nausea, vomiting, and dehydration related to an antibiotic allergy. Which electrolyte-associated imbalance does the nurse expect with this diagnosis?
hyperantremia
A 66-year-old woman has a complex medical history that includes poorly-controlled type 1 diabetes, renal failure as a result of diabetic nephropathy and chronic heart failure (CHF). Her care provider has recently added spironolactone (Aldactone) to the woman's medication regimen. The nurse should consequently assess for signs and symptoms of
hyperkalemia
A 91-year-old client, who is being prepared for discharge, has been prescribed the diuretic spironolactone. While teaching the client about the drug, what major adverse effect should the nurse be sure to mention?
hyperkalemia
The nurse is assessing a client who has been prescribed a potassium-sparing diuretic. For what disorder would the nurse assess the client?
hyperkalemia
A health care provider is considering ordering hydrochlorothiazide for a client. This drug must be used cautiously, if at all, if the client has a history of:
hypersensitivity of sulfonamides
After teaching a group of students about the effects of mineralocorticoids, the instructor determines that additional teaching is needed when the students identify what as an effect?
increased calcium retention
The nursing students are learning about digoxin therapy in their pharmacology class. The students will learn that there is a higher risk of digoxin toxicity in clients with
low serum potassium levels
A child diagnosed with a serious fungal infection is prescribed amphotericin B parenterally. When considering possible adverse effects, the nurse should monitor the child's level of which mineral?
magnesium
In addition to calcium, what electrolyte affects parathyroid hormone (PTH) secretion?
magnesium
A nurse is caring for a client who is undergoing chemotherapy. The client has experienced several episodes of vomiting. Which would be appropriate for the nurse to do for this client as part of the ongoing assessment?
measure all fluid intake and output
A male client tells the nurse that he takes antacid tablets several times each day. Knowing that the brand of antacid he uses contains calcium carbonate, the nurse cautions the client that overuse could place him at risk for:
metabolic alkalosis
Ms. Crampton is prescribed furosemide for chronic heart failure. The nurse knows that furosemide can cause electrolyte imbalances and what other serious side effect?
metabolic alkalosis
Sodium is the major extracellular cation in the body. What is one of its functions?
nerve impulse transmission
A senior-level nurse is teaching a course on lifespan considerations when administering magnesium infusions. Which of the following information would the nurse include while teaching the subject?
older adults may need reduced dose because of decreased renal function
When a client has an increased serum level of ionized calcium, which hormone will be released?
parathyroid hormone (PTH)
A client reports numbness and tingling around the mouth and has a positive Trousseau's sign after a parathyroidectomy. Which medication will be administered?
parenteral calcium gluconate
Clients who are taking nifedipine should be monitored for which of the following adverse effects?
peripheral edema
The nurse administers a loop diuretic to the client. In addition to sodium and water, what other electrolyte would the nurse expect to be excreted in significant amounts?
potassium
The nurse has a prescription to administer a saline cathartic to a client who has a history of congestive heart failure (CHF). Why is this type of cathartic contraindicated with this client?
pt at risk for excess fluid volume
The nurse is caring for a client whose potassium level is 5.9 mg/dL (5.9 mmol/L). How will the client's kidneys respond to this potassium level?
removing more potassium in the distal convoluted tubule
The nurse is explaining the kidney's role in acid-base balance to a client. What function does the nurse state the kidney performs to assist in maintaining acid-base balance within the necessary normal range?
return acid to the body's circulation
Calcium levels are directly related to which of the following blood components?
serum albumin
A female client presents to the health care provider's office with weakness, dizziness, and heart palpitations. She takes over-the-counter Super Dieter's Tea. What laboratory tests does the nurse expect the provider to order for this client?
serum electrolytes
You are caring for a client with shock. You are concerned about hypoxemia and metabolic acidosis with your client. What finding should you analyze for evidence of hypoxemia and metabolic acidosis in a client with shock?
serum thyroid levels findings
A nurse is caring for a patient who has been prescribed potassium. From the patient's health history, the nurse understands that the patient has also been taking salt substitutes. Which of the following conditions should the nurse monitor for in this patient, occurring due to the interaction of the salt substitutes with potassium?
severe hyperkalemia
A client is receiving an IV potassium infusion. During the infusion, the client develops an irregular pulse. The nurse would take which action (s)?
slow the infusion to keep the vein open and notify the primary care provider and apply cardiac monitor
What substance is reabsorbed in the ascending limb of the loop of Henle?
sodium
The nurse knows that which two major electrolytes are normally found in extracellular body fluid?
sodium and calcium
A 48-year-old female patient has acute pyelonephritis. Her urine pH is below 5.5, which indicates that it is acidic. Which of the following medications would serve to decrease the acidity of her urine?
sodium bicarbonate
A 77-year-old man's chronic heart failure is being treated with a regimen of quinapril (Accupril) and furosemide (Lasix). Which of the following assessment findings would suggest that the loop diuretic is contributing to a therapeutic effect?
the mans chest sounds are clear and his ankle edema has lessened
