pharm prep u ch 35

The student nurse is assigned to a client who is to receive an 80 mEq/1000 mL infusion of potassium over 16 hours for a K+ level of 2.1. The student voices concern over the concentration. Which of the following statements by the nursing instructor would be the best response?

"80 mEq in 1000 mL of IV solution is the maximum recommended dose, although in an acute emergency situation a higher concentration of potassium may be required."

A client, diagnosed with iron deficiency, has been taking oral ferrous sulfate for several days. When the nurse is assessing for therapeutic effects, what question is most warranted?

"How is your energy level compared with a few days ago?"

A female client presents to the health care provider's office for her yearly physical examination. When the nurse asks about her current drug regimen, she states that she self-administers megadoses of vitamin C to prevent cancer. Which statement is an appropriate response?

"Large doses of single vitamins do not prevent cancer."

The nurse has just administered oral niacin to a client. What is the most important instruction the nurse can give to this client at this time?

"Lie down for about 30 minutes, and then be careful when you sit and stand up."

A male client tells the nurse that he obtains all of his nutrients from vitamins. What is the correct explanation the nurse would give this client?

"Nutrients are best obtained from foods."

A client asks the nurse about fat-soluble vitamins. Which statement should the nurse include when discussing fat-soluble vitamins with a client?

"The body stores fat-soluble vitamin excess to use later."

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

Water is a vital element for the human body. What is one of its functions?

Aids in digestion and absorption

Adequate intake of vitamin B12 is necessary for cell metabolism, nutrient absorption, and normal development of red blood cells and nerve cells. Which of the following foods are natural sources of this vitamin?

All the above (meat, fish, cheese)

An elderly client has been ordered magnesium 483 mg daily orally. The student nurse is about to administer that dose when the nursing instructor questions it. The student states that the regular dose is 54 to 483 mg/day. Why did the instructor question this dose?

Because older adults may need a reduced dosage as a result of decreased renal function.

Trace minerals in the body, though small in quantity, play large roles in its functioning. Trace minerals have been hard to study because of what factor?

Bioavailability varies within the context of the total diet

The nursing instructor is discussing dietary needs as they relate to age. According to the instructor, adequate intake of what vitamin is especially important in sexually active women of childbearing age to prevent severe birth defects?

Folic acid

A client demonstrating electrocardiography (EKG) changes and dysthymias would be expected to have which electrolyte imbalance?

Hypokalemia

The nurse is reviewing the lab results for a client with congestive heart failure. The report is as follows: sodium, 142 mEq/L; potassium, 2.5 mEq/L; calcium, 5 mEq/L; and chloride, 98 mEq/L. Which electrolyte disturbances should the nurse report?

Hypokalemia

A health care provider orders intravenous magnesium sulfate to control convulsions in a pregnant client. When will the preparation take effect?

Immediately following administration

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 nurse is caring for a client prescribed warfarin for chronic atrial fibrillation. Which information should be included in this client's medication teaching plan?

Keep intake of vitamin K foods constant.

Sodium is the major extracellular cation in the body. What is one of its functions?

Nerve impulse transmission

When administering medications through a feeding tube, what intervention should the nurse implement?

Obtain liquid forms of medications whenever possible.

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 a reduced dose because of decreased renal function.

Which of the following is a correct route of administration for potassium?

Oral

The nurse is caring for a client who is receiving an iron supplement for treatment of anemia. What food/liquid will the nurse offer the client to take with the iron that will increase the iron's absorption?

Orange juice

The nurse knows to monitor the IV site for which of the following complications during parenteral management of body fluids?

Phlebitis and/or thrombosis

A 69-year-old client, who has been prescribed a daily diuretic, is admitted to critical care with a cardiac arrhythmia. Which electrolyte should be monitored due to its' effect on heart rate and excretion or retention during diuretic therapy?

Potassium

Many people throughout the world are practicing vegetarians. Their diet is rich in fruits and vegetables so it is also likely to be rich in:

Potassium

The nurse is caring for a critically ill client in the unit who has an IV dedicated to fluid and electrolyte replacement. To prevent imbalances and adverse reactions, what should the nurse closely monitor?

Serum electrolyte levels

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 a cardiac monitor

What is a major electrolyte in extracellular fluid that influences the distribution of water and maintains acid-base balance and nerve function?

Sodium

A nurse is caring for a 56-year-old client who is known to abuse alcohol. The nurse should know that alcoholic clients are most likely to have a deficiency of which of the following vitamins?

Thiamine (vitamin B1)

You administer a single intramuscular (IM) injection of Vitamin K to each newborn in your nursery. What is the reason for the injection?

To prevent hemorrhagic disease

A 61-year-old client arrives at your clinic with reports of night blindness. The client's diet may be severely deficient in which vitamin?

Vitamin A

The nurse is assessing a client in the clinic who admits to taking megadoses of vitamins, but he is not sure which ones he has been taking. The client presents with hair loss, double vision, headaches, and nausea and vomiting. The nurse suspects that this client has taken a toxic amount of which vitamin?

Vitamin A

A nurse is caring for a client who is a strict vegan. Which vitamin deficiency is the client at risk for developing?

Vitamin B12

A nurse is completing an admission assessment. During a 24-hour diet recall, the client reports eating spinach, asparagus, and green beans for lunch and dinner. Which vitamin is the client most likely consuming?

Vitamin K

A nurse is teaching a client about carbohydrates, proteins, and fats. Which statements should be included in the teaching plan? Select all that apply.

Water is necessary for cellular metabolism; Carbohydrates and fats provide most of the energy for the body; Vitamins, minerals, and electrolytes mainly come from ingested food

Which statement best compares the differences between fat- and water-soluble vitamins?

Water-soluble vitamins are rapidly eliminated while fat-soluble vitamins are stored in the body when taken in excess.

When do vitamins act as drugs in the body?

When they are taken in megadoses

Beta-carotene is found in what food?

Winter squash

Understanding the absorption of fat-soluble vitamins, what substance is necessary to facilitate absorption from the intestine with dietary fat?

bile salts

Which factors should the nurse monitor when evaluating the effectiveness of a client's enteral nutrition therapy? Select all that apply.

daily weight, serum albumin

A client has just presented for care after a positive OTC pregnancy test. When performing health education with this client, the nurse should emphasize the need for supplementation with what nutrient?

folic acid

The nurse would assess a client receiving which medication for signs and symptoms of hypokalemia?

furosemide

Which medication, being taken regularly by a client, may create a need for oral potassium supplementation?

furosemide

A toddler who has been vomiting for the last 3 days is seen in the clinic. The mother reports the toddler refuses to eat or take fluids. In order to prevent dehydration, the nurse anticipates the primary health care provider will recommend which treatment?

pedialyte

If you were told to eat more vitamin E, what would you want to eat more of?

vegetable oils

Accidental overdose of which drug would warrant the immediate (STAT) administration of vitamin K?

warfarin