PrepU Chapter 41: Fluid, Electrolyte, and Acid-Base Balance

A nursing student is teaching a healthy adult client about adequate hydration. Which statement by the client indicates understanding of adequate hydration?

"I should drink 2,500 mL/day of fluid."

what is calcium important in?

-wound healing -synaptic transmission in nervous tissue -membrane excitability -essential for blood clotting (big one)

A healthy client eats a regular, balanced diet and drinks 3,000 mL of liquids during a 24-hour period. In evaluating this client's urine output for the same 24-hour period, the nurse realizes that it should total approximately how many mL?

3,000

A health care provider orders an infusion of 250 mL of NS in 100 minutes. The set is 20 gtt/ml What is the flow rate?

50 gtt/min gtt/min = (250mL x 20 gtt/mL)/100 minutes

A client with a diagnosis of colon cancer has opted for a treatment plan that will include several rounds of chemotherapy. What vascular access device is most likely to meet this client's needs?

An implanted central venous access device (CVAD)

What is the lab test commonly used in the assessment and treatment of acid-base balance?

Arterial blood gas

The nurse is educating a client with hypokalemia on why it is important to maintain potassium balance. Which does the nurse include in the teaching?

Cardiac function

A student has joined the marching band at high school and the band begins practicing outside during hot summer weather. Which health promotion guidance will the school nurse teach the student?

Consume commercial oral rehydration drinks on practice days.

A nurse is caring for a client who requires intravenous (IV) therapy. The nurse understands that which actions are the nurse's responsibilities related to this therapy? Select all that apply.

Deciding the location of the IV catheter. Deciding the size of the IV catheter. Administering the IV solution.

A 50-year-old client with hypertension is being treated with a diuretic. The client reports muscle weakness and fatigue and the nurse's assessment reveals an irregular heart rate. The nurse should assess the client's levels of which electrolyte?

Potassium

A client has been diagnosed with excessive levels of aldosterone. The nurse's assessment will include what value?

Potassium level

A client has been receiving intravenous (IV) fluids that contain potassium. The IV site is red and there is a red streak along the vein that is painful to the client. What is the priority nursing action?

Remove the IV.

The nurse is caring for a client receiving intravenous fluids through a peripheral intravenous catheter (IV). On rounds, the nurse notes that the client's IV site and arm are swollen and cool to the touch. Based on these assessment findings, what will the nurse do next?

Remove the peripheral intravenous catheter.

The nurse is performing an assessment of a client with hypocalcemia who has been admitted to the acute care facility. Which symptom(s) does the nurse document that correlates with the admitting diagnosis? Select all that apply.

Report of muscle cramps Report of numbness and tingling of the mouth Seizure activity Blood clotting

A nurse is assessing for the presence of edema in a client who is confined to bed and who often lies supine. The nurse would pay particular attention to which area?

Sacral area

The primary extracellular electrolytes include which of the following?

Sodium, chloride, and bicarbonate

what is infiltration and what is it caused by?

escape of fluid into the subQ tissue dislodged needle or penetrated vessel wall swelling, pallor, coldness, or pain around infusion site

how does excess aldosterone affect potassium levels?

excess aldosterone decreases potassium levels

what is the formula for flow rate?

flow rate (gtt/min) = (volume (mL) x drip factor (gtt/mL))/time (min)

The student nurse asks, "What is interstitial fluid?" What is the appropriate nursing response?

fluid in the tissue space between and around cells

how do diuretic affect electrolytes?

loss of K, Na, Ca, Mg

Upon assessment of a client's peripheral intravenous site, the nurse notices the area is red and warm. The client complains of pain when the nurse gently palpates the area. These signs and symptoms are indicative of:

phlebitis

An intravenous hypertonic solution containing dextrose, proteins, vitamins, and minerals is known as:

total parenteral nutrition

what causes air embolism and what is it characterized by?

air in the circulatory system caused by a break in the IV system above the heart level respiratory distress, tachycardia, cyanosis, drop in blood pressure, and a change in the level of consciousness

A nurse is reviewing the dietary intake of a client prescribed a potassium-sparing diuretic. The client tells the nurse that they had a banana, yogurt, and bran cereal for breakfast and a turkey sandwich with a glass of milk for lunch. The intake of which food would be a cause for concern?

banana Bananas are high in potassium and would place the client receiving a potassium-sparing diuretic at risk for increased potassium levels

what is the difference between cations and anions?

cations are positive and anions are negative

Which is a common anion?

chloride Chloride is a common anion, which is a negatively charged ion. Magnesium, potassium, and calcium are cations, or positively charged ions.

A client who is NPO prior to surgery reports feeling thirsty. What is the physiologic process that drives the thirst factor?

decreased blood volume and intracellular dehydration