PRepU Fluids & Electrolytes

Which electrolyte is a major cation in body fluid?

K+

The nurse is conducting discharge teaching for a client with diverticulosis. Which instruction should the nurse include in the teaching?

Drink 8 to 10 glasses of fluid daily.

During a routine checkup, a nurse observes the client's skin to be tight and shiny. Which of the following is the correct indication of this sign?

Fluid retention

A client with acute myeloid leukemia (AML) receiving chemotherapy is treated for an acute renal injury. What is the nurse's best understanding of the pathophysiological reason behind the client's injury?

Chemo causes an increase in kidney stone formation

The nurse is caring for a client with a serum potassium concentration of 6.0 mEq/L (6.0 mmol/L) and a fluid volume excess. The client is ordered to receive oral sodium polystyrene sulfonate and furosemide. What other order should the nurse anticipate giving?

D/C the IV LR

A patient is undergoing a pericardiocentesis. Following withdrawal of pericardial fluid, which assessment by the nurse indicates that cardiac tamponade has been relieved?

Decrease in central venous pressure (CVP)

Which diagnostic study is usually performed to confirm the diagnosis of heart failure?

Echocardiogram

Following a voiding cystogram, the client has a nursing diagnosis of risk for infection related to the introduction of bacterial following manipulation of the urinary tract. An appropriate nursing intervention for the client is to:

Encourage high fluid intake

A client has experienced hypovolemic shock and is being treated with 2 liters of lactated Ringer's solution. It is now most important for the nurse to assess

Lung sounds

A client experiencing vomiting and diarrhea for 2 days has a blood pressure of 88/56, a pulse rate of 122 beats/minute, and a respiratory rate of 28 breaths/minute. The nurse places the client in which position?

Modified Trendelenburg

Which is an effect of aging on upper and lower urinary tract function?

More prone to develop hypernatremia

The nurse is caring for a client with essential hypertension. The nurse reviews lab work and assesses kidney function. Which action of the kidney would the nurse evaluate as the body's attempt to regulate high blood pressure?

The kidney excretes sodium and water

The nurse is caring for a client after cardiac surgery. What laboratory result will lead the nurse to suspect possible renal failure?

a serum BUN of 70 mg/dL

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

Which solution is hypotonic?

0.45% NaCl

A nurse can estimate serum osmolality at the bedside by using a formula. A patient who has a serum sodium level of 140 mEq/L would have a serum osmolality of

280 mOsm/kg

The nurse knows which is the normal serum value for potassium?

3.5-5.0 mEq/L (3.5-5.0 mmol/L).

The nurse is reviewing the potassium level of a patient with kidney disease. The results of the test are 6.5 mEq/L, and the nurse observes peaked T waves on the ECG. What priority intervention does the nurse anticipate the physician will order to reduce the potassium level?

Administration of sodium polystyrene sulfonate [Kayexalate])

A client with liver and renal failure has severe ascites. On initial shift rounds, his primary nurse finds his indwelling urinary catheter collection bag too full to store more urine. The nurse empties more than 2,000 ml from the collection bag. One hour later, she finds the collection bag full again. The nurse notifies the physician, who suspects that a bladder rupture is allowing the drainage of peritoneal fluid. The physician orders a urinalysis to be obtained immediately. The presence of which substance is considered abnormal?

Albumin

Which colloid is expensive but rapidly expands plasma volume?

Albumin

Which is the most common cause of symptomatic hypomagnesemia?

Alcoholism

The nurse is able to identify which condition as uremia?

An excess of urea in the blood

A client has returned to the postsurgical unit from the PACU after an above-the-knee amputation of the right leg. Results of the nurse's initial postsurgical assessment were unremarkable but the client has called out. The nurse enters the room and observes copious quantities of blood at the surgical site. What should be the nurse's initial action?

Apply a tourniquet

A nurse expects to note an elevated serum glucose level in a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which other laboratory finding should the nurse anticipate?

Below-normal serum potassium level

The nurse is caring for a client who has just arrived for surgery. Which assessment finding indicates to the nurse that the client may be experiencing dehydration because of taking nothing by mouth after midnight for the surgery?

Blood pressure 80/50 mm Hg

The nurse recognizes that which laboratory test is a key diagnostic indicator of heart failure?

Brain natriuretic peptide (BNP)

A patient had a lumbar puncture 3 days ago in the outpatient clinic and calls the nurse with complaints of a throbbing headache. What can the nurse educate the patient to do for relief of the discomfort? Select all that apply.

Force fluids (unless contraindicated). Get plenty of bed rest. Take some over-the-counter analgesics.

Which of the following is an immediate danger after a prostate surgery?

Hemorrhagic shock

A nurse is caring for a client with metastatic breast cancer who is extremely lethargic and very slow to respond to stimuli. The laboratory report indicates a serum calcium level of 12.0 mg/dl, a serum potassium level of 3.9 mEq/L, a serum chloride level of 101 mEq/L, and a serum sodium level of 140 mEq/L. Based on this information, the nurse determines that the client's symptoms are most likely associated with which electrolyte imbalance?

Hypercalcemia

When malignant cells are killed (tumor lysis syndrome), intracellular contents are released into the bloodstream. This leads to which of the following? Select all that apply.

Hyperkalemia Hyperuricemia Hyperphosphatemia

An elderly client diagnosed with diarrhea is taking digoxin. Which electrolyte imbalance should the nurse be alert to?

Hypokalemia

What is a characteristic of the intrarenal category of acute renal failure?

Increased BUN

A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which finding suggests that the client has developed hyperglycemia?

Increased urine output

A client is prescribed digitalis medication. Which condition should the nurse closely monitor when caring for the client?

N/V

The nurse cares for a client with acute kidney injury (AKI). The client is experiencing an increase in the serum concentration of urea and creatinine. The nurse determines the client is experiencing which phase of AKI?

Oliguria

A patient in the recovery room after cardiac surgery begins to have extremity paresthesia, peaked T waves, and mental confusion. What type of electrolyte imbalance does the nurse suspect this patient is having?

Potassium

Retention of which electrolyte is the most life-threatening effect of renal failure?

Potassium

A client is taking amiloride and lisinopril for the treatment of hypertension. What laboratory studies should the nurse monitor while the client is taking these two medications together?

Potassium level

Which term describes the degree of stretch of the ventricular cardiac muscle fibers at the end of diastole?

Preload

A client reports nausea, vomiting, and diarrhea for 5 days. The nurse assesses the mucous membranes as pale and dry. The client has sunken eyes with the following vital signs: pulse 122 and thready, respirations 23, blood pressure 78/55, temperature 101.8°F oral. Which is the priority nursing intervention?

Request an order from the physician for IV rehydration therapy.

Which of the following endocrine disorder causes the patient to have dilutional hyponatremia?

SIADH

A client is admitted with nausea, vomiting, and diarrhea. His blood pressure on admission is 74/30 mm Hg. The client is oliguric and his blood urea nitrogen (BUN) and creatinine levels are elevated. The physician will most likely write an order for which treatment?

Start IV fluids with a normal saline solution bolus followed by a maintenance dose.

Beta-blockers are used in the treatment of hyperthyroidism to counteract which of the following effects?

Sympathetic

Which nursing intervention should the nurse caring for the client with pyelonephritis implement?

Teach client to increase fluid intake up to 3 liters per day.

A client who has developed congestive heart failure must learn to make dietary adaptations. The client should avoid:

canned peas

The nurse assesses a client who is diagnosed with bulimia nervosa and at risk for alterations in both fluid and electrolyte balance. Complete the following sentence by choosing from the lists of options. During the assessment, the nurse focuses on monitoring the client for ________________________ as evidenced by ______________________

hypokalemia, Cardiac arrythmias

A client has been experiencing a decrease in serum calcium. After diagnostics, the physician believes the calcium level fluctuation is due to altered parathyroid function. What is the role of parathormone?

increase serum calcium level

Which option should the nurse encourage to replace fluid and electrolyte losses in a client with AIDS?

liquids

The client is experiencing nausea and vomiting following surgery. What will the nurse expect the surgeon to order?

ondansetron