EAQ fluid and electrolytes

When assessing the client during the post operative period of receiving a kidney transplant the clients creatinine level is 3.1mg/dl. which action will the nurse take first in response to this laboratory report? 1. Notify the Primary Health care provider 2. obtain current blood test results 3. assess for decreased urine output 4. check the intravenous infusion

3

Which disease increases the risk of hyperkalemia? 1. Chrohn disease 2. Cushing disease 3. End-stageage renal disease 4. gastroesophageal reflux disease

3

which intravenous fluid is a hypertonic solution

5% dextrose in a normal saline

which client would the nurse see first among this group of clients?

A toddler with diarrhea

A client with renal failure receives prescriptions for vitamin D and calcium supplements. The client asked the nurse why do I need to take these? The nurse explains that with renal failure which condition exist?

A will be a decrease in the active metabolite of vitamin D in your body

which medication will the nurse expect the health care provider to prescribe a client who had a thyroidectomy and is pale with spasms of the hand when taking the blood pressure?

Calcium

which clinical finding indicates that a client taking digoxin may have developed a digoxin toxicity?

Cardiac dysrhythmias

The nurse is evaluating the effectiveness of a treatment for a client with excessive fluid volume. Which clinical finding indicate that the treatment was successful?

Clear breath sounds

Which action will the nurse take when a client appears flushed and complaints of palpitations 10 minutes after the start of intravenous vancomycin schedule to infuse over 30 minutes?

Contact the Primary Health care provider to obtain a prescription to decrease the infusion rate

For which reason would clients who receive IV fluids rather than total parenteral nutrition for gastrointestinal problems lose weight?

Deficit carbohydrate intake

Which adverse medication effect will the nurse monitor for in a client with cirrhosis of the liver who develops ascites and is prescribed spironolactone?

Hyperkalemia

Which fluid shift will the nurse take into consideration when assessing a client with type one diabetes who is experiencing a I should turn fluid imbalance?

Intracellular to intravascular as a result of hyperosmolality

A client with a femoral fracture and osteomyelitis is immobilized for three weeks. Which rationale explains the nurses plan to assess for the development of renal calculi?

Lack of weight bearing activity promotes bone demilitarization.

A client is admitted with severe diarrhea that resulted in hypokalemia. The nurse would monitor for which clinical manifestations for the electrolyte deficiency?

Leg cramps and muscle weakness

which antidiarrheal medication would the nurse anticipate administering to a client with severe diarrhea who is prescribed intravenous fluids sodium bicarbonate and an antidiarrheal medication?

Loperamide

Which principle explains how loop diuretics promote diuresis?

Osmosis

Which electrolyte deficiency triggers the secretion of renin?

Sodium

Which indication requires the nurse to monitor the client for signs of hyperkalemia?

Spironolactone

Which intravenous solution would a nurse anticipate administering when caring for a client with a history of severe diarrhea for the past three days who was admitted for dehydration?

0.9% sodium chloride

Which findings are consistent with hypercalcemia after prolonged immobility? 1. Bone pain 2. Convulsions 3. muscle spasms 4. tingling of extremities 5. depressed deep tendon reflexes

1, 5

A client is to receive 2000ML of intravenous fluid in 12 hours. The nurse will set the control device to deliver how many milliliters per hour?

167

which client problem with the nurse expect to decrease in response to the administration of serum albumin intravenously to a client with ascites?

Abdominal girth

Which nursing assessment would perform by a nurse be administering IV infusion of potassium chloride 40 MEQ in 100ML of 5% dextrose and water to be infused over 2 hours?

Urinary output patency of the IV access last serum potassium level

Which data collection assessment would be performed to evaluate the effectiveness of furosemide administered to a client with congestive heart failure? 1. Daily weight 2. Intake and output 3. Monitor for edema 4. Daily pulse oximetry 5. Auscultate breath sounds

all

Which clinical manifestation would the nurse expect when assessing the client with hypercalcemia? SATA

cardiac dysrhythmias and hypoactive bowel sounds

Which clinical finding is important for the nurse to monitor for when a total parental nutrition solution is prescribed to infuse at one liter every 12 hours? SATA 1. Active tolerance 2. intake and output 3. orthostatic vital signs 4. glucose levels 5. serum electrolytes

2, 4, 5

Which clinical finding leads the nurse to conclude that an IV has infiltrated rather than cause inflammation?

coolness

Which concern when caring for a client prescribed furosemide 40MG every day in conjunction with digoxin would prompt the nurse to ask the health care provider about potassium supplements? 1. digoxin causes significant potassium depletion 2. the liver destroys potassium as digoxin is detoxified 3. Lasix requires adequate serum potassium to prompt diuresis 4. digoxin toxicity occurs rapidly in presence of hypokalemia

4

When evaluating fluid loss for a client with burns, which relationship between a client's burned body surface area and fluid loss would the nurse consider?

directly proportional

Which purpose of insulin would a nurse identify when caring for a client prescribed insulin added to a solution of 10% dextrose in water after an intravenous solution containing potassium inadvertently was infused too rapidly?

potassium follows glucose into the cell of the body thereby raising the intracellular potassium level

Which reason would an intravenous infusion of 5% dextrose with 0.5% sodium chloride and 20 mEq of potassium be prescribed for a client with a nasal gastric tube set to low intermittent suction?

prevent electrolyte imbalance

which factor is likely cause of hyponatremia? SATA

profuse diaphoresis and rapid intravenous infusion of 5% dextrose in water

which action will the nurse take when a client with an intravenous infusion containing 40 MEQ of potassium reports a stinging pain at the IV site? SATA

assess the IV site...................................verify that the potassium is adequately diluted and not infusing too rapidly

which response would the nurse monitor for when a client is receiving furosemide to relieve edema? SATA

weight loss and excessive loss of potassium ions

which indicator of client status is important for the nurse to assess in a client receiving total parenteral nutrition?

Blood glucose

which physiological alteration will the nurse Monitor to best determine the effectiveness of a clients hydrochlorothiazide therapy?

Blood pressure

which symptom in a client receiving hydrochlorothiazide would cause a nurse to notify the health care provider?

Generalized weakness

which statement about administration IV potassium would a nurse make to a client with a diagnosis of hypokalemia?

Oliguria is an indication for withholding IV potassium.

When a client in the emergency department has a blood pressure of 90/60 mm Hg, weak quality radial pulse of 108 beats/ minute, and reports working outside for several hours on a hot day which prescribed would the nurse first takes?

start infusion of normal saline 500 ml

12 hours after sustaining full thickness burns to the chest and thighs the client who is on nothing by mouth status is reporting severe thirst. The client's urinary output has been 60ML/h for the past 10 hours. No bowel sounds are heard. Which action would the nurse say?

Moisten the client's lips with a wet 4x4 gauze

a client is to receive 0.25 MG of digoxin intramuscularly. The ampule is labeled 0.5 MG = 2 ML. How many milliliters will the nurse administer?

1ML

Which mechanism of action is responsible for the therapeutic effects of mannitol prescribed for a client with a head injury? 1. Decreasing the production of cerebrospinal fluid 2. limiting the metabolic requirements of the brain 3. drawing fluid from brain cells into the bloodstream 4. preventing uncontrolled electrical discharges in the brain

3

Which nursing assessment finding is consistent with fluid volume overload from high flow intravenous fluid replacement therapy? SATA

bounding pulse presence of dependent edema neck vein distension in the upright position

List the actions in order in which they will be performed by the nurse transfusing packed red blood cells prescribed for a client with anemia

1. ensure that the client signed a consent for transfusion 2. determine the clients vital signs 3. verified that the number on the blood product laboratory record and clients armband match 4. Don a pair of gloves 5. initiate the transfusion slowly

An intravenous (IV) antibiotic in 50 mL of 0.9% sodium chloride needs to be administered over 20 minutes. The nurse will set the infusion pump to deliver how many milliliters per hour? Record your answer using a whole number. ___ mL/h

150

Which action is important when administering blood? 1. Warm the blood to body temperature to prevent chilling the client 2. obtain baseline vital signs before beginning blood administration 3. draw a blood sample from the client before each unit is transfused 4. Maintain potency of the intravenous catheter with dextrose solution

2

Which sign of hypokalemia will the nurse monitor for in a client receiving furosemide? 1. Chvostel 2. Muscle weakness 3. anxious behavior 4. abdominal cramping

2

Which purpose would potassium chloride added to the intravenous solution of a client with diabetic ketoacidosis serve? 1. Treats hyperpnea 2. prevents flacid paralysis 3. prevents hypokalemia 4. treats cardiac dysrhythmias

3

why would the nurse advise a client who takes furosemide and digoxin for heart failure to drink a glass of orange juice every day?

Maintaining potassium levels

which action would be most important for the nurse take when caring for a client who started furosemide 2 days ago and has a serum potassium level of 2.8 mEq/L?

notify the Primary Health care provider of critically low result

An older client is admitted to the hospital for rehydration therapy after three days of diarrhea. In addition to sodium which electrolyte would the nurse most be concerned about?

potassium

In which category of fluids would the nurse classify an intravenous solution of 0.45 percent sodium chloride?

Hypotonic

Which statement by the client receiving diuretic therapy indicates that the teaching about potassium supplements is understood?

I will report any abdominal distress

After reviewing the chart of a client recently admitted to the emergency department which intervention would the nurse anticipate implementing?

IV fluids

Which nursing action has a specific gerontological implication the nurse must consider when caring for an older adult receiving chemotherapy for cancer whose severe nausea and vomiting causes dehydration requiring hospital add a mission for rehydration therapy? SATA

assessment of skin turgor administration of antiemetic medications replacement of fluid and electrolytes

Which pressure changes does the nurse determine to be the cause of edema for a client with albuminuria?

Decrease in plasma colloid oncotic pressure.

Which clinical finding will the nurse anticipate when admitting a client with extracellular fluid volume excess?

Distended jugular veins

A client is to receive an intravenous solution of normal saline to be infused AT175 ml/h. the drop factor of the IV set is 15 gtts/ml. the nurse will adjust the flow to deliver how many drops per minute?

44 gtts/min

which clinical manifestation would the nurse expect the client who has chronic kidney disease with hypocalcemia to exhibit?

c. Fractures d. Osteomalacia e. Eye calcium deposits

Which clinical manifestation indicates a need for the nurse to contact the health care provider to increase intravenous fluid infusion rate for an older client with an infection?

Acute confusion