FLUID AND ELECTROLYTE IMBALANCE EXAM 1

As a nurse, what should you assess if there is a fluid imbalance?

1. daily weigh 2. I & O 3. lung sounds 4. vital signs 5. monitor lab results for BUN, Na, and hct 6. assess neurological changes 7. assess skin

treatment for hypernatremia

1. dilute the sodium concentration 2. administer IV D5W or 0.4% NaCl 3. restrict sodium intake 4. give free water 5. give diuretics to excrete sodium

Treatment for hypervolemia

1. give diuretics 2. fluid restriction 3. abdominal para-or thoracentesis

Identify three electrolyte imbalances that are caused by: hyperaldosteronism

1. hypervolemia 2. hypernatremia 3. hypokalemia

The nurse is preparing to administer 25 mg furosemide (Lasix) IV to a client with peripheral edema and lung crackles. The 2 mL vial is labeled 20 mg/mL. How many mL of solution should the nurse draw up? Record your answer rounding to two decimal places.

1.25

A postoperative client with a serum potassium level of 3.6 mEq/L is ordered to receive an IV with a potassium supplement (KCl) via peripheral line. The nurse checks to determine that the amount of KCl ordered does not exceed the standard hourly replacement rate of ____ mEq/hr. Record your answer to the nearest whole number

10

Normal lab values for phosphorus

2.4-4.4 mEq

A client with a feeding tube has been experiencing severe watery diarrhea. The client is lethargic with decreased skin turgor, a pulse rate of 110, and hyperactive reflexes. The nurse would include which of the following interventions on the client's plan of care? Select all that apply. a. monitor and record intake, output, and daily weights b. administer salt tablets c. withhold tube feedings until diarrhea subsides d. avoid adding additional water before and after tube feedings e. initiate seizure precautions

a, e

A nurse prepares to administer calcium gluconate to a client post-thyroidectomy. The nurse explains to the LPN that this medication is being given for which reason? a. because of accidental removal of the parathyroid gland b. because it is related to increased parathyroid hormone release during surgery c. to prevent complications from immobility postoperatively d. due to hypophosphatemia after this type of surgery

a.

The nurse anticipates the client with which condition would be most at risk to develop hyperkalemia? a. chronic renal failure b. newly diagnosed cirrhosis c. partial bowel obstruction requiring nasogastric suctioning d. diarrhea for the last 4 days

a.

The nurse instructs a client receiving hydrochlorothiazide (HCTZ) to report which of the following symptoms to the health care provider? a. leg cramps and muscle weakness b. muscle weakness and diarrhea c. fatigue and irritability d. nausea and irritability

a.

The nurse is caring for a client who is experiencing a steady decline in sodium level. The nurse places highest priority on which of the following interventions? a. close monitoring of a neurological status b. preventing weakness and fatigue c. spacing activities to conserve energy d. providing oral hygiene and skin care

a.

Which intervention should the nurse anticipate implementing in a client who is experiencing dilutional hyponatremia? a. administration of hypotonic intravenous solutions b. restriction of additional oral fluids c. increasing sodium intake in the diet d. encouraging intake of tap water

b

What are two nursing interventions that may be ordered for hypoosmolar imbalance? a. water along with solutes, hang hypotonic IV solution b. water restriction, daily weight c. diuretics, decrease salt intake d. IV solutions of normal saline, blood transfusions

b.

The nurse is assisting in a health fair at a senior citizen center. Which instruction should the nurse include when giving an older adult guidelines about remaining hydrated in hot weather? a. "If your urine is clear yellow, you are drinking adequate fluids" b. "Drink only water to keep yourself properly hydrated" c. "Popsicles, gelatin, and ice cream provide fluid intake as liquids you drink" d. "Use your thirst as a guide for the amount of fluid you should drink"

c.

A client is receiving an intravenous infusion of 0.0255% sodium chloride at 50 mL/hour. It is most important for the nurse to monitor which of the following to detect complications of therapy? a. urine output and concentration b. legs and arms for edema c. tongue and mouth for dryness d. mental status and orientation

d.

A client is semiconscious and restless, and exhibits tremors and muscle weakness. Physical examination reveals a dry, swollen tongue and a body temperature of 99.8 degrees Farenheit. The nurse anticipates that the serum sodium value for this client is most likely to be which of the following? a. 120 mEq/L b. 132 mEq/L c. 142 mEq/L d. 155 mEq/L

d.

A client present with reports of fatigue, headache, and increasing muscle weakness, and has blood work drawn to evaluate the serum calcium level. The nurse anticipates medical management for an abnormal value to include which of the following? a. thiazide diuretics b. vitamin D supplements c. fluid restriction d. increased hydration

d.

An example of an IV solution that would be appropriate to treat an extracellular fluid volume deficit is a. D5W b. 3% sodium chloride in water c. D5W in 1/2 normal saline (0.45%) d. lactated Ringer's solution

d.

Normal lab values for calcium

8.5-10.5 mg/dL

blood and blood products IV

colloids

Treatment of hypovolemia

1. oral rehydration 2. IV replacement with Lactated Ringers or isotonic NaCl (0.9% or normal saline) or blood

A client with abnormal sodium loss is receiving a regular diet. To encourage foods high in sodium, the nurse would recommend which of the following foods for lunch? a. a cheese and ham sandwich b. chicken salad on lettuce c. tossed salad with vinegar dressing d. white fish and plain baked potato

a.

The nurse determines that the IV administration of calcium gluconate to a client with hyperkalemia has been effective for which finding is seen on assessment? a. urine output increases b. bowel movements are loose c. cardiac dysrhythmia is corrected d. muscles are relaxed and weak

c.

A client is admitted to the hospital with a serum potassium level of 2.8 mEq/L. The nurse anticipates that assessment findings will include which of the following? a. elastic skin turgor and vomiting a small amount of bile-stained emesis b. pink nail beds, and EKG showing a normal sinus rhythm with a rate of 76 c. respiratory rate of 16 with equal bilateral breath sounds, and two loose stools this morning d. irregular pulse rate and shallow respirations

d.

If you develop nausea, vomiting, or diarrhea in the future, it is important to replace fluids with ______ drinks such as Gatorade and to consult your physician for medications to control the nausea, vomiting, and diarrhea. Drinking only _____ to replace fluid lost as a result of vomiting and diarrhea can lead to a very serious drop in serum ____, leading to the symptoms of ____ and ___ you demonstrated on admission.

electrolyte rich; water; sodium; confusion; disorientation

treatment for hyperkalemia

1. eliminate potassium intake or restrict 2. dialysis 3. Kayexalate - a cation exchange resin given orally or rectally to bind with potassium 4. force potassium from ECF to ICF with IV insulin with dextrose- causes increase potassium intake at cellular level, beta adrenergic agonists, NaHCO3- moves Na into cells 5. stabilize cardiac membranes with IV calcium chloride or gluconate - types of calcium 6. monitor EKG

treatment for hypokalemia

1. give potassium orally or IV (drip only) -Lidocaine for pain -Liquid potassium by mouth can cause GI lesions

3 categories of IV solutions- definition, osmolality, and types

1. hypertonic: causes cells to swell -<250 -0.45% NaCl (normal saline); D5W in patient 2. Isotonic: no loss or gain from the intracellular space -250-350 -normal saline (NS or 0.9%); lactated ringers; blood 3. hypertonic: cells to shrink ->350 -10% dextrose; >10 % dextrose in central line; 3% or 5% NaCl

Identify three electrolyte imbalances that are caused by: chronic kidney disease

1. hypocalcemia 2. hyperkalemia 3. hyponatremia

Identify three electrolyte imbalances that are caused by: loop and thiazide diuretics

1. hypokalemia 2. hyponatremia 3. hypocalcemia

The nurse is teaching a client who is on a low-sodium diet how to read food labels and check for hidden sodium content. The nurse informs the client that sodium is contained in higher amounts in which of the following products? Select all that apply a. baking goods containing baking powder b. seasonings using monosodium glutamate c. OTC cold and cough medications d. canned vegetables e. salad oil

a, b, c, d

The nurse should include dietary teaching regarding addition of potassium-rich foods if the client is receiving which diuretic? Select all that apply. a. hydrochlorothiazide (HCTZ) b. spironolactone (Aldactone) c. triamaterene with hydrochlorothiazide (Maxide) d. furosemide (Lasix)

a, d

The nurse evaluates the hydration status of a client who has been receiving intravenous (IV) fluids at 150 mL/hour. The nurse identifies that the client has fluid volume excess (FVE) after assessing which of the following? Select all that apply. a. neck veins are distended when head of the bed is elevated 45 degrees b. hand veins empty when hand is raised above the head c. peripheral pulses are rapid and weak d. client becomes short of breath when ambulating e. pitting edema is present over tibia

a, d, e

When caring for an adult receiving an IV infusion of 3% sodium chloride (NaCl), the nurse places priority on monitoring which of the following to detect complications of therapy? Select all that apply a. neurological status b. urine specific gravity c. serum glucose levels d. lungs sounds e. serum sodium levels

a, d, e

A 28-year-old client is admitted with severe bleeding from a fractured femur. Which IV fluid does the nurse anticipate as the most appropriate for use to replace potential fluid losses? a. 0.9% sodium chloride b. 3% sodium chloride c. 5% dextrose in water d. 5% dextrose in 0.22% sodium chloride

a.

A client develops hypocalcemia as a result of prolonged NG tube suctioning. The nurse concludes that which of the following is the primary cause for hypocalcemia at this time? a. metabolic alkalosis b. fluid shifts from hypoalbuminemia c. hypermagnesemia d. metabolic acidosis

a.

A client was brought to the hospital following a near-drowning experience in the Atlantic Ocean. In providing care to this client, the nurse plans to carefully monitor for which of the following? a. hypernatremia b. hyponatremia c. hypocalcemia d. hypercalcemia

a.

During intershift report, the nurse is told that a client who has suffered a stroke has also developed diabetes insipidus (DI). The nurse concludes this client is now at risk for which of the following? a. severe deficient fluid volume because of excess urine output b. severe excess fluid volume because of inadequate urine output c. hyperglycemia because of poor insulin production d. hypoglycemia because of excess insulin production

a.

The nurse determines that which client is at highest risk for developing a fluid volume deficit (FVD)? a. a 76-year-old client who has a nasogastric tube to low suction following surgery for colon cancer b. a thin 55-year-old client who smokes and takes glucocorticoids for chronic lung disease c. a one-year-old child being treated in the clinic for a runny nose and ear infection d. a 30-year-old client jogging in 50-degree weather

a.

The nurse is helping a client who was recently placed on a low-sodium diet to reduce fluid retention to choose foods for lunch. The nurse recommends which lunch menu that would be most beneficial for this client? a. grilled chicken sandwich on white bread, apple, salad and iced tea b. tuna salad sandwich on wheat bread, canned fruit cocktail, salad, and a soda c. ham and bean soup, fresh fruit salad, low-sodium crackers and a diet soda d. cheeseburger, grapes, fresh pineapple, and tomato juice

a.

A 17-year old client who sustained a head injury in a motorcycle collision two days ago is responsive only to pain. Which IV fluid order would the nurse question because it could increase the risk of complications? a. Ringer's solution b. 5% dextrose in water c. 0.9% sodium chloride d. lactated ringer's solution

b.

A 45- year old client with FVE because of acute kidney dysfunction is placed on a 1000 mL fluid restriction per 24-hour period. the client asks the nurse, "Why is there such a severe fluid restriction when I already have dry lips and mouth?" Which response by the nurse is best? a. "The doctor ordered the fluid restriction, so it is important to comply with those orders" b. "Your kidneys cannot eliminate extra fluid right now, so intake must be limited to protect your heart and lungs from being overloaded with fluid" c. "Your probably drank too much fluid before you got sick, so you can't compare your usual intake to your limitations now that your kidneys are not working" d. "Too much fluid will cause your heart to fail and your lungs to fill with water, which could be fatal"

b.

A 78-year old client is admitted with dehydration and urinary tract infection. After IV infusion of 750 mL normal saline, the client begins to cough and asks for the head of the bed to be raised to ease breathing. The nurse assesses jugular vein distention and increased respiratory rate. How should the nurse interpret the data? a. the fluid volume deficit is worsening b. hypervolemia is developing c. hypotonic water intoxication is beginning d. ascites is causing respiratory compromise

b.

A client receiving treatment for hypernatremia is being monitored for signs and symptoms of complications of therapy. The nurse would assess this client for which of the following? a. cellular dehydration b. cerebral edema c. red blood cell destruction d. renal shutdown

b.

A client who has a serum calcium level of 11.8 mg/dL is receiving a 0.9% sodium chloride infusion. The nurse determines that hydration has been effective after noting which of the following? a. Chvostek sign is positive b. volume status has been restored c. calcium level is 11.0 mg/dL d. serum creatinine is elevated

b.

A client with a diagnosis of bipolar disorder has been drinking copious amounts of water and voiding frequently. The client is experiencing a bounding pulse and confusion and is reporting a headache. The nurse checks laboratory test results for which of the following? a. low platelet count b. low sodium level c. high serum osmolality d. high urine specific gravity

b.

A client with hypocalcemia has been started on IV corticosteroids. Which of the following findings would indicate to the nurse a further decrease in calcium level in the client? a. absence of Trousseau sign b. positive Chvostek sign c. muscle weakness d. frequent urination

b.

The nurse evaluates that discharge teaching has been effective when the client with hypocalcemia makes which statement? a. "I shouldn't take antacids such as Tums" b. "I should notify my health care provider if I start to feel tingling or numbness around my mouth" c. "I will need to cut down on the amount of protein I include in my diet each day" d. "I will watch my urine for signs of kidney stones"

b.

The nurse is providing care to a client with syndrome of inappropriate antidiuretic hormone (SIADH). What should the nurse explain to the unlicensed assistant about water intake? a. it should be encouraged b. it should be restricted c. it is given according to the client's preference d. it is given via intravenous fluids only

b.

To provide free water and intracellular fluid hydration for a patient with acute gastroenteritis who is NPO, the nurse would expect administration of a. lactated Ringer's solution b. dextrose 5% in water c. dextrose 10% in water d. dextrose 5% in normal saline

b.

When assessing a client with diabetes insipidus, the nurse expects to find which of the following? a. n/v b. polyuria and polydipsia c. dysuria d. confusion

b.

When caring for the client with signs of severe hypocalcemia, the nurse anticipates administration of which of the following? a. isotonic normal saline as a rapid infusion b. 10% calcium gluconate by slow IV push c. IV phosphorus over 6-8 hours d. 10% calcium chloride by rapid IV push

b.

Which of the following foods should the nurse instruct the client with end stage renal disease (ESRD) to avoid? a. bread b. cantaloupe c. green beans d. apple juice

b.

A client hospitalized for GI bleeding has orders for NGT placement with irrigations until returns are clear. Which prescribed solution should the nurse plan on using? a. 10% dextrose in water (D10W) b. 5% dextrose in water (D5W) c. 0.9% sodium chloride (NaCl) d. 0.45% sodium chloride (1/2NaCl)

c

An adult client in the clinic reports a cough, fever, feeling weak and dizzy, and having nausea and vomiting for three days. Examination reveals dry tongue and oral mucosa, and concentrated urine. To best assess the client's fluid status, the nurse checks which assessment parameters? a. core and body temperature b. respiratory rate and depth c. bp and pulse in lying and standing positions d. pulse oximetry reading at rest

c

The nurse plans to administer which intravenous treatment to a client for treatment of hyperkalemia associated with severe acidosis? a. calcium gluconate to make the potassium shift from the ICF to the ECF b. insulin and dextrose to make the client hypoglycemic c. sodium bicarbonate to make the client alkalotic so the potassium will shift into the ICF d. normal saline to provide extra sodium to the potassium will move out of the ICF into the ECF

c

The nurse assigned to a client with hyponatremia would conclude that which of the following client factors probably contributed to this electrolyte imbalance? Select all that apply. a. osmotic diuretic therapy b. fever c. fluid retention d. excessive hypertonic intravenous infusion e. heart failure

c, e

The nurse caring for the following group of clients considers which client to be at highest risk for developing deficient fluid volume? a. a thin, 52-year-old female receiving corticosteroid therapy for bronchitis b. a 60-year old male who had a left inguinal herniorrhaphy 12 hours ago c. a 76-year old male who has a nasogastric tube to intermittent suction following colon resection d. a 68-year old female who is NPO for a flexible sigmoidoscopy procedure

c.

The nurse concludes that a client understands the side effects of furosemid (Lasix) and its relationship to potassium levels when the client makes which statement? a. "I do not need to take my pulse anymore when I take my Digoxin" b. "I should call the doctor if I develop diarrhea" c. "I should call my doctor if I feel myself becoming dizzy when I stand up" d. "I do not need to eat bananas for breakfast anymore because I am taking this medicaiton"

c.

The nurse provides which instruction to a client going home with a prescription for spironolactone (Aldactone)? a. "Be sure to take this medication on an empty stomach" b. "Take this pill just before you go to bed" c. "Cut back on your intake of those foods on your list that are high in potassium" d. "You do not have to watch your intake of fluid while you are taking this medication"

c.

What is the best response by the nurse to the 22-year old daughter of a 56-year old client admitted with hypokalemia and who reports being dizzy upon standing? a. "Your mother has been lying in bed too long and when she stands up she will get dizzy" b. "Once we correct your mother's potassium level, the dizziness should improve" c. "Your mother is probably dizzy because her heart is not pumping as effectively making her bp low" d. "Your mother is dizzy because her nervous system is not functioning correctly; once her potassium level goes up, she will improve"

c.

Which of the following interventions does the nurse complete when caring for a client admitted with a sodium level of 152 mEq/L? a. provide extra blankets for warmth b. observe client for nausea and malaise c. observe and prepare for possible seizures d. restrict fluids to 1200 mL per day

c.

Which statement should the nurse include when teaching a client about oral potassium supplementation? a. "When you take your potassium pill, if you cannot swallow it, you can crush it up and put it in orange juice." b. "potassium should only be taken in the morning on an empty stomach" c. "take your potassium tablet after you have eaten breakfast" d. "you can continue to use a salt substitute while you are taking your potassium supplement"

c.

A client is admitted with chronic renal failure. The nurse would use which statement to explain the need to monitor for hypocalcemia? a. "Your kidneys do not eliminate as much calcium, so we need to check for signs of hypocalcemia" b. "Your calcium level can decrease because it goes down when the creatinine in the bloodstream is high" c. "Signs of hypocalcemia will appear before you experience pain from renal colic" d. "Your kidneys are unable to produce calcitriol, which is needed to regulate calcium levels in the blood stream"

d.

The nurse caring for a client with a calcium imbalance places highest priority on nursing interventions that help to manage which of the following? a. renal signs and symptoms b. cardiac changes c. hematologic disorders d. neuromuscular clinical manifestations

d.

When caring for a client with syndrome of inappropriate hormone (SIADH), the nurse plans to carry out which intervention to restore fluid and electrolyte imbalance? a. encourage client to drink plenty of water b. restrict dietary salt intake c. monitor infusion of hypotonic saline infusion d. administer prescribed loop diuretics

d.

Which of the following manifestations should the nurse assess for when developing a plan of care for a client with hypernatremia? a. muscle weakness b. moist mucous membranes c. subnormal temp d. complaints of thirst

d.

While obtaining an assessment and health history from a patient, which of the following statements by the patient will alert the nurse to a possible fluid volume excess? a. "I have been urinating a lot, and my urine is dark, almost brown" b. "I get light-headed and dizzy when I stand up too fast after sitting or lying down." c. "My heart feels like it is about to run away with me some of the time because it goes so fast" d. "I have been taking some salt tablets while working outdoors in the summer, but they sure make me thirsty."

d.

Fluid volume excess does what to BUN, Na, and hct?

decreases

Does ICF or ECF have more fluid?

ICF

treatment for hypocalcemia

1. oral or IV calcium 2. promote CO2 retention- to control muscle spasms

Normal lab values for sodium

135-145 mEq

normal lab values for Cl

96-106 mEq

sign to test for hypocalcemia in which you inflate BP cuff above systolic bp leading to carpal spasms

Trousseau's sign

The nurse is caring for a client admitted with heart failure. When assessing the client's risk for fluid imbalances, the nurse should check which laboratory values? Select all that apply. a. hemoglobin b. hematocrit c. brain natriuretic peptide (BNP) d. blood glucose e. liver enzymes

a, b, c

When caring for an adult client diagnosed with hyponatremia, the nurse plans to restrict which of the following? a. water b. sodium c. potassium d. chloride

a.

A client with hypercalcemia is receiving digoxin. The nurse plans to incorporate which of the following in client assessments? a. checking for Trousseau sign b. frequent pulse checks c. auscultation of bowel sounds d. inspection of skin for signs of bleeding

b

Volume problems mainly affect what area? Osmolarity problems affect what?

heart; brain- CNS

Fluid volume deficit does what to BUN, Na, and hct?

increases

Does an adult or infant have more fluid in their body?

infant

males or females have more fluid in their body? Why?

males, because water is in muscles not fat

You admit J.M.., obtain a health history, and perform a physical examination. You pay particular attention to the signs and symptoms that J.M. manifests related to her diagnosis of hyponatremia and fluid volume deficit. Identify the expected manifestations of hyponatremia and fluid volume deficit. There are 8 correct answers. 1. irritability 2. confusion 3. tachycardia 4. weight gain 5. postural hypotension 6. dry mucous membranes 7. polyuria 8. bradycardia 9. tremors 10. seizures 11. hypertension 12. coma

1, 2, 3, 5, 6, 9, 10, 12

treatment for hypercalcemia

1. IV or oral fluids with normal saline - flushes out excess calcium 2. IV phosphorus- opposes calcium 3. Calcitonin- lowers calcium 4. Biphosphonates- inhibits bone resorption 5. low calcium diet 6. dialysis 7. mobilization- enhances bone mineralization

Treatment for hyponatremia

1. restrict fluids 2. Give lactated ringers or normal saline IV fluid 3. give 3 or 5% NaCl IV solutions slowly (only ICU setting) 4. give loop diuretics to decrease water or withhold diuretics 5. give oral rehydration fluids with electrolytes

normal lab values for magnesium

1.7-2.7 mEq

Normal lab values for potassium

3.5-5.0 mEq

Which of the following statements by a client indicates a need for further instruction regarding treatment for hypokalemia? a. "I will eat more bananas and cataloupes for breakfast" b. " I will eat more bran flakes to increase my potassium level" c. "I will take my potassium in the morning after breakfast so it does not upset my stomach" d. "I will tell my primary care provider if I Start having muscle cramps or weakness"

B.

What two electrolytes are inverse?

Calcium and potassium

sign to test for hypocalcemia in which you tap on facial nerve leading to facial contractions

Chvostek's sign

A 45-year old client is receiving a loop diuretic for treatment of edema. The nurse determines the client is experiencing an excessive response to the treatment when the client demonstrates which of the following? a. BUN 28 mg/dL, Hct 45% and an 8-pound weight loss in 24 hours b. BUN 21 mg/dL, Hct 29% and an 8-pound weight gain in 24 hours c. BUN 16 mg/dL, Hct 31% and an 8-pound weight loss in 24 hours d. BUN 25 mg/dL, Hct 33% and an 8-pound weight gain in 24 hours

a

A client with a nursing diagnosis of Excess Fluid Volume has been treated with diuretics and fluid restriction. Which findings would best indicate to the nurse that fluid volume balance has not yet totally achieved? a. S1 heart sounds and moist lung crackles resolving b. return to coherent conversations and appropriate behavior c. oral mucous membranes are no longer sticky and cracked and skin is warm and dry d. skin tenting decreasing and conjunctiva of eyes moist

a

When caring for a 79-year old client who has a sodium level of 149 mEq/L, the nurse identifies the client will be at increased risk to develop dehydration because of which factor? a. a diminished thirst drive b. an increased level of aldosterone c. a decrease in muscle mass d. ADH is no longer produced

a

The nurse should place highest priority on which nursing intervention for a client with renal failure who has a potassium level of 6.8 mEq/L? a. obtain an EKG b. evaluate level of consciousness c. measure urinary output d. draw arterial blood gases

a.

When caring for a client who has a potassium level of 2.8 mEq/L, the nurse should assess for which of the following? a. perforated bowel b. paralytic ileus c. renal failure d. diabetes mellitus

b

The nurse identifies which of the following clients admitted to the hospital to be at risk for developing hypokalemia? Select all that apply. a. a client whose arterial blood gases indicate metabolic acidosis b. a client who had developed metabolic alkalosis c. a client with acute renal failure d. a client with adult respiratory distress syndrome (ARDS) e. the client with a nasogastric tybe to low intermittent suction

b, e

clear IV solutions

crystalloids

A patient at risk for hypernatremia is one who a. has a deficiency of aldosterone b. has prolonged vomiting and diarrhea c. receives excessive 5% dextrose solution intravenously d. has impaired consciousness and decreased thirst sensitivity

d

Which of the following potassium levels would be of greatest concern to the nurse when seen in a client who is taking furosemide? a. 5.4 mEq/L b. 4.3 mEq/L c. 3.4 mEq/L d. 3.1 mEq/L

d

A 70-year old client with a past medical history of hypertension and myocardial infarction is postoperative after stomach surgery. Vital signs have been stable and an IV of D51/2NS infusing at 100 mL/hour. The client now reports dyspnea, has a moist cough, and oxygen saturation has fallen to 92%. What action should the nurse take? a. measure bp and heart rate b. assess legs and arms for pitting edema c. telophone and notify the physician d. slow the intravenous rate to 10-20 mL/hour

d.

The nurse determines that client with a serum calcium level of 12 mg/dL understands client teaching when the client makes which statement? a. "If my stomach becomes upset, I can just take more Tums" b. "I will need to take my phosphorus supplements once a day" c. "I will need to be on a strict bed rest to help with this problem" d. "I will need to drink many more fluids than I have been, even up to two or three liters each day"

d.