Fluid and Electrolytes

Which laboratory finding can be seen in a patient with clinical dehydration?

Blood urea nitrogen (BUN) of 28 mg/dL Urine specific gravity of 1.150 Serum sodium level of 160 mEq/L

A patient had 200 mL of ice chips and 900 mL intravenous (IV) fluid during the nurse's shift. Which total intake would the nurse record?

1000mL

How much fluid does an adult lose through feces?

100ml

Which range is the normal value of phosphate in human blood?

2.7 to 4.5 mg/dL

Which range is the normal concentration of ionized calcium in human blood?

4.5 to 5.3 mg/dL

Which patient would the nurse expect to be at risk of developing dehydration?

A 78-year-old patient with dementia

Which acute condition will place the patient at a high risk of hyperkalemia?

Crush injuries

Which statement about antidiuretic hormone (ADH) leads the nurse to recognize that a patient with highly concentrated blood may have impaired renal function?

ADH circulates in the blood to the kidneys, where it acts on the collecting ducts

Which clinical finding would the nurse expect to find in a patient with chronic heart failure at risk of developing extracellular fluid volume (ECV) excess?

Ankle edema Overnight weight gain Neck veins full when upright

When a patient has an increased loss of sodium and water in the urine, which hormone does the nurse know is inhibiting the secretion of antidiuretic hormone (ADH)?

Atrial natriuretic peptide (ANP)

Which sign is true of hypokalemia?

Bilateral muscle weakness Signs of digoxin toxicity at normal digoxin levels

Which condition may lead to an extracellular fluid volume (ECV) deficit?

Burns Hemorrhage Adrenal insufficiency

Which electrolyte influences excitability of nerve and muscle cells and is necessary for muscle contraction?

Calcium (Ca2+)

Which laboratory finding is consistent with a diagnosis of milk-alkali syndrome?

Calcium level of 15 mg/dL

Which ion is an example of an anion?

Chloride

How might sepsis manifest?

Circulatory shock

After assessing a patient with gastroenteritis, the nurse suspects deficient fluid volume related to vomiting and diarrhea. Which symptom supports the nurse's suspicion?

Dark yellow urine Heart rate of 102 beats per minute

Which food item would the nurse include in the diet plan of a patient with magnesium deficiency?

Dark-green leafy vegetables

Which therapy would be prescribed for a patient with circulatory overload?

Oxygen Diuretics

Which donor would the nurse consider when choosing platelets for a patient with type O blood?

Donor should be of blood group O

Which statement is correct about active transport?

Energy is required to move electrolytes

Which effect is caused by respiratory acidosis?

Excessive carbonic acid in the blood

The nurse finds that a patient has sudden weight gain, confusion, edema in the dependent areas, and crackles in the lungs upon auscultation. Which condition does the nurse suspect?

Extracellular fluid volume (ECV) excess

For which reason would the nurse elevate a patient's extremity while receiving intravenous therapy?

Extravasation

Which transport mechanism is governed by oncotic and hydrostatic pressures?

Filtration

Patients should be taught to replace sweat, vomiting, or diarrhea fluid losses with which type of fluid?

Fluid that has sodium (salt) in it

Which symptom is caused by respiratory acidosis?

Headache

Which factor can be a risk of causing extracellular volume (ECV) deficit?

Hemorrhage

Which fluid electrolyte imbalance may develop in a patient who consumes spironolactone?

Hyperkalemia

A patient reports intense thirst, decreased alertness, and has a serum sodium level of 170 mEq/L. Which condition would the nurse document in the patient's medical chart?

Hypernatremia

Which condition is common in patients with chronic diarrhea?

Hypocalcemia Hypernatremia Hypomagnesemia

Which electrolyte abnormality is least likely to be caused by the use of laxatives?

Hyponatremia

Which electrolyte imbalance does syndrome of inappropriate antidiuretic hormone (SIADH) cause?

Hyponatremia

Which statement describes the cause of metabolic alkalosis?

Increase of carbonic acid ions in the blood

The nurse is learning about fluid, electrolyte, and acid-base balance. Which clinical finding would the nurse evaluate in a patient with hypomagnesemia?

Insomnia Muscle cramps Hyperactive deep tendon reflexes

Which organ's function is regularly observed in older-adult patients to monitor for metabolic acidosis?

Kidney

Which organ excretes carbonic acid?

Lungs

Which electrolyte controls the function of neuromuscular junctions?

Magnesium

Which activity related to intravenous (IV) therapy can the nurse delegate to assistive personnel (AP)?

Measuring oral intake and urine output Reporting an IV container that is low in fluid Reporting an electronic infusion device alarm

Which condition is characterized by severe hyperthyroidism, confusion, increased respiratory rate, and a pH of arterial blood gas below 7.35?

Metabolic acidosis

A health care provider prescribes carbenicillin for a patient with a urinary tract infection. Which acid-base imbalance is suspected in the patient?

Metabolic alkalosis

A patient who had an intravenous (IV) line reports purulent discharge at the catheter skin entry point. The nurse notices redness, localized warmth, and swelling at the catheter entry point. Which intervention would be beneficial for the patient?

Obtain drainage for culture. Cleanse the skin with alcohol. Apply a sterile dressing.

Which clinical symptom supports the nurse's documentation of grade 2 phlebitis?

Pain at the access site with erythema

Which buffer prevents urine from becoming too acidic?

Phosphate

Which electrolyte is necessary for the production of adenosine triphosphate?

Phosphate (PO43-)

Which substance is intravascular fluid?

Plasma

Which clinical finding can the nurse expect to document for a patient with suspected hypocalcemia? Select

Positive Chvostek's sign Positive Trousseau's sign Muscle twitching and cramping

Which drug can cause hypokalemia?

Prednisone Furosemide

Which condition in the patient can lead to respiratory alkalosis?

Psychological distress

A patient with cardiac failure is found to have excess extracellular fluid of normal tonicity. Which life-threatening complication is this patient likely to suffer?

Pulmonary edema

Which symptom can be seen in a patient with phlebitis?

Redness of the skin

Which condition can cause paresthesia?

Respiratory alkalosis

Which condition is characterized by metabolic acidosis with a high anion gap?

Severe hyperthyroidism

Which condition may result in excessive metabolic acids in the body of the patient?

Severe infection

Which ion is a cation?

Sodium Calcium Potassium

Which drug increases the risk of metabolic acidosis?

Spironolactone

Which condition places a patient at a higher risk of hypomagnesemia?

Steatorrhea Chronic alcoholism

A patient develops an acute intravascular hemolytic transfusion reaction after a transfusion with incompatible blood. Which treatment strategy should be included in the patient's management?

Stop the transfusion immediately. Maintain the blood pressure (BP) at the normal range. Administer diuretics. Insert an indwelling urinary catheter.

Which body fluid is a transcellular fluid?

Synovial fluid Peritoneal fluid Cerebrospinal fluid

Why are older adults prone to dehydration?

The ability of their kidneys to concentrate urine decreases

Which physical finding can be seen in a patient with extracellular fluid volume (ECV) deficit?

Thready pulse Postural hypotension Dry mucous membranes

Which body fluid is considered an intravascular fluid?

plasma of blood