Fluid and Electrolytes S25 PrepU's

The nurse is instructing a client with recurrent hyperkalemia about following a potassium-restricted diet. Which statement by the client indicates the need for additional instruction? - "I will not salt my food; instead I'll use salt substitute." - "Bananas have a lot of potassium in them; I'll stop buying them." - "I'll drink cranberry juice with my breakfast instead of coffee." - "I need to check to see whether my cola beverage has potassium in it."

"I will not salt my food; instead I'll use salt substitute."

Which of the following measurable urine outputs indicates the client is maintaining adequate fluid intake and balance? - A client with a minimal urine output of 50 mL/hour - A client with a minimal urine output of 10 mL/hour - A client with a minimal urine output of 30 mL/hour - A client with a minimal urine output of 20 mL/hour

A client with a minimal urine output of 30 mL/hour

An adult client is brought in to the clinic feeling thirsty with dry, sticky mucous membranes; decreased urine output; fever; a rough tongue; and lethargy. The nurse reconciles the client's medication list and notes that salt tablets had been prescribed. What would the nurse do next? - Continue to monitor client with another appointment - Be prepared to administer a lactated Ringer's IV - Be prepared to administer a sodium chloride IV - Consider sodium restriction with discontinuation of salt tablets

Consider sodium restriction with discontinuation of salt tablets

The nurse is caring for a client admitted with a diagnosis of acute kidney injury. When reviewing the client's most recent laboratory reports, the nurse notes that the client's magnesium levels are high. The nurse should prioritize assessment for what health problem? - Diminished deep tendon reflexes - Tachycardia - Cool, clammy skin - Acute flank pain

Diminished deep tendon reflexes

Which of the following is a clinical manifestation of fluid volume excess (FVE)? Select all that apply. - Distended neck veins - Crackles in the lung fields - Shortness of breath - Decreased blood pressure - Bradycardia

Distended neck veins Crackles in the lung fields Shortness of breath

Which laboratory result does the nurse identify as a direct result of the client's hypovolemic status with hemoconcentration? - Abnormal potassium level - Elevated hematocrit level - Low white blood count - Low urine specific gravity

Elevated hematocrit level

Before seeing a newly assigned client with respiratory alkalosis, a nurse quickly reviews the client's medical history. Which condition is a predisposing factor for respiratory alkalosis? - Myasthenia gravis - Type 1 diabetes mellitus - Extreme anxiety - Opioid overdose

Extreme anxiety

The nurse is assigned to care for a client with a serum phosphorus concentration of 5.0 mg/dL (1.61 mmol/L). The nurse anticipates that the client will also experience which electrolyte imbalance? - Hypocalcemia - Hyperchloremia - Hypermagnesemia - Hyponatremia

Hypocalcemia

A client reports muscle cramps in the calves and feeling "tired a lot." The client is taking ethacrynic acid (Edecrin) for hypertension. Based on these symptoms, the client will be evaluated for which electrolyte imbalance? - Hypokalemia - Hyperkalemia - Hypocalcemia - Hypercalcemia

Hypokalemia (ethacrynic acid is a loop diuretic)

A client has a respiratory rate of 38 breaths/min. What effect does breathing faster have on arterial pH level? - No effect - Increases arterial pH - Decreases arterial pH - Provides long-term pH regulation

Increases arterial pH

An emergency department nurse is caring for a trauma client with arterial blood gas (ABG) results of pH 7.26, PaCO2 28, HCO3 11 mEq/L. How would the nurse interpret these results? - Respiratory acidosis with no compensation - Metabolic alkalosis with compensatory alkalosis - Metabolic acidosis with no compensation - Metabolic acidosis with compensatory respiratory alkalosis

Metabolic acidosis with compensatory respiratory alkalosis

The nurse on a surgical unit is caring for a client recovering from recent surgery with the placement of a nasogastric tube to low continuous suction Which acid-base imbalance is most likely to occur? - Respiratory alkalosis - Metabolic alkalosis - Respiratory acidosis - Metabolic acidosis

Metabolic alkalosis

Following a unilateral adrenalectomy, a nurse should assess for hyperkalemia as indicated by: - Muscle weakness - Tremors - Diaphoresis - Constipation

Muscle weakness

A client has questioned the nurse's administration of intravenous (IV) normal saline, asking, "Wouldn't sterile water be a more appropriate choice than saltwater?" Under what circumstances would the nurse administer electrolyte-free water intravenously? - Never, because it rapidly enters red blood cells, causing them to rupture - When the client is severely dehydrated resulting in neurologic signs and symptoms - When the client is in excess of calcium and/or magnesium ions - When a client's fluid volume deficit is due to acute or chronic kidney disease

Never, because it rapidly enters red blood cells, causing them to rupture

The nurse is adding the intake and output results for a client diagnosed with dehydration. The nurse notes a 24-hour intake of 1500 mL/day between oral fluids and intravenous solutions. The output total is calculated as 2800 mL/day from urine output, emesis, and Hemovac drainage. Which nursing action is best to maintain an acceptable fluid balance? - Suggest a fluid restriction - Encourage oral fluids - Remove the Hemovac - Offer a prescribed antiemetic medication

Offer a prescribed antiemetic medication

The nurse caring for a client post colon resection is assessing the client on the second postoperative day. The nasogastric tube remains patent and is draining moderate amounts of greenish fluid. Which assessment finding would suggest that the client's potassium level is too low? - Diarrhea - Paresthesia's - Increased muscle tone - Joint pain

Paresthesia's

A client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should the nurse assess first? - Blood pressure - Respirations - Temperature - Pulse

Pulse

A client with arginine vasopressin deficiency (AVP-D, aka diabetes insipidus) presents to the emergency room for treatment of dehydration. The nurse knows to review serum laboratory results for which diagnostic indicator? - Sodium level of 137 mEq/L - Potassium level of 3.8 mEq/L - Sodium level of 150 mEq/L - Potassium level of 6 mEq/L

Sodium level of 150 mEq/L

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? - Vital signs - Edema - Intake and output - Weight

Weight

Which arterial blood gas (ABG) result would the nurse anticipate for a client with a 3-day history of vomiting? - pH: 7.55, PaCO2: 60 mm Hg, HCO3-: 28 - pH: 7.45, PaCO2: 32 mm Hg, HCO3-: 21 - pH: 7.28, PaCO2: 25 mm Hg, HCO3: 15 - pH: 7.34, PaCO2: 60 mm Hg, HCO3: 34

pH: 7.55, PaCO2: 60 mm Hg, HCO3-: 28