Fluid/Electrolyte

The nurse is caring for a client diagnosed with bulimia. The client is being treated for a serum potassium concentration of 2.9 mEq/L (2.9 mmol/L). Which statement made by the client indicates the need for further teaching? "I can use laxatives and enemas but only once a week." "A good breakfast for me will include milk and a couple of bananas." "I will be sure to buy frozen vegetables when I grocery shop." "I will take a potassium supplement daily as prescribed."

"I can use laxatives and enemas but only once a week

Which is considered an isotonic solution? 0.9% normal saline Dextran in normal saline 0.45% normal saline 3% NaCl

0.9% normal saline

The community health nurse is performing a home visit to an 84-year-old client recovering from hip surgery. The nurse notes that the client seems uncharacteristically confused at times and has dry mucous membranes. When asked about fluid intake, the client states, "I stop drinking water early in the day because it is just too difficult to get up during the night to go to the bathroom." What would be the nurse's best response? "If you build up too much urine in your bladder, it can cause you to get confused, especially when your body is under stress." "I will need to have your medications adjusted, so you will need to be readmitted to the hospital for a complete workup." "Limiting your fluids can create imbalances that can result in confusion, so let's try adjusting the timing of your fluids." "It is normal to be a little confused following surgery, and it is safe not to urinate at night."

"Limiting your fluids can create imbalances that can result in confusion, so let's try adjusting the timing of your fluids."

A client is to receive hypotonic IV solution in order to provide free water replacement. Which solution does the nurse anticipate administering? Lactated Ringer solution 0.45% NaCl 0.9% NaCl 5% NaCl

0.45% NaCl

A client diagnosed with hypernatremia needs fluid volume replacement. What intravenous solution would be the safest for the nurse to administer? 5% dextrose in water 0.45% sodium chloride 0.9% sodium chloride 5% dextrose in normal saline solution

0.45% sodium chloride

Aclient has chronic hyponatremia, which requires weekly laboratory monitoring to prevent the client lapsing into convulsions or a coma. What is the level of serum sodium at which a client can experience these side effects? 114 mEq/L 130 mEq/L 135 mEq/L 148 mEq/L

114mEq/L

At which serum sodium concentration might convulsions or coma occur? 145 mEq/L (145 mmol/L) 142 mEq/L (142 mmol/L) 130 mEq/L (130 mmol/L) 140 mEq/L (140 mmol/L)

130 mE/q/L

At which serum sodium concentration might convulsions or coma occur? 130 mEq/L (130 mmol/L) 145 mEq/L (145 mmol/L) 140 mEq/L (140 mmol/L) 142 mEq/L (142 mmol/L)

130 mEq/L

A client weighing 160.2 pounds (72.7 kg), who has been diagnosed with hypovolemia, is weighed every day. The health care provider asked to be notified if the client loses 1,000 mL of fluid in 24 hours. What weight would be consistent with this amount of fluid loss? 156.0 lbs (70.8 kg) 157.0 lbs (71.2 kg) 158.0 lbs (71.7 kg) 159.0 lbs (72.1 kg)

158.0LBS(71.7kg()

A patient is admitted with severe vomiting for 24 hours as well as weakness and "feeling exhausted." The nurse observes flat T waves and ST-segment depression on the electrocardiogram. Which potassium level does the nurse observe when the laboratory studies are complete? 4.5 mEq/L 5.5 mEq/L 2.5 mEq/L 3.5 mEq/L

2.5mEq/L

The nurse knows which is the normal serum value for potassium? 96-106 mEq/L (96-106 mmol/L). 3.5-5.0 mEq/L (3.5-5.0 mmol/L). 8.5-10.5 mg/dL (2.13-2.63 mmol/L). 135-145 mEq/L (135-145 mmol/L).

3.5-5.0mEq/L

The nurse has been assigned to care for various clients. Which client is at the highest risk for a fluid and electrolyte imbalance? An 82-year-old client who receives all nutrition via tube feedings and whose medications include carvedilol and torsemide. A 66-year-old client who had an open cholecystectomy with a T-tube placed that is draining 125 mL of bile per shift. A 45-year-old client who had a laparoscopic appendectomy 24 hours ago and is being advanced to a regular diet. A 79-year-old client admitted with a diagnosis of pneumonia.

An 82-year-old client who receives all nutrition via tube feedings and whose medications include carvedilol and torsemide.

The nurse is caring for a client with laboratory values indicating dehydration. Which clinical symptom is consistent with the dehydration? Cool and pale skin Dark, concentrated urine Crackles in the lung fields Distended jugular veins

Dark, concentrated urine

A client was admitted to the unit with a diagnosis of hypovolemia. When it is time to complete discharge teaching, which of the following will the nurse teach the client and family? Select all that apply. Drink caffeinated beverages to retain fluid. Drink at least eight glasses of fluid each day. Drink water as an inexpensive way to meet fluid needs. Drink alcoholic beverages to help balance fluid volume. Respond to thirst

Drink at least eight glasses of fluid each day, drink water as an inexpensive way to meet fluid needs, respond to thirst

A client is taking spironolactone to control hypertension. The client's serum potassium level is 6 mEq/L. What is the nurse's priority during assessment? electrocardiogram (ECG) results respiratory rate bowel sounds neuromuscular function

Electrocardiogram (ECG) results

A client with hypertension has been prescribed hydrochlorothiazide. What nursing action will best reduce the client's risk for electrolyte disturbances? Encourage fluid intake. Ensure the client has sufficient potassium intake. Encourage the use of over-the-counter calcium supplements. Maintain a low-sodium diet.

Ensure the client has sufficient potassium intake

In which of the following medical conditions would administering IV normal saline solution be inappropriate? Select all that apply. Severe hemorrhage Heart failure Renal impairment Pulmonary edema Burns

Heart failure, Renal impairment, pulmonary edema.

A physician orders regular insulin 10 units I.V. along with 50 ml of dextrose 50% for a client with acute renal failure. What electrolyte imbalance is this client most likely experiencing? Hypernatremia Hyperglycemia Hypercalcemia Hyperkalemia

Hyperkalemia

Oral intake is controlled by the thirst center, located in which of the following cerebral areas? Hypothalamus Cerebellum Brainstem Thalamus

Hypothalamaus

The nurse is caring for a geriatric client in the home setting. Due to geriatric changes decreasing thirst, the nurse is likely to see a decrease in which fluid location which contains the most body water? Extracellular fluid Interstitial fluid Intravascular fluid Intracellular fluid

Intracellular fluid

When caring for a client who has risk factors for fluid and electrolyte imbalances, which assessment finding is the highest priority for the nurse to follow up? Weight loss of 4 lb Irregular heart rate Blood pressure 96/53 mm Hg Mild confusion

Irregular heart rate

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

A 64-year-old client is brought in to the clinic with thirsty, dry, sticky mucous membranes, decreased urine output, fever, a rough tongue, and lethargy. Serum sodium level is above 145 mEq/L. Should the nurse start salt tablets when caring for this client? Yes, along with the hypotonic IV. No, sodium intake should be restricted. No, start with the sodium chloride IV. Yes, this will correct the sodium deficit

No, sodium intake should be restricted

The nurse is caring for a client who was admitted with fluid volume excess (FVE). Which nursing assessments should the nurse include in the ongoing monitoring of the client? Select all that apply. Nutritional status and diet Strength testing for muscle wasting Blood pressure, heart rate, and rhythm Intake and output, urine volume, and color Skin assessment for edema and turgor

Nutritional status and diet, blood pressure, heart rate and rhythm, intake and output, urine volume, and color, skin assessment for edema and turgor.

A client with pancreatic cancer has the following blood chemistry profile: Glucose, fasting: 204 mg/dl; blood urea nitrogen (BUN): 12 mg/dl; Creatinine: 0.9 mg/dl; Sodium: 136 mEq/L; Potassium: 2.2 mEq/L; Chloride: 99 mEq/L; CO2: 33 mEq/L. Which result should the nurse identify as critical and report immediately? Sodium Chloride Potassium CO2

Potassium

The nurse is reviewing client lab work for a critical lab value. Which value is called to the physician for additional orders? Magnesium:2 mEq/L Potassium: 5.8 mEq/L Calcium: 10 mg/dL Sodium: 138 mEq/L

Potassium 5.8mEq/L

Which of the following electrolytes is the primary determinant of extracellular fluid (ECF) osmolality? Magnesium Sodium Potassium Calcium

Sodium

What foods can the nurse recommend for the patient with hyperkalemia? Milk and yogurt Melons Apples and berries Green, leafy vegetables

apples and berries

A client's most recent laboratory results show a slight decrease in potassium. The health care provider has opted to forgo drug therapy but has suggested increasing the client's dietary intake of potassium. What should the nurse recommend?

banana

A client reports tingling in the fingers as well as feeling depressed. The nurse assesses positive Trousseau's and Chvostek's signs. Which decreased laboratory results does the nurse observe when the client's laboratory work has returned? Potassium Phosphorus Calcium Iron

calcium

Air embolism is a potential complication of IV therapy. The nurse should be alert to which clinical manifestation associated with air embolism? Slow pulse Hypertension Jaundice Chest pain

chest pain

A client was admitted to the hospital unit after 2 days of vomiting and diarrhea. The client's spouse became alarmed when the client demonstrated confusion and elevated temperature, and reported "dry mouth." The nurse suspects the client is experiencing which condition? hypercalcemia dehydration hyperkalemia hypervolemia

dehydration

Which nerve is implicated in the Chvostek's sign? Optic Spinal accessory Facial Hypoglossal

facial

A client with severe hypervolemia is prescribed a loop diuretic and the nurse is concerned with the client experiencing significant sodium and potassium losses. What drug was most likely prescribed? hydrochlorothiazide metolazone spironolactone furosemide

furosemide

You are caring for a new client on your unit who is third-spacing fluid. You know to assess for what type of edema? Generalized Dependent Brassy Pitting

generalized

Clients diagnosed with hypervolemia should avoid sweet or dry food because it can cause dehydration. increases the client's desire to consume fluid. can lead to weight gain. obstructs water elimination.

increases the client's desire to consume fluid.

The nurse is performing an admission assessment on a 79-year-old client newly admitted for end-stage liver disease. What principle should guide the nurse's assessment of the client's skin turgor? Overhydration is common among healthy older adults. Dehydration causes the skin to appear spongy. Inelastic skin turgor is a normal part of aging. Skin turgor cannot be assessed in clients over the age of 70.

inelastic skin turgor is a normal part of aging.

The nurse is assessing residents at a summer picnic at the nursing facility. The nurse expresses concern due to the high heat and humidity of the day. Although the facility is offering the residents plenty of fluids for fluid maintenance, the nurse is most concerned about which? Lung function Summer allergies Insensible fluid loss Cardiovascular compromise

insensible fluid loss

With which condition should the nurse expect that a decrease in serum osmolality will occur? Influenza Hyperglycemia Kidney failure Uremia

kidney faliure

Your client has a diagnosis of hypervolemia. What would be an important intervention that you would initiate? Give medications that promote fluid retention. Limit sodium and water intake. Assess for dehydration. Teach client behaviors that decrease urination.

limit sodium and water intake

Your client has a diagnosis of hypervolemia. What would be an important intervention that you would initiate? Teach client behaviors that decrease urination. Limit sodium and water intake. Give medications that promote fluid retention. Assess for dehydration.

limit sodium and water intake

A client who complains of an "acid stomach" has been taking baking soda (sodium bicarbonate) regularly as a self-treatment. This may place the client at risk for which acid-base imbalance? metabolic alkalosis metabolic acidosis respiratory acidosis respiratory alkalosis

metabolic alkalosis

A priority nursing intervention for a client with hypervolemia involves which of the following? Establishing I.V. access with a large-bore catheter. Drawing a blood sample for typing and crossmatching. Monitoring respiratory status for signs and symptoms of pulmonary complications. Encouraging the client to consume sodium-free fluids.

monitoring respiratory status for signs and symptoms of pulmonary complications

Which is the preferred route of administration for potassium? Oral Subcutaneous IV (intravenous) push Intramuscular

oral

Fluid and electrolyte balance is maintained through the process of translocation. What specific process allows water to pass through a membrane from a dilute to a more concentrated area? osmosis filtration evaporation active transport

osmosis

When evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis? HCO 21 mEq/L pH 7.48 PaCO 36 O saturation 95%

pH 7.48

A client with Guillain-Barré syndrome develops respiratory acidosis as a result of reduced alveolar ventilation. Which combination of arterial blood gas (ABG) values confirms respiratory acidosis? pH, 7.5; PaCO2 30 mm Hg pH, 7.40; PaCO2 35 mm Hg pH, 7.35; PaCO2 40 mm Hg pH, 7.25; PaCO2 50 mm Hg

pH, 7.25; PaCO2 50 mm Hg

What does the nurse understand is the primary method by which fluid volume is regulated? Urine excretion Breathing Bowel elimination Perspiration

urine excretion

A client with respiratory acidosis is admitted to the intensive care unit for close observation. What client complication associated with respiratory acidosis would the nurse observe? papilledema stroke seizures hyperglycemia

papillaedema

What does the nurse recognize as one of the best indicators of the patient's renal function? Serum creatinine Urine osmolality Blood urea nitrogen Specific gravity

serum creatinine

A client has been admitted to the hospital unit with signs and symptoms of hypovolemia; however, the client has not lost weight. The client exhibits a localized enlargement of her abdomen. What condition could the client be presenting? hypovolemia third-spacing anasarca pitting edema

third-spacing