Nurs 107 Chapter 10 Fluid and Electrolytes PrepU

The health care provider ordered an IV solution for a dehydrated patient with a head injury. Select the IV solution that the nurse knows would be contraindicated. 0.45% NS 3% NS 0.9% NaCl 5% DW

5% DW

Upon shift report, the nurse states the following laboratory values: pH, 7.44; PCO2, 30mmHg; and HCO3,21 mEq/L for a client with noted acid-base disturbances. Which acid-base imbalance do both nurses agree is the client's current state? Compensated metabolic alkalosis Compensated metabolic acidosis Uncompensated respiratory alkalosis Compensated respiratory alkalosis

Compensated respiratory alkalosis

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

Distended neck veins Shortness of breath Crackles in the lung fields

A patient has a serum osmolality of 250 mOsm/kg. The nurse knows to assess further for: Dehydration. Hyperglycemia. Acidosis. Hyponatremia.

Hyponatremia.

A client has a serum calcium level of 7.2 mg/dl (1.8 mmol/L). During the physical examination, the nurse expects to assess: Homans' sign. Hegar's sign. Trousseau's sign. Goodell's sign.

Trousseau's sign.

A client with hypervolemia asks the nurse by what mechanism the sodium-potassium pump will move the excess body fluid. What is the nurse's best answer? passive osmosis active transport passive elimination free flow

active transport

A client with emphysema is at a greater risk for developing which acid-base imbalance? chronic respiratory acidosis metabolic alkalosis respiratory alkalosis metabolic acidosis

chronic respiratory acidosis

The nurse is caring for a client diagnosed with chronic obstructive pulmonary disease (COPD) and experiencing respiratory acidosis. The client asks what is making the acidotic state. The nurse is most correct to identify which result of the disease process that causes the fall in pH? The lungs have ineffective cilia from years of smoking. The lungs are unable to breathe in sufficient oxygen. The lungs are unable to exchange oxygen and carbon dioxide. The lungs are not able to blow off carbon dioxide.

The lungs are not able to blow off carbon dioxide.

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

Chest pain

A client is being treated in the ICU 24 hours after having a radical neck dissection completed. The client's serum calcium concentration is 7.6 mg/dL (1.9 mmol/L). Which physical examination finding is consistent with this electrolyte imbalance? Muscle weakness Negative Chvostek sign Presence of Trousseau sign Slurred speech

Presence of Trousseau sign

Which medication does the nurse anticipate administering to antagonize the effects of potassium on the heart for a patient in severe metabolic acidosis? Furosemide Sodium bicarbonate Magnesium sulfate Calcium gluconate

Sodium bicarbonate

A volume-depleted patient would present with which of the following diagnostic lab results? Urinary output of 1.2 L/24 hours BUN-to-creatinine ratio of 24:1 Urine specific gravity of 1.02 Capillary refill time of 3 seconds

BUN-to-creatinine ratio of 24:1

The Emergency Department (ED) nurse is caring for a client with a possible acid-base imbalance. The physician has ordered an arterial blood gas (ABG). What is one of the most important indications of an acid-base imbalance that is shown in an ABG? Bicarbonate PaO2 PO2 Carbonic acid

Bicarbonate

A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse informs the client that the physician will order diuretic therapy and restrict fluid and sodium intake to treat the disorder. If the client doesn't comply with the recommended treatment, which complication may arise? Tetany Cerebral edema Severe hyperkalemia Hypovolemic shock

Cerebral edema

The nurse is caring for a client being treated with isotonic IV fluid for hypernatremia. What complication of hypernatremia should the nurse continuously monitor for? Red blood cell crenation Renal failure Red blood cell hydrolysis Cerebral edema

Cerebral edema

Which electrolyte is a major anion in body fluid? Chloride Calcium Potassium Sodium

Chloride

A client presents with severe diarrhea and a history of chronic renal failure to the emergency department. Arterial blood gas results are as follows:pH 7.30PaO2 97PaCO2 37HCO3 18The nurse would expect which of the following sets of assessment findings? Confusion, respiratory rate 8 breaths/min, dry skin Headache, blood pressure 90/54, dry skin Clammy skin, blood pressure 86/46, headache Blood pressure 188/120, nausea, vomiting

Clammy skin, blood pressure 86/46, headache

The physician has prescribed 0.9% sodium chloride IV for a hospitalized client in metabolic alkalosis. Which nursing actions are required to manage this client? Select all that apply. Compare ABG findings with previous results. Maintain intake and output records. Administer IV bicarbonate. Suction the client's airway. Document presenting signs and symptoms.

Compare ABG findings with previous results. Maintain intake and output records. Document presenting signs and symptoms.

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? Be prepared to administer a sodium chloride IV. Continue to monitor client with another appointment. Consider sodium restriction with discontinuation of salt tablets. Be prepared to administer a lactated Ringer's IV.

Consider sodium restriction with discontinuation of salt tablets.

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

Elevated hematocrit level

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 Hyperkalemia Hyperglycemia Hypercalcemia

Hyperkalemia

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? Hyperchloremia Hypermagnesemia Hyponatremia Hypocalcemia

Hypocalcemia

The nurse is caring for a client who has been admitted with a possible clotting disorder. The client is complaining of excessive bleeding and bruising without cause. The nurse knows to take extra care to check for signs of bruising or bleeding in what condition? Hypocalcemia Dehydration Hypomagnesemia Hypokalemia

Hypocalcemia

The nurse is conducting a lecture on the difference between hypovolemia and dehydration. When completing a verbal comparison, which point needs clarified? Hypovolemia contains only low blood volume. Similar causes are present in both conditions. In dehydration, only extracellular is depleted. Both conditions result in abnormal laboratory studies.

In dehydration, only extracellular is depleted.

The nurse is caring for a client diagnosed with hyperchloremia. Which are signs and symptoms of hyperchloremia? Select all that apply. Lethargy Tachypnea Hypotension Dehydration Weakness

Lethargy Tachypnea Weakness

The nurse is caring for a client with multiple organ failure and in metabolic acidosis. Which pair of organs is responsible for regulatory processes and compensation? Heart and lungs Lungs and kidney Kidney and liver Pancreas and stomach

Lungs and kidney

A client has been diagnosed with an intestinal obstruction and has a nasogastric tube set to low continuous suction. Which acid-base disturbance is this client at risk for developing? Respiratory acidosis Respiratory alkalosis Metabolic acidosis Metabolic alkalosis

Metabolic alkalosis

The nurse is assigned a client with calcium level of 4.0 mg/dL. Which system assessment would the nurse ask detailed questions? Gastrointestinal system Musculoskeletal system Neurological system Endocrine system

Neurological system

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? Offer a prescribed antiemetic medication. Remove the Hemovac. Suggest a fluid restriction. Encourage oral fluids.

Offer a prescribed antiemetic medication.

A patient with abnormal sodium losses is receiving a regular diet. How can the nurse supplement the patient's diet to provide 1,600 mg of sodium daily? One beef cube and 16 oz of tomato juice Four beef cubes and 8 oz of tomato juice One beef cube and 8 oz of tomato juice One beef cube and 12 oz of tomato juice

One beef cube and 8 oz of tomato juice

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

Potassium: 5.8 mEq/L

A client with a suspected overdose of an unknown drug is admitted to the emergency department. Arterial blood gas values indicate respiratory acidosis. What should the nurse do first? Prepare to assist with ventilation. Obtain a urine specimen for drug screening. Monitor the client's heart rhythm. Prepare for gastric lavage.

Prepare to assist with ventilation

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. Skin assessment for edema and turgor Strength testing for muscle wasting Blood pressure, heart rate, and rhythm Nutritional status and diet Intake and output, urine volume, and color

Skin assessment for edema and turgor Blood pressure, heart rate, and rhythm Nutritional status and diet Intake and output, urine volume, and color

A patient has been involved in a traumatic accident and is hemorrhaging from multiple sites. The nurse expects that the compensatory mechanisms associated with hypovolemia would cause what clinical manifestations? (Select all that apply.) Tachypnea Bradycardia Hypertension Tachycardia Oliguria

Tachypnea Tachycardia Oliguria

A nurse is conducting an initial assessment on a client with possible tuberculosis. Which assessment finding indicates a risk factor for tuberculosis? The client had a liver transplant 2 years ago. The client sees the health care provider for a check-up yearly. The client works in a health insurance office. The client has never traveled outside of the country.

The client had a liver transplant 2 years ago.

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

0.45% sodium chloride

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? Blood pressure 96/53 mm Hg Weight loss of 4 lb Irregular heart rate Mild confusion

Irregular heart rate

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

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

A client being treated for a chronic illness has a serum potassium level of 2.9 mEq/L (2.9 mmol/L). Which assessment findings will the nurse expect to assess in the client? Select all that apply. Numb fingers Hyperactive reflexes Abdominal distention Anorexia Muscle weakness

Abdominal distention Anorexia Muscle weakness

Which condition leads to chronic respiratory acidosis in older adults? Decreased renal function Overuse of sodium bicarbonate Thoracic skeletal change Erratic meal patterns

Thoracic skeletal change

A client presents with muscle weakness, tremors, slow muscle movements, and vertigo. The following are the client's laboratory values:Sodium 134 mEq/L (134 mmol/L)Potassium 3.2 mEq/L (3.2 mmol/L)Chloride 111 mEq/L (111 mmol/L)Magnesium 1.1 mg/dL (0.45 mmol/L)Calcium 8.4 mg/dL (2.1 mmol/L)What fluid and electrolyte imbalance would the nurse relate to the client's findings? hyponatremia hypocalcemia hypomagnesemia hypokalemia

hypomagnesemia

Early signs of hypervolemia include thirst. moist breath sounds. increased breathing effort and weight gain. a decrease in blood pressure.

increased breathing effort and weight gain.

A client with cancer is being treated on the oncology unit for bilateral breast cancer. The client is undergoing chemotherapy. The nurse notes the client's serum calcium concentration is 12.3 mg/dL (3.08 mmol/L). Given this laboratory finding, the nurse should suspect that the client has a history of alcohol abuse. client may be developing hyperaldosteronism. client's diet is lacking in calcium-rich food products. malignancy is causing the electrolyte imbalance.

malignancy is causing the electrolyte imbalance.

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? respiratory alkalosis metabolic alkalosis metabolic acidosis respiratory acidosis

metabolic alkalosis

Oncotic pressure refers to the excretion of substances such as glucose through increased urine output. number of dissolved particles contained in a unit of fluid. osmotic pressure exerted by proteins. amount of pressure needed to stop the flow of water by osmosis.

osmotic pressure exerted by proteins.

The nurse should assess the patient for signs of lethargy, increasing intracranial pressure, and seizures when the serum sodium reaches what level? 145 mEq/L 160 mEq/L 115 mEq/L 130 mEq/L

115 mEq/L

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

130 mEq/L (130 mmol/L)

A patient is admitted with a diagnosis of renal failure. The patient complains of "stomach distress" and describes ingesting several antacid tablets over the past 2 days. Blood pressure is 110/70 mm Hg, face is flushed, and the patient is experiencing generalized weakness. Which is the most likely magnesium level associated with the symptoms the patient is having? 1 mEq/L 11 mEq/L 5 mEq/L 2 mEq/L

5 mEq/L

What percentage of potassium excreted daily leaves the body by way of the kidneys? 20 60 40 80

80

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

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

The nurse is reviewing lab work on a newly admitted client. Which of the following diagnostic studies confirm the nursing diagnosis of Deficient Fluid Volume? Select all that apply. Low protein level in the urine Absence of ketones in urine An elevated hematocrit level A low urine specific gravity Electrolyte imbalance

An elevated hematocrit level Electrolyte imbalance

A nurse is caring for an adult client with numerous draining wounds from gunshots. The client's pulse rate has increased from 100 to 130 beats per minute over the last hour. The nurse should further assess the client for which of the following? Respiratory acidosis Altered blood urea nitrogen (BUN) value Extracellular fluid volume deficit Metabolic alkalosis

Extracellular fluid volume deficit

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? Extreme anxiety Myasthenia gravis Opioid overdose Type 1 diabetes mellitus

Extreme anxiety

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

To confirm an acid-base imbalance, it is necessary to assess which findings from a client's arterial blood gas (ABG) results? Select all that apply. HCO3 K+ PaCO2 Glucose Na+ pH

HCO3 PaCO2 pH

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

Heart failure Pulmonary edema Renal impairment

Which intervention is most appropriate for a client with an arterial blood gas (ABG) of pH 7.5, a partial pressure of arterial carbon dioxide (PaCO2) of 26 mm Hg, oxygen (O2) saturation of 96%, bicarbonate (HCO3-) of 24 mEq/L, and a PaO2 of 94 mm Hg? Instruct the client to breathe into a paper bag. Administer ordered supplemental oxygen. Offer the client fluids frequently. Administer an ordered decongestant.

Instruct the client to breathe into a paper bag.

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 Intravascular fluid Intracellular fluid Interstitial fluid

Intracellular fluid

The nurse is caring for a client with an arterial blood pH of 7.48 and bicarbonate level of 29 mEq/L (29 mmol/L). Which treatment will the nurse expect to be prescribed for this client? Bronchodilator Oxygen through a rebreather mask Potassium supplements Intravenous 0.9% normal saline

Intravenous 0.9% normal saline

A client with a magnesium concentration of 2.6 mEq/L (1.3 mmol/L) is being treated on a medical-surgical unit. Which treatment should the nurse anticipate will be used? Fluid restriction Intravenous furosemide Dialysis Oral magnesium oxide

Intravenous furosemide

A nurse is assessing a client with syndrome of inappropriate antidiuretic hormone. Which finding requires further action? Tetanic contractions Jugular vein distention Weight loss Polyuria

Jugular vein distention

A client has the following arterial blood gas (ABG) values: pH, 7.12; partial pressure of arterial carbon dioxide (PaCO2), 40 mm Hg; and bicarbonate (HCO3-), 15 mEq/L. These ABG values suggest which disorder? Metabolic acidosis Respiratory alkalosis Metabolic alkalosis Respiratory acidosis

Metabolic acidosis

The nurse is caring for a client with an acid-base imbalance. For which imbalance will the nurse calculate the anion gap? Metabolic alkalosis Respiratory alkalosis Metabolic acidosis Respiratory acidosis

Metabolic acidosis

The nurse is caring for a client with severe diarrhea. The nurse recognizes that the client is at risk for developing which acid-base imbalance? Respiratory alkalosis Respiratory acidosis Metabolic acidosis Metabolic alkalosis

Metabolic acidosis

Your client's lab values are sodium 166 mEq/L, potassium 5.0 mEq/L, chloride 115 mEq/L, and bicarbonate 35 mEq/L. What condition is this client likely to have, judging by anion gap? Metabolic alkalosis Metabolic acidosis Respiratory acidosis Respiratory alkalosis

Metabolic acidosis

A nurse is caring for a client with acute renal failure and hypernatremia. In this case, which action can be delegated to the nursing assistant? Monitor for signs and symptoms of dehydration. Provide oral care every 2-3 hours. Assess the client's weight daily for trends. Teach the client about increased fluid intake.

Provide oral care every 2-3 hours.

A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Laboratory results reveal serum sodium level 130 mEq/L and urine specific gravity 1.030. Which nursing intervention helps prevent complications associated with SIADH? Restricting fluids to 800 ml/day Elevating the head of the client's bed to 90 degrees Restricting sodium intake to 1 gm/day Administering vasopressin as ordered

Restricting fluids to 800 ml/day

A client with nausea, vomiting, and abdominal cramps and distention is admitted to the health care facility. Which test result is most significant? Serum sodium level of 132 mEq/L Urine specific gravity of 1.025 Blood urea nitrogen (BUN) level of 29 mg/dl Serum potassium level of 3 mEq/L

Serum potassium level of 3 mEq/L

A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should anticipate which laboratory test result? Serum sodium level of 124 mEq/L Serum creatinine level of 0.4 mg/dl Serum blood urea nitrogen (BUN) level of 8.6 mg/dl Hematocrit of 52%

Serum sodium level of 124 mEq/L

A patient with diabetes insipidus presents to the emergency room for treatment of dehydration. The nurse knows to review serum laboratory results for which of the diagnostic indicators? Sodium level of 137 mEq/L Sodium level of 150 mEq/L Potassium level of 6 mEq/L Potassium level of 3.8 mEq/L

Sodium level of 150 mEq/L

Which of the following is a factor affecting an increase in urine osmolality? Myocardial infarction Syndrome of inappropriate antidiuretic hormone release (SIADH) Alkalosis Fluid volume excess

Syndrome of inappropriate antidiuretic hormone release (SIADH)

A nurse is caring for a client in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat: hypernatremia. hypokalemia. hyperkalemia hypercalcemia.

hyperkalemia

A client is experiencing edema in the tissue. What type of intravenous fluid would the nurse expect to be prescribed? hypotonic solution isotonic fluid no intravenous solution hypertonic solution

hypertonic solution

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? hypocalcemia hypokalemia hypercalcemia hyperkalemia

hypokalemia

The nurse assesses a client who is diagnosed with bulimia nervosa and at risk for alterations in both fluid and electrolyte balance. Complete the following sentence by choosing from the lists of options. During the assessment, the nurse focuses on monitoring the client for Select... hypernatremia hypervolemia hypokalemia as evidenced by Select... peripheral edema extreme thirst cardiac arrhythmia

hypokalemia , cardiac arrhythmia

A client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should the nurse assess first? blood pressure pulse respirations temperature

pulse