Patho Wk 1: Chapter 4: Fluid and Electrolyte and Acid-Base Imbalances

The nurse is caring for a client with a serum sodium concentration of 113 mEq/L (113 mmol/L). The nurse should monitor the client for the development of which condition?

Confusion

Which is considered an isotonic solution?

0.9% normal saline

Which solution is hypotonic?

0.45% NaCl

The calcium concentration in the blood is regulated by which mechanism?

Parathyroid hormone (PTH)

Which findings indicate that a client has developed water intoxication secondary to treatment for diabetes insipidus?

Confusion and seizures

The nurse is caring for a 72-year-old client who has been admitted to the unit for a fluid volume imbalance. The nurse knows which of the following is the most common fluid imbalance in older adults?

Dehydration

A patient's scheduled dose of furosemide (Lasix) 20 mg IV has recently finished infusing, and the nurse is preparing to administer metoclopramide (Reglan) 10 mg IV, which has just been ordered. Before administering this drug, the nurse should:

Flush the patient's IV tubing.

When the postcardiac surgery client demonstrates restlessness, nausea, weakness, and peaked T waves, the nurse reviews the client's serum electrolytes, anticipating which abnormality?

Hyperkalemia

The nurse is caring for a patient with diabetes type I who is having severe vomiting and diarrhea. What condition that exhibits blood values with a low pH and a low plasma bicarbonate concentration should the nurse assess for?

Metabolic acidosis

A client in the emergency department reports that he has been vomiting excessively for the past 2 days. His arterial blood gas analysis shows a pH of 7.50, partial pressure of arterial carbon dioxide (PaCO2) of 43 mm Hg, partial pressure of arterial oxygen (PaO2) of 75 mm Hg, and bicarbonate (HCO3-) of 42 mEq/L. Based on these findings, the nurse documents that the client is experiencing which type of acid-base imbalance?

Metabolic alkalosis

A 43-year-old patient with a history of alcohol abuse has been admitted to an acute medical unit with complications resulting from liver failure. Upon assessment, the patient's abdomen is distended, firm to touch, and nontender. The nurse recognizes that the patient has excess fluid in his peritoneal space (ascites), a problem that results from the disruption of normal movement of water and electrolytes. What process is primarily responsible for maintaining fluid balance along a concentration gradient?

Osmosis

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

As the ICU nurse caring for a patient with multiple trauma from an ATV accident you draw arterial blood gases (ABGs) every 4 hours. What are you primarily assessing in this patient with the ABGs?

The bicarbonate-carbonic acid buffer system

Mrs. Kruger is a 53-year-old woman who has been admitted to the surgical unit following urethral sling surgery that was performed to treat her recurrent stress incontinence. The nurse notes that Mrs. Kruger was treated for breast cancer 3 years earlier and had a left unilateral mastectomy and axillary node biopsy performed. How will Mrs. Kruger's medical history affect the nurse's care during this admission?

The nurse should use Mrs. Kruger's right arm for IV access and blood pressure assessment.

A nurse evaluates a client's laboratory results. What is a factor that may be affecting an increase in serum osmolality?

free water loss

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?

furosemide

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

The nurse is analyzing the arterial blood gas (ABG) results of a client diagnosed with severe pneumonia. Which of the following ABG results indicates respiratory acidosis?

pH: 7.20, PaCO2: 65 mm Hg, HCO3-: 26 mEq/L

A client is diagnosed with hypocalcemia and the nurse is teaching the client about symptoms. What symptom would the nurse include in the teaching?

tingling sensation in the fingers