Prep U Ch 39 Fluid, Electrolyte, and Acid Base Balance

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daily weights

A client admitted with heart failure requires careful monitoring of his fluid status. Which method will provide the nurse with the best indication of the client's fluid status?

maintenance of cell size

A group of nursing students is reviewing information about body fluid and locations. The students demonstrate understanding of the material when they identify which of the following as a function of intracellular fluid?

bottled water.

A mother of an infant calls the pediatric nurse and asks which fluids she should provide her baby since he is suffering from diarrhea. The nurse would inform the mother not to give:

distended neck veins

A nurse who has diagnosed a client as having "fluid volume excess" related to compromised regulatory mechanism (kidneys) may have been alerted by what symptom?

replacement of fluids for those lost from vomiting and diarrhea.

A woman age 58 years is suffering from food poisoning after eating at a local restaurant. She has had nausea, vomiting, and diarrhea for the past 12 hours. Her blood pressure is 88/50 and she is diaphoretic. She requires:

risk for metabolic alkalosis

A young man has developed gastric esophageal reflux disease. He is treating it with antacids. Which acid-base imbalance is he at risk for developing?

Offer fluids at times other than meals. Offer small amounts of preferred liquids frequently. Identify fluid preferences (do not give caffeinated beverages or initiate an unprescribed IV fluid replacement)

An older adult client with dehydration repeatedly tells the nurse, "I am just not thirsty. I don't want anything to drink." Which nursing actions are appropriate? (Select all that apply.)

It helps to prevent large changes in pH by absorbing or releasing H+ ions.

Because metabolism continually produces acids, maintenance of pH within these incredibly narrow limits depends on two processes: buffering and compensation. Which statement describes a function of buffering?

stop the transfusion immediately.

During a blood transfusion of a client, the nurse observes the appearance of rash and flushing in the client, although the vital signs are stable. Which intervention should the nurse perform for this client first?

hemolytic transfusion reaction: incompatibility of blood product

During a blood transfusion, a client displays signs of immediate onset facial flushing, fever, chills, headache, low back pain, and shock. Which transfusion reaction should the nurse suspect?

hypovolemia

During an assessment of an older adult client, the nurse notes an increase in pulse and respiration rates, and notes that the client has warm skin. The nurse also notes a decrease in the client's blood pressure. Which medical diagnosis may be responsible?

aldosterone

Major control over the extracellular concentration of potassium within the human body is exerted by:

metabolic alkalosis

Miss Roberts is admitted to the unit with a diagnosis of three days of continuous vomiting. You would suspect which of the following acid/base imbalances related to the loss of stomach acid?

muscle cramping and tetany

Mr. Jones is admitted to the nurse's unit from the emergency department with a diagnosis of hypocalcemia. His laboratory results show a serum calcium level of 8.2 mg/dL (2.05 mmol/L). For what assessment findings will the nurse be looking?

regulated by RAAS

Sodium is the most abundant cation in the extracellular fluid. Which is true regarding sodium?

1 +

The nurse is assessing a newly admitted client and finds that he has edema of his right ankle that is 2 mm and just perceptible. The nurse documents this at which grade?

increase in fat cells.

The nurse is caring for Mrs. Roberts, an 86-year-old client, who fell at home and was not found for 2 days. Mrs. Roberts is severely dehydrated. The nurse is aware that older adults are at increased risk for fluid imbalance due to:

intracellular

The nurse, along with a nursing student, is caring for Mrs. Roper, who was admitted with dehydration. The student asks the nurse where most of the body fluid is located. The nurse should answer with which fluid compartment?

0.45% NaCl

What commonly used intravenous solution is hypotonic?

apply a warm compress

When caring for a client who is on intravenous therapy, the nurse observes that the client has developed redness, warmth, and discomfort along the vein. Which intervention should the nurse perform for this complication?

change the site every 3 to 4 days.

When providing care for a client who has a peripheral intravenous catheter in situ, the nurse should:

a client with colitis and bloody diarrhea

Which client would be a candidate for total parenteral nutrition?

a client who has second and third degree burns over 40% of their body a client who had gastric surgery and is unable to eat for a few weeks

Which of the following clients would be appropriate candidates for total parenteral nutrition? (Select all that apply.)


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