ATI Fluid and Electrolytes
A nurse is caring for a client who has hypernatremia and requires IV fluid therapy due to his NPO status. Which of the following solutions should the nurse prepare to infuse for this client? -Lactated Ringer's -Dextrose 5% in 0.9% sodium chloride -0.45% sodium chloride -Dextrose 10% in water
0.45% sodium chloride -Hypotonic IV solution, 0.225% accepted as well
A nurse is admitting a 6-month-old infant who has dehydration. Which of the following amounts of urinary output should indicate to the nurse that the treatment has corrected the fluid imbalance? -0.5 mL/kg/hr -2 mL/kg/hr -7.5 mL/kg/hr -15 mL/kg/hr
2 mL/kg/hr
A nurse is admitting a client who is dehydrated. Which of the following BUN levels should the nurse expect the client to have upon admission? -3.1mg/dL -10mg/dL -16.5mg/dL -35mg/dL
35mg/dL -Decreased blood flow leads to decreased renal excretion of blood. Other causes of increased BUN include GI bleeding, heart failure, burns, shock, and myocardial infarction?
A nurse is assessing four clients for fluid balance. The nurse should identify that which of the following clients is exhibiting manifestations of dehydration? -A client who has a urine specific gravity of 1.010 -A client who has a weight gain of 2.2kg (2 lb) in 24 hours -A client who has a hematocrit of 45% -A client who has a temperature of 39C (102)F
A client who has a temperature of 39C (102F) -Expected temperature is 36-37C (96.8-98.6F)
A nurse is reviewing a client's laboratory values and discovers the client has a serum potassium of 6.2 mEq/L. Which of the following interventions should the nurse anticipate? -Initiating an IV potassium infusion -Encouraging the client to eat bananas -Administering sodium polystyrene sulfonate -Administering a potassium-sparing diuretic
Administering sodium polystyrene sulfonate -Absorbs excessive potassium and excretes it through stool; other treatments include hemodialysis and IV glucose and insulin
A nurse in an emergency department is caring for an infant who has a 2-day history of vomiting and an elevated temperature. Which of the following should the nurse recognize as the most reliable indicator of fluid loss? -Bodyweight -Skin integrity -Blood pressure -Respiratory rate
Bodyweight
A nurse is assessing an older adult client who is receiving IV therapy. The nurse should recognize that which of the following findings indicate fluid volume excess? (Select all that apply). -Bounding pulse -Pitting edema -Swelling at the IV site -Urine specific gravity greater than 1.030 -Crackles upon auscultation
Bounding pulse, pitting edema, crackles upon auscultation
A nurse in a provider's office is reviewing the lab results of a client who takes furosemide for hypertension. The nurse notes that the client's potassium level is 3.3 mEq/L. The nurse should monitor the client for which of the following complications? -Cardiac dysrhythmias -Hypoglycemia -Seizures -Neurogenic shock
Cardiac dysrhythmias -Flattened T waves, prominent U waves, ST depression
A nurse is reviewing the medical record of a client who has a potassium level of 3.0 mEq/L. Which of the following findings should the nurse recognize as a potential causative factor? -Client is currently prescribed spironolactone -Client has a history of alcohol abuse disorder -Client reports drinking 3.5-4 L water each day -Client has an NG tube to gastric suction
Client has an NG tube to gastric suction -Due to gastrointestinal loss of potassium
A nurse is assessing a client who has chronic kidney disease for fluid volume increase. Which of the following provides a reliable measure of fluid retention? -Daily weight -Sodium level -Tissue turgor -Intake and output
Daily weight
A nurse in the ED is caring for a client who collapsed after playing football on a hot day. Lab findings are Sodium (152 mEq/L), Potassium (3.6 mEq/L), Chloride (105 mEq/L), Glucose (102 mg/dL), BUN (18 mg/dL), Creatinine (0.7 mg/dL). Which condition? -Renal failure -Low-protein diet -Dehydration -Syndrome of inappropriate antidiuretic hormone (SIADH)
Dehydration
A nurse is preparing to administer a transfusion of RBCs to a client who has heart failure. For which of the following manifestations should the nurse monitor to prevent fluid volume overload? (Select all that apply). -Dyspnea -GI bleeding -Jugular vein distention -Confusion -Hypotension
Dyspnea, jugular vein distention, confusion -Hypertension is a manifestation of fluid volume overload
A nurse is caring for a male client who reports nausea and vomiting and is receiving IV fluid therapy. His BUN is 32 mg/dL, creatinine 1.1 mg/dL, and hematocrit 50%. Which of the following nursing interventions is appropriate? -Collect a urine specimen for culture and sensitivity -Continue routine care because the results are within the expected reference range -Decrease the IV fluid infusion rate and limit oral intake -Evaluate urine for amount and for specific gravity
Evaluate urine for amount and for specific gravity -Dehydration, supports the laboratory findings
A nurse in a community clinic is assessing an older adult client for manifestations of dehydration. Which of the following findings should the nurse expect? -Hypothemia -Protruding eyeballs -Elevated BP -Furrows in the tongue
Furrows in the tongue
A nurse is providing teaching to a group of adult athletes about prevention of the effects of dehydration on the body. Which of the following manifestations should the nurse include in the teaching? -Impaired motor control -Drop in body temperature during exercise -Increase in appetite -Decreased resting heart rate
Impaired motor control
A nurse is assessing a client who has fluid volume deficit. The nurse should expect which of the following findings? -Decreased urine specific gravity -Decreased Hgb -Increased BUN -Increased urine ketones
Increased BUN
A nurse is assessing a client who has fluid overload. Which of the following findings should the nurse expect? (Select all that apply). -Increased heart rate -Increased blood pressure -Increased respiratory rate -Increased hematocrit -Increased temperature
Increased heart rate, increased BP, increased respiratory rate -Decreased hematocrit -Decreased temperature
A nurse in an emergency department is assessing an infant who is dehydrated? Which of the following findings should the nurse expect? -Irritability -Slow, bounding pulse -Decreased temperature -Tetany
Irritability -tachycardia -increased temperature
A nurse is admitting a client who has a serum calcium level of 12.3 mg/dL and initiates cardiac monitoring. which of the following findings should the nurse expect during the initial assessment?
Lethargy -Above reference range; generalized weakness and confusion common
A nurse is admitting a client who reports flu-like symptoms with hyperactive reflexes and a new onset of confusion. The nurse should recognize that the client is experiencing which of the following conditions? -Metabolic acidosis -Metabolic alkalosis -Respiratory acidosis -Respiratory alkalosis
Metabolic alkalosis -Confusion, dizziness, circumoral paresthesia, numbness in extremities -Objective: hyperactive reflexes, tetany, decreased respiratory rate and depth
A nurse is assessing a preschooler who has a calcium level of 8.0 mg/dL. Which of the following findings should the nurse expect? -Dry, sticky mucous membranes -Polyuria -Negative Chvostek's sign -Muscle tremors
Muscle tremors -Can progress to tetany and convulsions
A nurse is assessing a client who has a sodium level of 116 mEq/L. Which of the following findings should the nurse expect? -Nausea and vomiting -Extreme thirst -Flushed skin -Fever
Nausea and vomiting
A nurse is assessing a client who reports frequent vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect? (Select all that apply). -Poor skin turgor -Bradycardia -Hypotension -Pale yellow urine -Flat neck veins
Poor skin turgor, hypotension, flat neck veins -Tachycardia
A nurse is performing an admission assessment on a client. Which of the following findings should the nurse identify as an indication that the client is dehydrated? -Low body temperature -Jugular vein distention -Skin tenting present -Blood pressure 178/90 mmHg
Skin tenting present -Check on the sternum or back of the hand
A nurse is reviewing a client's lab results. Which of the following lab values should the nurse report to the provider? -Sodium 126 mEq/L -Potassium 3.5 mEq/L -Magnesium 1.9 mEq/L -Chloride 99 mEq/L
Sodium 126 mEq/:
A nurse is caring for four hospitalized clients. Which of the following clients should the nurse identify as being at risk for fluid volume deficit? -The client who has been NPO since midnight for endoscopy -The client who has left-sided HF and has a brain natriuretic peptide (BNP) level of 600 pg/mL -The client who has end-stage renal failure and scheduled for dialysis today -The client who has gastroenteritis and is febrile
The client who has gastroenteritis and is febrile -Diarrhea and vomiting can lead to fluid loss, diaphoresis is common, as well as fever
A nurse is caring for a 3-year-old who was admitted with acute diarrhea and dehydration. Which of the following findings indicates the oral rehydration therapy has been effective? -Heart rate 130/min -Respiratory rate 24/min -Urine specific gravity 1.015 -Capillary refill greater than 3 seconds
Urine specific gravity 1.015
A nurse is caring for a client who is receiving IV fluids to correct dehydration. Which of the following laboratory values should indicate to the nurse that the client is effectively responding to treatment? -Sodium 165 mEq/L -Potassium 5.2 mEq/L -Urine specific gravity 1.020 -HCT 62%
Urine specific gravity 1.020
A nurse is reviewing the lab results of a client who has a fluid volume deficit. The nurse would expect which of the following findings? -Urine specific gravity 1.035 -Hematocrit 44% -BUN 19 mg/dL -Sodium 155 mEq/L
Urine specific gravity 1.035
A nurse is caring for a client who sustained blood loss. Which of the following is a manifestation of hypovolemia? -Decreased HR -Dyspnea -Increased BP -Weak pulse
Weak pulse -Less pressure in the vessels -Heart rate would be increased -BP would be lower
A nurse is assessing a client who has hypokalemia as a result of nausea, vomiting, and diarrhea. Which of the following findings should the nurse expect? -Hyperactive reflexes -Extreme thirst -Weak, irregular pulse -Hyperactive bowel sounds
Weak, irregular pulse -Muscle weakness Fatigue -Ventricular dysrhytmias
