Ch 40 Fluid, Electrolyte and Acid-Base Balance

potassium

A 50-year-old client with hypertension is being treated with a diuretic. The client reports muscle weakness and falls easily. The nurse should assess which electrolyte?

metabolic alkalosis

A client is admitted to the unit with a diagnosis of intractable vomiting for 3 days. What acid-base imbalance related to the loss of stomach acid does the nurse observe on the arterial blood gas (ABG)?

electrolytes

A client loses consciousness after strenuous exercise and needs to be admitted to a health care facility. The client is diagnosed with dehydration. The nurse knows that the client needs restoration of:

decreased blood volume and intracellular dehydration

A client who is NPO prior to surgery reports feeling thirsty. What is the physiologic process that drives the thirst factor?

an implanted central venous access device (CVAD)

A client with a diagnosis of colon cancer has opted for a treatment plan that will include several rounds of chemotherapy. What vascular access device is most likely to meet this client's needs?

total parenteral nutrition (TPN)

An intravenous hypertonic solution containing dextrose, proteins, vitamins, and minerals is known as:

extracellular fluid volume excess

Edema happens when there is which fluid volume imbalance?

phlebitis

The nurse is administering intravenous (IV) therapy to a client. The nurse notices acute tenderness, redness, warmth, and slight edema of the vein above the insertion site. Which complication related to IV therapy should the nurse most suspect?

pH: 7.60; PaCO2: 64 mm Hg (8.51 kPa); HCO3: 42 mEq/l (42 mmol/l)

The nurse is caring for a client with metabolic alkalosis whose breathing rate is 8 breaths/min. Which arterial blood gas data does the nurse anticipate finding?

a newly admitted 88-year-old with a 2-day history of vomiting and loose stools

The oncoming nurse is assigned to the following clients. Which client should the nurse assess first?

phlebitis

Upon assessment of a client's peripheral intravenous site, the nurse notices the area is red and warm. The client complains of pain when the nurse gently palpates the area. These signs and symptoms are indicative of:

arterial blood gas

What is the lab test commonly used in the assessment and treatment of acid-base balance?

metabolic acidosis

Which acid-base balance would the nurse suspect after assessing the following arterial blood gas values: pH 7.30, PaCO2 36 mmhg, HCO3 14 MEq/l

chloride

Which is a common anion?

if a portion of the catheter breaks when removing it, apply a tourniquet to the upper arm and notify the health care provider

Which statement accurately describes appropriate nursing interventions in unexpected situations when removing a peripherally inserted central catheter (PICC)?

hyponatremia

Endurance athletes who exercise for long periods of time and consume only water may experience a sodium deficit in their extracellular fluid. This electrolyte imbalance is known as:

1 unit over 2-3 hours, no longer than 4 hours

A client has been diagnosed with a gastrointestinal bleed and the health care provider has ordered a transfusion. At what rate should the nurse administer the client's packed red blood cells?

- ask another nurse to assist with confirming the order, blood group, and other vital information - start the administration slowly for the first 15 minutes of the transfusion

A client has been prescribed 2 units of packed red blood cells. A type and cross-match has been performed and the first unit has arrived on the floor from the blood bank. When administering this client's blood transfusion, the nurse should perform which actions? Select all that apply.

apricots

A home care nurse is teaching a client and family about the importance of a balanced diet. The nurse determines that the education was successful when the client identifies which of the following as a rich source of potassium?

offer small amounts of preferred beverage frequently

An older adult has fluid volume deficit and needs to consume more fluids. Which approach by the nurse demonstrates gerontologic considerations?

muscle weakness, fatigue, and dysrhythmias

Mr. Jones is admitted to the nursing unit from the emergency department with a diagnosis of hypokalemia. His laboratory results show a serum potassium of 3.2 mEq/L (3.2 mmol/L). For what manifestations should the nurse be alert?

cardiac dysrhythmias

The nurse is caring for a male client who has a diagnosis of heart failure. Today's laboratory results show a serum potassium of 3.2 mEq/L (3,2 mmol/L). For what complications should the nurse be aware, related to the potassium level?

stop the transfusion

The nurse is monitoring a blood transfusion for a client with anemia. Five minutes after the transfusion begins, the client reports feeling short of breath and itchy. What is the priority nursing action?

uncompensated respiratory alkalosis

What is the acid-base status of a patient with these ABG results? pH: 7.50; PaCO2: 24mmHg; and HCO3: 26mEq/L?

discontinue the IV

A nurse assessing the IV site of a client observes swelling and pallor around the site and notes a significant decrease in the flow rate. The client complains of coldness around the infusion site. What is the nurse's most appropriate action?

- deciding the location of the IV catheter - deciding the size of the IV catheter - administering the IV solution

A nurse is caring for a client who requires intravenous (IV) therapy. The nurse understands that which actions are the nurse's responsibilities related to this therapy? Select all that apply.

- The use of packed cells instead of whole blood will decrease the fluid volume delivered to the client. - A symptom of fluid overload is distended neck veins. - Fluid overload is more likely in very young children. - The infusion rate must be carefully monitored during the administration of blood.

The nursing instructor is discussing IV fluid overload with the nursing students. What will the nurse include in her discussion? Select all that apply.