Chapter 10 Fluid & Electrolytes
The nurse is caring for a client diagnosed with bulimia. The client is being treated for a serum potassium concentration of 2.9 mEq/L (2.9 mmol/L). Which statement made by the client indicates the need for further teaching? "I will take a potassium supplement daily as prescribed." "A good breakfast for me will include milk and a couple of bananas." "I will be sure to buy frozen vegetables when I grocery shop." "I can use laxatives and enemas but only once a week."
"I can use laxatives and enemas but only once a week." The client is experiencing hypokalemia, most likely due to the diagnosis of bulimia. Hypokalemia is defined as a serum potassium concentration <3.5 mEq/L (3.5 mmol/L), and usually indicates a deficit in total potassium stores. Clients diagnosed with bulimia frequently suffer increased potassium loss through self-induced vomiting and misuse of laxatives, diuretics, and enemas; thus, the client should avoid laxatives and enemas. Prevention measures may involve encouraging the client at risk to eat foods rich in potassium (when the diet allows), including fruit juices and bananas, melon, citrus fruits, fresh and frozen vegetables, lean meats, milk, and whole grains. If the hypokalemia is caused by abuse of laxatives or diuretics, client education may help alleviate the problem.
Which solution is hypotonic? 0.9% NaCl 5% NaCl Lactated Ringer solution 0.45% NaCl
0.45% NaCl Half-strength saline is hypotonic. Lactated Ringer solution and normal saline (0.9% NaCl) are isotonic. A 5% NaCl solution is hypertonic.
Which is considered an isotonic solution? 0.45% normal saline 0.9% normal saline 3% NaCl Dextran in normal saline
0.9% normal saline
A client has chronic hyponatremia, which requires weekly laboratory monitoring to prevent the client lapsing into convulsions or a coma. What is the level of serum sodium at which a client can experience these side effects? 130 mEq/L 135 mEq/L 114 mEq/L 148 mEq/L
114 mEq/L
A client weighing 160.2 pounds (72.7 kg), who has been diagnosed with hypovolemia, is weighed every day. The health care provider asked to be notified if the client loses 1,000 mL of fluid in 24 hours. What weight would be consistent with this amount of fluid loss? 156.0 lbs (70.8 kg) 157.0 lbs (71.2 kg) 158.0 lbs (71.7 kg) 159.0 lbs (72.1 kg)
158.0 lbs (71.7 kg) Explanation: A loss of 0.5 kg, or 1.1 lb, represents a fluid loss of about 500 mL. Therefore, a loss of 1,000 mL would be equivalent to the loss of 2.2 lbs (1 kg), bringing the client's weight to 158.0 lbs (71.7 kg).
A patient is admitted with severe vomiting for 24 hours as well as weakness and "feeling exhausted." The nurse observes flat T waves and ST-segment depression on the electrocardiogram. Which potassium level does the nurse observe when the laboratory studies are complete? 5.5 mEq/L 3.5 mEq/L 4.5 mEq/L 2.5 mEq/L
2.5 mEq/L
A nurse can estimate serum osmolality at the bedside by using a formula. A patient who has a serum sodium level of 140 mEq/L would have a serum osmolality of: 250 mOsm/kg. 230 mOsm/kg. 280 mOsm/kg. 210 mOsm/kg.
280 mOsm/kg. Explanation: Serum osmolality can be estimated by doubling the serum sodium or using the formula: Na × 2 = glucose/18 + BUN/3. Therefore, the nurse could estimate a serum osmolality of 280 mOsm/kg by doubling the serum sodium value of 140 mEq/L.
Which of the following measurable urine outputs indicates the client is maintaining adequate fluid intake and balance?
30ml/hr
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 elimination Free flow Active transport Passive osmosis
Active transport
Which is the most common cause of symptomatic hypomagnesemia? Sedentary lifestyle Alcoholism Intravenous drug use Burns
Alcoholism
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
When a client's ventilation is impaired, the body retains which substance? Oxygen Carbon dioxide Nitrous oxide Sodium bicarbonate
Carbon dioxide When ventilation is impaired, the body retains carbon dioxide (CO2) because the carbonic acid level increases in the blood. Sodium bicarbonate is used to treat acidosis. Nitrous oxide, which has analgesic and anesthetic properties, commonly is administered before minor surgical procedures. When ventilation is impaired, the body doesn't retain oxygen. Instead, the tissues use oxygen and CO2 results.
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 lactated Ringer's IV. Continue to monitor client with another appointment. Be prepared to administer a sodium chloride IV. Consider sodium restriction with discontinuation of salt tablets.
Consider sodium restriction with discontinuation of salt tablets. Explanation: The client's symptoms of feeling thirsty with dry, sticky mucous membranes; decreased urine output; fever; a rough tongue; and lethargy suggest hypernatremia. The client needs to be evaluated with serum blood tests soon; a later appointment will delay treatment. It is necessary to restrict sodium intake. Salt tablets and a sodium chloride IV will only worsen this condition. A Lactated Ringer's IV is a hypertonic IV and is not used with hypernatremia. A hypotonic solution IV may be a part of the treatment, but not along with the salt tablets.
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? Fluid volume excess Hypovolemia Dehydration Hypervolemia
Dehydration The most common fluid imbalance in older adults is dehydration. Because of reduced thirst sensation that often accompanies aging, older adults tend to drink less water. Use of diuretic medications, laxatives, or enemas may also deplete fluid volume in older adults. Chronic fluid volume deficit can lead to other problems such as electrolyte imbalances.
Which of the following is a clinical manifestation of fluid volume excess (FVE)? Select all that apply. Distended neck veins Decreased blood pressure Shortness of breath Crackles in the lung fields Bradycardia
Distended neck veins Shortness of breath Crackles in the lung fields
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. Document presenting signs and symptoms. Suction the client's airway. Administer IV bicarbonate. Maintain intake and output records. Compare ABG findings with previous results.
Document presenting signs and symptoms. Maintain intake and output records. Compare ABG findings with previous results.
A client was admitted to the unit with a diagnosis of hypovolemia. When it is time to complete discharge teaching, which of the following will the nurse teach the client and family? Select all that apply. respond to thirst Drink alcoholic beverages to help balance fluid volume. Drink at least eight glasses of fluid each day. Drink caffeinated beverages to retain fluid. Drink water as an inexpensive way to meet fluid needs.
Drink at least eight glasses of fluid each day. respond to thirst Drink water as an inexpensive way to meet fluid needs. Explanation: In addition, the nurse teaches clients who have a potential for hypovolemia and their families to respond to thirst because it is an early indication of reduced fluid volume; consume at least 8 to 10 (8 ounce) glasses of fluid each day and more during hot, humid weather; drink water as an inexpensive means to meet fluid requirements; and avoid beverages with alcohol and caffeine because they increase urination and contribute to fluid deficits.
Which laboratory result does the nurse identify as a direct result of the client's hypovolemic status with hemoconcentration? Abnormal potassium level Low white blood count Elevated hematocrit level Low urine specific gravity
Elevated hematocrit level Explanation: When hemoconcentration occurs due to a hypovolemic state, a high ratio of blood components in relation to watery plasma occurs, thus causing an elevated hematocrit level. A high white blood cell count and urine specific gravity is also noted. Other causes of an abnormal potassium level may be present.
The nurse notes that a client has lost 5 lbs. (2.27 kg) of body weight over 5 days. Which additional assessment findings indicate to the nurse that the client is experiencing hypovolemia? Select all that apply. Lung crackles Bounding pulse Flat neck veins Concentrated urine Muscle cramps
Explanation: An acute weight loss of 5 lbs. (2.27 kg) over 5 days can indicate a fluid volume deficit or hypovolemia. Additional assessment findings that support a loss of fluid include flat neck veins, muscle cramps, and concentrated urine. Lung crackles and a bounding pulse would occur with an excess of fluid or hypervolemia.
A nurse is caring for a client with metastatic breast cancer who is extremely lethargic and very slow to respond to stimuli. The laboratory report indicates a serum calcium level of 12.0 mg/dl, a serum potassium level of 3.9 mEq/L, a serum chloride level of 101 mEq/L, and a serum sodium level of 140 mEq/L. Based on this information, the nurse determines that the client's symptoms are most likely associated with which electrolyte imbalance? Hyperkalemia Hypercalcemia Hypokalemia Hypocalcemia
Hypercalcemia
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? Hypermagnesemia Hyponatremia Hyperchloremia Hypocalcemia
Hypocalcemia Explanation: The client is experiencing an elevated serum phosphorus concentration. Hyperphosphatemia is defined as a serum phosphorus that exceeds 4.5 mg/dL (1.45 mmol/L). Because of the reciprocal relationship between phosphorus and calcium, a high serum phosphorus concentration tends to cause a low serum calcium concentration.
An elderly client takes 40 mg of furosemide twice a day. Which electrolyte imbalance is the most serious adverse effect of diuretic use? Hyperkalemia Hypernatremia Hypophosphatemia Hypokalemia
Hypokalemia Hypokalemia (potassium level below 3.5 mEq/L) usually indicates a deficit in total potassium stores. Potassium-losing diuretics, such as furosemide, can induce hypokalemia. Hyperkalemia refers to increased potassium levels. Loop diuretics can bring about lower sodium levels, not hypernatremia. Furosemide does not affect phosphorus levels.
A patient has a serum osmolality of 250 mOsm/kg. The nurse knows to assess further for: Hyperglycemia. Hyponatremia. Dehydration. Acidosis.
Hyponatremia. Explanation: Decreased serum sodium is a factor associated with decreased serum osmolality. Dehydration and hyperglycemia are associated with increased serum osmolality; acidosis is associated with increased urine osmolality.
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? Oxygen through a rebreather mask Potassium supplements Bronchodilator Intravenous 0.9% normal saline
Intravenous 0.9% normal saline Explanation: Treatment of both acute and chronic metabolic alkalosis is aimed at correcting the underlying acid-base disorder. Because volume depletion is commonly present, treatment includes restoring normal fluid volume by administering normal saline. Bronchodilators are used to treat respiratory acidosis. Potassium supplements would be used to treat metabolic acidosis. Oxygen delivered through a rebreather mask would be used to treat respiratory alkalosis.
A nurse is assessing a client with syndrome of inappropriate antidiuretic hormone. Which finding requires further action? Polyuria Weight loss Tetanic contractions Jugular vein distention
Jugular vein distention Jugular vein distention requires further action because this finding signals vascular fluid overload. Tetanic contractions aren't associated with this disorder, but weight gain and fluid retention from oliguria are. Polyuria is associated with diabetes insipidus, which occurs with inadequate production of antidiuretic hormone.
With which condition should the nurse expect that a decrease in serum osmolality will occur? Uremia Influenza Kidney failure Hyperglycemia
Kidney failure Failure of the kidneys results in multiple fluid and electrolyte abnormalities including fluid volume overload. If renal function is so severely impaired that pharmacologic agents cannot act efficiently, other modalities are considered to remove sodium and fluid from the body.
Your client has a diagnosis of hypervolemia. What would be an important intervention that you would initiate? Teach client behaviors that decrease urination. Give medications that promote fluid retention. Assess for dehydration. Limit sodium and water intake.
Limit sodium and water intake. Implement prescribed interventions such as limiting sodium and water intake and administering ordered medications that promote fluid elimination. Assessing for dehydration and teaching to decrease urination would not be appropriate interventions.
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? Kidney and liver Pancreas and stomach Heart and lungs Lungs and kidney
Lungs and kidney
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 alkalosis Respiratory acidosis Respiratory alkalosis Metabolic acidosis
Metabolic acidosis
Which of the following is a function of calcitonin? Select all that apply. Decreases urinary excretion of phosphate Reduces bone resorption Decreases deposition of phosphorous in bones Increases urinary excretion of calcium Increases deposition of calcium in bones
Reduces bone resorption Increases urinary excretion of calcium Increases deposition of calcium in bones
A 64-year-old client is brought in to the clinic with thirsty, dry, sticky mucous membranes, decreased urine output, fever, a rough tongue, and lethargy. Serum sodium level is above 145 mEq/L. Should the nurse start salt tablets when caring for this client? No, start with the sodium chloride IV. No, sodium intake should be restricted. Yes, this will correct the sodium deficit. Yes, along with the hypotonic IV.
No, sodium intake should be restricted.
Which is the preferred route of administration for potassium? Subcutaneous IV (intravenous) push Oral Intramuscular
Oral When the client cannot ingest sufficient potassium by consuming foods that are high in potassium, administering oral potassium is ideal because oral potassium supplements are absorbed well. Administration by IV is done with extreme caution using an infusion pump, with the patient monitored by continuous ECG. To avoid replacing potassium too quickly, potassium is never administered by IV push or intramuscularly. Potassium is not administered subcutaneously.
A client with pancreatic cancer has the following blood chemistry profile: Glucose, fasting: 204 mg/dl; blood urea nitrogen (BUN): 12 mg/dl; Creatinine: 0.9 mg/dl; Sodium: 136 mEq/L; Potassium: 2.2 mEq/L; Chloride: 99 mEq/L; CO2: 33 mEq/L. Which result should the nurse identify as critical and report immediately? CO2 Chloride Sodium Potassium
Potassium The nurse should identify potassium: 2.2 mEq/L as critical because a normal potassium level is 3.5 to 5.0 mEq/L. Severe hypokalemia can cause cardiac and respiratory arrest, possibly leading to death. Hypokalemia also depresses the release of insulin and results in glucose intolerance. The glucose level is above normal (normal is about 75 to 110 mg/dl), and the chloride level is a bit low (normal is about 100 to 110 mEq/L). Although these levels should be reported, neither is life-threatening. The BUN (normal is ~ 8 to 26 mg/dl) and creatinine (normal is ~ 0.8 to 1.4 mg/dl) are within normal range.
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. Prepare for gastric lavage. Monitor the client's heart rhythm.
Prepare to assist with ventilation.
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. Respiratory acidosis is associated with hypoventilation; in this client, hypoventilation suggests intake of a drug that has suppressed the brain's respiratory center. Therefore, the nurse should assume the client has respiratory depression and should prepare to assist with ventilation. After the client's respiratory function has been stabilized, the nurse can safely monitor the heart rhythm, prepare for gastric lavage, and obtain a urine specimen for drug screening.
A nurse is caring for a client admitted with a diagnosis of exacerbation of myasthenia gravis. Upon assessment of the client, the nurse notes the client has severely depressed respirations. The nurse would expect to identify which acid-base disturbance? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis
Respiratory acidosis
A client with nausea, vomiting, and abdominal cramps and distention is admitted to the health care facility. Which test result is most significant? Blood urea nitrogen (BUN) level of 29 mg/dl Serum potassium level of 3 mEq/L Serum sodium level of 132 mEq/L Urine specific gravity of 1.025
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 blood urea nitrogen (BUN) level of 8.6 mg/dl Serum sodium level of 124 mEq/L Hematocrit of 52% Serum creatinine level of 0.4 mg/dl
Serum sodium level of 124 mEq/L Explanation: In SIADH, the posterior pituitary gland produces excess antidiuretic hormone (vasopressin), which decreases water excretion by the kidneys. This, in turn, reduces the serum sodium level, causing hyponatremia, as indicated by a serum sodium level of 124 mEq/L. In SIADH, the serum creatinine level isn't affected by the client's fluid status and remains within normal limits. A hematocrit of 52% and a BUN level of 8.6 mg/dl are elevated. Typically, the hematocrit and BUN level decrease.
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.) Tachycardia Oliguria Tachypnea Hypertension Bradycardia
Tachycardia Oliguria Tachypnea Explanation: Hypovolemia, or fluid volume deficit, is indicated by decreased, not increased, blood pressure (hypotension), oliguria, tachycardia (not bradycardia), and tachypnea.
The nurse is caring for a client diagnosed with hyperchloremia. Which are signs and symptoms of hyperchloremia? Select all that apply. Tachypnea Dehydration Lethargy Weakness Hypotension
Tachypnea Lethargy Weakness Explanation: The signs and symptoms of hyperchloremia are the same as those of metabolic acidosis: hypervolemia and hypernatremia. Tachypnea; weakness; lethargy; deep, rapid respirations; diminished cognitive ability; and hypertension occur. If untreated, hyperchloremia can lead to a decrease in cardiac output, dysrhythmias, and coma. A high chlorid
A client seeks medical attention for an acute onset of severe thirst, polyuria, muscle weakness, nausea, and bone pain. Which health history information will the nurse report to the health care provider?
Takes high doses of vitamin D Explanation: Hypercalcemia can affect many organ systems and symptoms occur when the calcium level acutely rises. Hypercalcemia crisis refers to an acute rise in the serum calcium level. Severe thirst and polyuria are often present. Additional findings include muscle weakness, nausea, and bone pain. Excessive ingestion of vitamin D supplements may cause excessive absorption of calcium. Therefore, the nurse would report this finding to the health care provider. The client's symptoms are not associated with occasional alcohol intake, a high-fiber eating plan, or the client's employment status. These findings would not need to be reported.
The nurse is caring for a client who has been diagnosed with chronic obstructive pulmonary disease (COPD) and is experiencing respiratory acidosis. The client asks what is making the acidotic state. What does the nurse identify as the result of the disease process that causes the fall in pH? The lungs are unable to breathe in sufficient oxygen. The lungs are not able to regulate carbonic acid levels. The lungs have ineffective cilia from years of smoking. The lungs are unable to exchange oxygen and carbon dioxide.
The lungs are not able to regulate carbonic acid levels.
A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation? Absence of protein Urine pH of 3.0 Specific gravity of 1.02 Absence of glucose
Urine pH of 3.0
A nurse is providing client teaching about the body's plasma pH and the client asks the nurse what is the major chemical regulator of plasma pH. What is the best response by the nurse? renin-angiotensin-aldosterone system bicarbonate-carbonic acid buffer system sodium-potassium pump ADH-ANP buffer system
bicarbonate-carbonic acid buffer system The major chemical regulator of plasma pH is the bicarbonate-carbonic acid buffer system. The renin-angiotensin-aldosterone system regulates blood pressure. The sodium-potassium pump regulate homeostasis. The ADH-ANP buffer system regulates water balance in the body.
A client presents with anorexia, nausea and vomiting, deep bone pain, and constipation. The following are the client's laboratory values. sodium 137 mEq/L (137 mmol/L)potassium 4.6 mEq/L (4.6 mmol/L)chloride 94 mEq/L (94 mmol/L)calcium 12.9 mg/dL (3.2 mmol/L) What laboratory value is of highest concern to the nurse? calcium 12.9 mg/dL (3.2 mmol/L) sodium 137 mEq/L (137 mmol/L) chloride 94 mEq/L (94 mmol/L) potassium 4.6 mEq/L (4.6 mmol/L)
calcium 12.9 mg/dL (3.2 mmol/L)
A client with emphysema is at a greater risk for developing which acid-base imbalance? metabolic alkalosis metabolic acidosis chronic respiratory acidosis respiratory alkalosis
chronic respiratory acidosis Respiratory acidosis, which may be either acute or chronic, is caused by excess carbonic acid, which causes the blood pH to drop below 7.35. Chronic respiratory acidosis is associated with disorders such as emphysema, bronchiectasis, bronchial asthma, and cystic fibrosis.
A client is taking spironolactone to control hypertension. The client's serum potassium level is 6 mEq/L. What is the nurse's priority during assessment? electrocardiogram (ECG) results neuromuscular function bowel sounds respiratory rate
electrocardiogram (ECG) results Explanation: Although changes in all these findings are seen in hyperkalemia, ECG results should take priority because changes can indicate potentially lethal arrhythmias such as ventricular fibrillation. It wouldn't be appropriate to assess the client's neuromuscular function, bowel sounds, or respiratory rate for effects of hyperkalemia.
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 metolazone spironolactone hydrochlorothiazide
furosemide Explanation: Furosemide is the only loop diuretic choice. Hydrochlorothiazide and metolazone are thiazide diuretics that block sodium reabsorption. Spironolactone is a potassium-sparing diuretic that prevents sodium absorption.
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: hypokalemia. hypernatremia. hyperkalemia. hypercalcemia.
hyperkalemia. Hyperkalemia is a common complication of acute renal failure. It's life-threatening if immediate action isn't taken to reverse it. Administering glucose and regular insulin, with sodium bicarbonate if necessary, can temporarily prevent cardiac arrest by moving potassium into the cells and temporarily reducing serum potassium levels. Hypernatremia, hypokalemia, and hypercalcemia don't usually occur with acute renal failure and aren't treated with glucose, insulin, or sodium bicarbonate.
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?
hypokalemia Explanation: Hypokalemia causes fatigue, weakness, anorexia, nausea, vomiting, cardiac dysrhythmias, leg cramps, muscle weakness, and paresthesias. Many diuretics, such as ethacrynic acid (Edecrin), also waste potassium. Symptoms of hyperkalemia include diarrhea, nausea, muscle weakness, paresthesias, and cardiac dysrhythmias. Signs of hypocalcemia include tingling in the extremities and the area around the mouth and muscle and abdominal cramps. Hypercalcemia causes deep bone pain, constipation, anorexia, nausea, vomiting, polyuria, thirst, pathologic fractures, and mental changes.
Early signs of hypervolemia include moist breath sounds. thirst. a decrease in blood pressure. increased breathing effort and weight gain.
increased breathing effort and weight gain. Early signs of hypervolemia are weight gain, elevated blood pressure, and increased breathing effort. Eventually, fluid congestion in the lungs leads to moist breath sounds. One of the earliest symptoms of hypovolemia is thirst.
Clients diagnosed with hypervolemia should avoid sweet or dry food because it obstructs water elimination. can lead to weight gain. can cause dehydration. increases the client's desire to consume fluid.
increases the client's desire to consume fluid. Explanation: The management goal in hypervolemia is to reduce fluid volume. For this reason, fluid is rationed and the client is advised to take a limited amount of fluid when thirsty. Sweet or dry food can increase the client's desire to consume fluid. Sweet or dry food does not obstruct water elimination or cause dehydration. Weight regulation is not part of hypervolemia management except to the extent it is achieved on account of fluid reduction.
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 acidosis metabolic alkalosis metabolic acidosis respiratory alkalosis
metabolic alkalosis
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? active transport evaporation filtration osmosis
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: 7.50, PaCO2: 30 mm Hg, HCO3-: 24 mEq/L pH: 7.32, PaCO2: 40 mm Hg, HCO3-: 18 mEq/L pH: 7.40, PaCO2: 40 mm Hg, HCO3-: 24 mEq /L pH: 7.20, PaCO2: 65 mm Hg, HCO3-: 26 mEq/L
pH: 7.20, PaCO2: 65 mm Hg, HCO3-: 26 mEq/L
A nurse is monitoring a client being evaluated who has a potassium level of 7 mEq/L (mmol/L). Which electrocardiogram changes will the client display? peaked T waves prolonged T waves elevated ST segment shortened PR interval
peaked T waves Explanation: The earliest changes occur when the serum potassium level is 7 mEq/L (mmol/L). Cardiac tracings include peaked and narrow T waves, ST segment depression, and a shortened QT interval.
A client has been admitted to the hospital unit with signs and symptoms of hypovolemia; however, the client has not lost weight. The client exhibits a localized enlargement of her abdomen. What condition could the client be presenting? anasarca third-spacing pitting edema hypovolemia
third-spacing
