chapter 12 - Pharmacology

Which electrolyte is the major cation of extracellular fluid?

Sodium The major cation of extracellular fluid is sodium.

Based on the condition of the patient, an intravenous fluid that is hypotonic will be ordered. Which intravenous fluid is most likely to be ordered by the health care provider?

0.33% NaCl Of the fluids listed, the only one that is hypotonic is 0.33% NaCl. Normal saline is isotonic; both D

Based on the condition of the patient, an intravenous fluid that is hypertonic will be ordered. Which intravenous fluid is most likely to be ordered by the health care provider?

5% dextrose and normal saline Of the fluids listed, the only one that is hypertonic is 5% dextrose and normal saline. Normal saline is isotonic, and both 2.5% dextrose and water and 0.33% NaCl are considered to be hypotonic.

Which statement accurately describes the total body water (TBW) composition compared to weight?

A 6 kilogram (13.2 lb) 2-month-old neonate is 75% to 80% water. The TBW of a 70 kg (154 lb) man is approximately 60% (40 L). This percentage varies with age, sex, and percentage of body fat. Neonates are 75% to 80% water, whereas older adults are 45% to 55% water. Women tend to have less body water than men due to the effects of hormones and higher amount of adipose tissue, which contains very little water.

What is the priority nursing intervention when administering intravenous potassium replacement to the patient?

Administer the medication using an infusion device. Too rapid infusion of potassium can cause cardiac dysrhythmias; an intravenous infusion device must always be used. Potassium should not be bolused or pushed. Heat will not aid the infusion. Unless the patient is prone to constant hypokalemia, teaching the signs and symptoms is not a priority.

The nurse is administering hypertonic saline solution to treat a patient with severe hyponatremia. Which nursing intervention is the priority?

Assess skin for flushing and assess increased thirst. Flushed skin and increased thirst are signs and symptoms of hypernatremia.

Which is the priority intervention when the nurse is assessing a patient with a potassium level of 3.2 mEq/L?

Attach telemetry leads for monitoring. The patient is high risk for cardiac dysrhythmias due to low potassium level. Oxygen and IV fluids are not a priority; Kayexalate is not used for low potassium level.

The patient has been ordered to receive a unit of packed red blood cells. What is the highest priority nursing action prior to initiating the infusion of the blood product?

Confirm the identity of the patient. Although all of the actions listed are important, the highest priority one is confirmation of the identity of the patient. Failure to do this is a major safety violation.

A patient receiving a unit of red blood cells suddenly develops shortness of breath, chills, and fever. What will the nurse do first?

Discontinue the infusion. These are signs and symptoms of a blood transfusion reaction that could escalate to anaphylaxis; therefore, the blood transfusion should be stopped immediately.

The patient is ordered an isotonic intravenous fluid. Which intravenous fluid is most likely to be ordered by the health care provider?

Normal saline Of the fluids listed, the only one that is isotonic is normal saline. Both D

The nurse is preparing to administer a transfusion of a blood product. What is the most appropriate intravenous fluid to hang as a maintenance infusion?

Normal saline Of the intravenous solutions listed, the only one that is compatible with blood products is normal saline.

Which electrolyte is the major ion of the intracellular space?

Potassium The major cation of intracellular fluid is potassium.

The health care provider has ordered 5% dextrose in water as a maintenance fluid for the patient. The nurse is assessing the patient at the beginning of the shift and observes the fluid hanging to be 50% dextrose in water (D50W). Which is the highest priority nursing action?

Stop the infusion. The patient's safety is always the primary concern; the fluid should be stopped and the correct fluid hung before other measures are taken such as notifying the health care provider.