F&E
The nurse is caring for a client with chronic kidney disease. The patient has gained 4 kg in the past 3 days. In milliliters, how much fluid retention does this equal? Enter your response as a whole number.
4000 4kg = 4000mg and mg=mL
When teaching a class of new parents about the needs of their newborn, the nurse explains that the newborn's voiding is a good indicator that he or she is getting enough fluids. The nurse determines that the teaching was successful when the parents state which number of voidings per day is a good indicator of adequate fluids?
6 to 8
In which client would a clinician most suspect multiple myeloma as a diagnosis?
A 40-year-old man who has had three broken bones over the past 6 months and whose serum calcium and creatinine levels are elevated.
The nurse is caring for four clients on a medical unit. The nurse is most correct to review which client's laboratory reports first for an electrolyte imbalance?
A 52-year-old with diarrhea
What is the most prevalent mineralocorticoid that regulates fluid balance?
Aldosterone
The nurse is caring for a client with chronic renal failure who is on hemodialysis three times a week. In order to treat hyperphosphatemia and hypocalcemia, which medication will the nurse administer to decrease absorption of phosphate from the gastrointestinal tract?
Calcium carbonate
Trousseau's sign is elicited by which of the following?
Carpopedal spasm is induced by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff.
The nurse practitioner who is monitoring the patient's progression of HIV is aware that the most debilitating gastrointestinal condition found in up to 90% of all AIDS patients is:
Chronic diarrhea.
In a client with a dislocation, the nurse should initially perform neurovascular assessments a minimum of every 15 minutes until stable. Which complication does the assessments help the nurse to monitor in the client?
Compartment syndrome
The nurse is caring for a client with a serum sodium concentration of 113 mEq/L (113 mmol/L). The nurse should monitor the client for the development of which condition?
Confusion
The nurse is caring for a client with "hyperkalemia related to decreased renal excretion secondary to potassium-conserving diuretic therapy." What is an appropriate expected outcome?
ECG will show no cardiac arrythmias within 48 hours after removing salt substitutes, coffee, tea, and other K+-rich foods from diet.
An older adult client is admitted with polyuria, severe constipation, significant postural hypotension, and showing signs of alkalosis. While awaiting the lab results, what action by the nurse would be most appropriate?
Facilitate a STAT ECG.
A client with chronic kidney disease becomes confused and reports abdominal cramping, racing heart rate, and numbness of the extremities. The nurse relates these symptoms to which lab value?
Hyperkalemia
Which of the following symptoms would indicate that a client with chronic pancreatitis has developed secondary diabetes?
Increased appetite and thirst
Natriuretic peptides (NP) are part of the compensatory response to heart failure. Which are actions of NP?
Increased glomerular filtration Inhibition of endothelin action Decreased renal reabsorption of sodium and water
The most recent blood work of a client with a diagnosis of heart failure indicates increased levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP). What is the most likely effect of these peptides on the client's physiology?
Inhibition of the renin-angiotensin-aldosterone system
A client is exhibiting signs of increasing intracranial pressure (ICP). Which intravenous solution (IV) would the nurse anticipate hanging?
Lactated Ringer's
A client has experienced hypovolemic shock and is being treated with 2 liters of lactated Ringer's solution. It is now most important for the nurse to assess
Lung sounds
A teenager is admitted for complications resulting from bulimia nervosa. The nurse's admission assessment should pay close attention to which manifestations relating to complications associated with this disorder?
Missing tooth enamel and increased number of dental caries. Dry, cracked lips and poor skin turgor. Painful swallowing and stomach cramping related to reflux and esophagitis. Painless enlargement of the parotid gland due to vomiting.
Which is an effect of aging on upper and lower urinary tract function?
More prone to develop hypernatremia
While working in the emergency room, the nurse receives a call that a 3-year-old child sustained extensive burns in a house fire. Assuming all of the following actions are included in the standing burn-care protocol, which action should be the nurse perform first?
Obtain a weight.
Pressure generated as water moves across a membrane is also known as which of the following?
Osmotic pressure
Which glands regulate calcium and phosphorous metabolism?
Parathyroid
A patient in the recovery room after cardiac surgery begins to have extremity paresthesia, peaked T waves, and mental confusion. What type of electrolyte imbalance does the nurse suspect this patient is having?
Potassium
Retention of which electrolyte is the most life-threatening effect of renal failure?
Potassium
The nurse is caring for a 7-year-old boy who has just had a tonsillectomy. Which intervention is least appropriate for this child?
Providing fluids by straw
Which electrolyte filters through the glomerulus and enters the renal tubule?
Sodium
You notify the physician that your client is third-spacing fluid. What orders would you expect the physician to give you?
Start IV fluids and blood products
A primigravid with severe gestational hypertension has been receiving magnesium sulfate IV for 3 hours. The latest assessment reveals deep tendon reflexes (DTR) of +1, blood pressure of 150/100 mm Hg, a pulse of 92 beats/minute, a respiratory rate of 10 breaths/minute, and a urine output of 20 ml/hour. Which action should the nurse perform next?
Stop the magnesium sulfate infusion.
Potassium is the major cation in the body. It plays many important roles, including the excitability of nerves and muscles. Where is this action particularly important?
The heart
The nurse is to administer IV fluids to an infant. Which safeguard would be most important for the nurse to use?
Use of an infusion pump to regulate the flow rate
A 66-year-old obese man with diagnoses of ischemic heart disease has been diagnosed with heart failure that his care team has characterized as attributable to systolic dysfunction. Which assessment finding is inconsistent with his diagnosis?
Ventricular dilation and wall tension are significantly lower than normal.
The nurse is assessing a client with chronic bronchitis. For which finding should the nurse suspect that the client is developing right-sided heart failure?
bilateral edema of the feet and ankles
The physician has prescribed a thiazide diuretic for a client. The nurse anticipates that the medication will:
block the tubular reabsorption of sodium.
A nurse is caring for a 70-year-old client who is taking desmopressin (DDAVP). The client has a history of cardiovascular disease. The nurse will prioritize the assessment of:
electrolyte levels.
The nurse assesses a client who is diagnosed with bulimia nervosa and at risk for alterations in both fluid and electrolyte balance. During the assessment, the nurse focuses on monitoring the client for ________ as evidenced by _____________.
hypokalemia cardiac arrythmias
A client with heart failure is admitted to the hospital. What should the nurse assess in the client to determine a risk for impaired skin integrity?
neck vein distention with head of bed at 90 degrees increase in blood pressure from 122/76 to 144/90 crackling breath sounds auscultated over lung fields
The nurse is reviewing lab work prior to shift handoff on a client with a subnormal urine output. Which is the nurse most correct to report?
oliguria
A 6-month-old infant is assessed to have 4% volume depletion related to a gastrointestinal illness. What intervention would the nurse recommend to the parents based on the infant's condition?
oral electrolyte replacement solutions, breast milk, or lactose-free formula
The nurse is caring for a 5-year-old child who had a hernia repair 1 day ago. The child is vomiting, has a nasogastric (NG) tube to low intermittent suction, and has diarrhea. Which of the following laboratory results would be the immediate priority for the nurse to assess?
potassium level
The nurse is caring for a 3-year-old child with acute kidney injury. Which laboratory finding should the nurse immediately report to the healthcare provider?
potassium level of 6.5 mEq/L (6.5 mmol/L)
The nurse is aware of the importance of potassium and sodium for normal physiologic functions of a client. The rapid movement of potassium and sodium in actions is known as:
primary active transport.
A nurse is developing a care plan for a client in her 34th week of gestation who's experiencing premature labor. What nonpharmacologic intervention should the plan include to halt premature labor?
promoting adequate hydration
An older adult client has been treated for stage 4 left-sided heart failure for several days. New laboratory results indicate serum sodium of 130 mEq/L (130 mmol/L), TCO2 36 mEq/L (36 mmol/L), and potassium 3.4 mEq/L (3.4 mmol/L). The nurse suspects these results are related to one of the client's medications prescribed to treat heart failure and its complications. The nurse prioritizes assessing what systems prior to contacting the healthcare provider about reassessing the medication?
respiratory status and fluid balance
The nurse is teaching a group of nursing students about the major functions of the kidney. What should the nurse include in the discussion?
Elimination of water Removal of excess electrolytes Removal of waste products
A client with shock brought on by hemorrhage has a temperature of 97.6° F (36.4° C), a heart rate of 140 beats/minute, a respiratory rate of 28 breaths/minute, and a blood pressure of 60/30 mm Hg. For this client, the nurse should question which health care provider order?
"Infuse IV fluids at 83 ml/hour."
A nurse is caring for a client diagnosed with pneumonia, a urinary tract infection, dehydration, and temperature of 101.4°F;(38.6°C;). The health care provider orders 1,000 ml of D5W to infuse over 8 hours. The available drop factor is 20 gtt/ml. The nurse would regulate the intravenous flow rate to deliver how many drops per minute? Round your answer to the nearest whole number.
42 Calculate the flow rate using the formula below:(Total volume ordered) ÷(Number of hours) = Flow rate1,000 ml/8 hours = 125 ml/h125 ml/h X 1 h/60 min X 20 gtt/ml = 42 gtt/min
Which cellular dysfunction is responsible for the manifestations of cystic fibrosis?
Abnormal chloride channel proteins allow increased sodium and water reabsorption.
A client asks the nurse what may have caused elevation in urinary protein levels (proteinuria) on a urine test. The best response by the nurse would be:
Abnormal glomerular filtration
The critical care nurse is caring for a client with decreased cardiac output. For which consequence of low cardiac output does the nurse monitor the client?
Buildup of urea and electrolytes in the blood
Which occurrence is most likely to cause increased urination?
Decrease in antidiuretic hormone
Which outcome indicates that treatment of a client with diabetes insipidus has been effective?
Fluid intake is less than 2,500 ml/day.
The nurse has identified a collaborative problem of Risk for Complications of Electrolyte Imbalance for a client with diarrhea. The client begins to exhibit a decrease in level of consciousness. What is the nurse's most appropriate action?
Notify the health care provider for additional orders.
A client presents to the clinic with severe edema. Which type of deficiency should be suspected in this client?
Protein
A client is receiving intravenous fluids and upon assessment presents with increased pulse, increased respirations, and jugular vein distension. What is the priority action by the nurse?
Slow the intravenous rate and notify the physician.
The nurse is assessing a 10-day-old infant for dehydration. Which finding indicates severe dehydration?
Tenting of skin
The nurse is teaching a group of nursing students about the mechanism of action of common diuretics. What best reflects the mechanism of these drugs?
They block the reabsorption of sodium and chloride in the nephron.
A patient enters the emergency room with reports of visual changes, drowsiness, and tinnitus. The patient is confused and hyperventilating. These symptoms may be attributable to:
salicylate intoxication.
A major complication of prolonged bed rest is an increased risk of kidney stones. The nurse knows that this is most likely related to:
saturation of urine with calcium salts.