Fluid & Electrolyte Balance - ML5

The nurse is providing instructions to the client prior to an intravenous pyelogram. Which statement by the client indicates teaching was effective? "I should let the staff know if I feel claustrophobic." "I should remove all jewelry before the test." "I will need to drink all of the dye as quickly as possible." "I will feel a warm sensation as the dye is injected."

"I will feel a warm sensation as the dye is injected."

Which solution is hypotonic? Lactated Ringer solution 0.45% NaCl 5% NaCl 0.9% NaCl

0.45% NaCl

Which is considered an isotonic solution? Dextran in normal saline 3% NaCl 0.45% normal saline 0.9% normal saline

0.9% normal saline

The nurse notes that a patient who is retaining fluid had a 1-kg weight gain. The nurse knows that this is equivalent to about how many mL? 500 mL 250 mL 1,000 mL 750 mL

1,000 mL

A nurse is assisting the physician conducting a cystogram. The client has an intravenous (IV) infusion of D5W at 40 ml/hr. The physician inserts a urinary catheter into the bladder and instills a total of 350 ml of a contrast agent. The nurse empties 500 ml from the urinary catheter drainage bag at the conclusion of the procedure. How many milliliters does the nurse record as urine?

150 The urinary drainage bag contains both the contrast agent and urine at the conclusion of the procedure. Total contents (500 ml) in the drainage bag consist of 350 ml of contrast agent and 150 ml of urine.

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 A 1-kg weight gain is equal to 1,000 mL of retained fluid. 4 kg × 1,000 = 4,000. The most accurate indicator of fluid loss or gain in an acutely ill patient is weight. An accurate daily weight must be obtained and recorded.

A patient is admitted to a burn treatment center at 2:30 p.m. with full-thickness burns over 40% of his body. The injury occurred at 1:30 p.m. at a paper-making plant. The nurse knows that burn shock has to be prevented or treated. Based on fluid volume shifts, the nurse knows that fluid loss would peak by __________ to __________ hours, with the greatest volume being lost from __________ to__________ hours after the burn. 4:30 p.m. to 6:30 p.m.; 6 to 8 hours 7:30 p.m. to 9:30 p.m.; 24 to 36 hours 10:30 p.m. to 12:30 a.m.; 40 to 50 hours 5:30 p.m. to 6:30 p.m.; 9 to 12 hours

7:30 p.m. to 9:30 p.m.; 24 to 36 hours

A client is recovering from percutaneous endoscopic gastrostomy (PEG) tube placement. The nurse Administers an initial bolus of 50 mL water Pushes the stabilizing disk firmly against the skin Maintains a gauze dressing over the site for 3 days Immediately starts the prescribed tube feeding

Administers an initial bolus of 50 mL water

Which of the following is the primary hormone for the long-term regulation of sodium balance? Thyroxin Calcitonin Aldosterone Antidiuretic hormone (ADH)

Aldosterone

The nurse is able to identify which condition as uremia? An excess of blood in the urine An excess of protein in the urine An excess of urea in the blood An excess of protein in the blood

An excess of urea in the blood

A client is at postoperative day 1 after abdominal surgery. The client is receiving 0.9% normal saline at 75 mL/h, has a nasogastric tube to low wall suction with 200 mL every 8 hours of light yellow fluid, and a wound drain with 50 mL of dark red drainage every 8 hours. The 24-hour urine output total is 2430 mL. What action by the nurse is most appropriate? Assess for edema. Assess for signs and symptoms of fluid volume deficit. Document the findings and reassess in 24 hours. Discontinue the nasogastric tube suctioning.

Assess for signs and symptoms of fluid volume deficit.

The nurse recognizes that which laboratory test is a key diagnostic indicator of heart failure? Brain natriuretic peptide (BNP) Complete blood count (CBC) Creatinine Blood urea nitrogen (BUN)

Brain natriuretic peptide (BNP)

A client has been prescribed furosemide 80 mg twice daily. The asymptomatic client begins to have rare premature ventricular contractions followed by runs of bigeminy with stable signs. What action will the nurse perform next? Notify the health care provider. Administer potassium. Check the client's potassium level. Calculate the client's intake and output.

Check the client's potassium level.

A creatinine clearance test is ordered for a client with possible renal insufficiency. The nurse must collect which serum concentration midway through the 24-hour urine collection? Blood urea nitrogen Creatinine Osmolality Hemoglobin

Creatinine

A creatinine clearance test is ordered for a client with possible renal insufficiency. The nurse must collect which serum concentration midway through the 24-hour urine collection? Osmolality Creatinine Hemoglobin Blood urea nitrogen

Creatinine

A patient with chronic renal failure is examined by the health care provider for anemia. Which laboratory results will the nurse monitor? Increased mean corpuscular volume Increased reticulocyte count Decreased level of erythropoietin Decreased total iron-binding capacity

Decreased level of erythropoietin

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? Hypovolemia Fluid volume excess Dehydration Hypervolemia

Dehydration

The nurse is caring for a client with heart failure. What procedure should the nurse prepare the client for in order to determine the ejection fraction to measure the efficiency of the heart as a pump? Echocardiogram A pulmonary arteriography A chest radiograph Electrocardiogram

Echocardiogram

Following a voiding cystogram, the client has a nursing diagnosis of risk for infection related to the introduction of bacterial following manipulation of the urinary tract. An appropriate nursing intervention for the client is to: Strain all urine for 48 hours. Encourage high fluid intake. Monitor for hematuria. Apply moist heat to the flank area.

Encourage high fluid intake.

A client with acute pericarditis is exhibiting distended jugular veins, tachycardia, tachypnea, and muffled heart sounds. The nurse recognizes these as symptoms of what occurrence? The pericardial space is eliminated with scar tissue and thickened pericardium. Excess pericardial fluid compresses the heart and prevents adequate diastolic filling. Fibrin accumulation on the visceral pericardium infiltrates into the myocardium, creating generalized myocardial dysfunction. The parietal and visceral pericardial membranes adhere to each other, preventing normal myocardial contraction.

Excess pericardial fluid compresses the heart and prevents adequate diastolic filling.

A client with acute pericarditis is exhibiting distended jugular veins, tachycardia, tachypnea, and muffled heart sounds. The nurse recognizes these as symptoms of what occurrence? The parietal and visceral pericardial membranes adhere to each other, preventing normal myocardial contraction. Fibrin accumulation on the visceral pericardium infiltrates into the myocardium, creating generalized myocardial dysfunction. The pericardial space is eliminated with scar tissue and thickened pericardium. Excess pericardial fluid compresses the heart and prevents adequate diastolic filling

Excess pericardial fluid compresses the heart and prevents adequate diastolic filling.

A client with a traumatic brain injury has developed increased intracranial pressure resulting in diabetes insipidus. While assessing the client, the nurse expects which of the following findings? Oliguria and decreased urine osmolality Oliguria and serum hyperosmolarity Excessive urine output and decreased urine osmolality Excessive urine output and serum hypo-osmolarity

Excessive urine output and decreased urine osmolality

Which condition in a client with pancreatitis makes it necessary for the nurse to check fluid intake and output, check hourly urine output, and monitor electrolyte levels? Frequent vomiting, leading to loss of fluid volume High glucose concentration in the blood Dry mouth, which makes the client thirsty Acetone in the urine

Frequent vomiting, leading to loss of fluid volume

Which condition should a nurse expect to find in a client diagnosed with hyperparathyroidism? Hypophosphaturia Hyperphosphatemia Hypocalcemia Hypercalcemia

Hypercalcemia

Immediately after a burn injury, electrolytes need to be evaluated for a major indicator of massive cell destruction, which is: Hypoglycemia. Hypernatremia. Hyperkalemia. Hypocalcemia.

Hyperkalemia.

An elderly client diagnosed with diarrhea is taking digoxin. Which electrolyte imbalance should the nurse be alert to? Hypernatremia Hyperkalemia Hypokalemia Hyponatremia

Hypokalemia

The nurse identifies which of the following as a potential cause of premature ventricular complexes (PVCs)? Hypokalemia Alkalosis Hypovolemia Bradycardia

Hypokalemia

After chemotherapy for AML, what interventions will best help to prevent renal complications? Select all that apply. Administer potassium therapy. Encourage exercise. Administer rasburicase. Increase hydration. Administer allopurinol.

Increase hydration. Administer allopurinol. Administer rasburicase.

With which condition should the nurse expect that a decrease in serum osmolality will occur? Influenza Hyperglycemia Kidney failure Uremia

Kidney failure

With which condition should the nurse expect that a decrease in serum osmolality will occur? Kidney failure Influenza Uremia Hyperglycemia

Kidney failure

The nurse is aware that fluid replacement is a hallmark treatment for shock. Which of the following is the crystalloid fluid that helps treat acidosis? 0.9% sodium chloride Lactated Ringer's Dextran Albumin

Lactated Ringer's

Which of the following is the preferred IV fluid for burn resuscitation? D5W Normal saline (NS) Lactated Ringer's (LR) Total parenteral nutrition (TPN)

Lactated Ringer's (LR)

Which option should the nurse encourage to replace fluid and electrolyte losses in a client with AIDS? Gluten Sucrose Iron and zinc Liquids

Liquids

Retention of which electrolyte is the most life-threatening effect of renal failure? Potassium Sodium Calcium Phosphorous

Potassium

Which term describes the degree of stretch of the ventricular cardiac muscle fibers at the end of diastole? Preload Afterload Stroke volume Ejection fraction

Preload

What is a hallmark of the diagnosis of nephrotic syndrome? Hypokalemia Hyperalbuminemia Hyponatremia Proteinuria

Proteinuria

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 creatinine level of 0.4 mg/dl Hematocrit of 52% Serum sodium level of 124 mEq/L

Serum sodium level of 124 mEq/L

Which diuretic medication conserves potassium? Furosemide Chlorothiazide Spironolactone Chlorthalidone

Spironolactone

A nurse is transfusing whole blood to a client with impaired renal function. During the transfusion, the client tells the nurse, "I feel very short of breath all of a sudden." What is the nurse's primary action? Call the health care provider. Assess the client's vital signs. Stop the infusion. Slow the infusion.

Stop the infusion.

A nurse is required to monitor the effectiveness of fluid resuscitation in a client who is being treated for burns. Which of the following assessments would indicate the success of the fluid resuscitation? The client's urinary output is 0.5 mL/kg/hour. The client's heart rate is rapid. The client's breathing is unlabored and skin is clammy. The client is conscious.

The client's urinary output is 0.5 mL/kg/hour.

A client has a serum calcium level of 7.2 mg/dl (1.8 mmol/L). During the physical examination, the nurse expects to assess: Homans' sign. Hegar's sign. Trousseau's sign. Goodell's sign.

Trousseau's sign.

A client with sepsis is experiencing disseminated intravascular coagulation (DIC). The client is bleeding from mucous membranes, venipuncture sites, and the rectum. Blood is present in the urine. The nurse establishes the nursing diagnosis of Risk for deficient fluid volume related to bleeding. The most appropriate and measurable outcome for this client is that the client exhibits Systolic blood pressure greater than 70 mm Hg Urine output greater than or equal to 30 mL/hour Stable level of consciousness Decreased bleeding

Urine output greater than or equal to 30 mL/hour

A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report to the physician immediately? Serum sodium level of 135 mEq/L Serum potassium level of 4.9 mEq/L Temperature of 99.2° F (37.3° C) Urine output of 20 ml/hour

Urine output of 20 ml/hour

A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report to the physician immediately? Temperature of 99.2° F (37.3° C) Serum sodium level of 135 mEq/L Serum potassium level of 4.9 mEq/L Urine output of 20 ml/hour

Urine output of 20 ml/hour

Which medication taken by the client in the previous 24 hours would be of greatest concern to the nurse caring for a client undergoing a bone biopsy? NPH insulin furosemide digoxin aspirin

aspirin

A resident at a long-term care facility lost the ability to swallow following a stroke 4 years ago. The client receives nutrition via a PEG tube, has adapted well to the tube feedings, and remains physically and socially active. Occasionally, the client develops constipation that requires administration of a laxative to restore regular bowel function. What is the most likely cause of this client's constipation? increased fiber lack of free water intake lack of exercise lack of solid food

lack of free water intake

One of the roles of the nurse in caring for clients with chronic kidney disease is to help them learn to minimize and manage potential complications. This would include: allowing liberal use of sodium. eating protein liberally. limiting iron and folic acid intake. restricting sources of potassium.

restricting sources of potassium.

A nurse is assessing a client who may be in the early stages of dehydration. Early manifestations of dehydration include: increased heart rate with hypotension. coma or seizures. thirst or irritability. sunken eyeballs and poor skin turgor.

thirst or irritability.