hogan fluid and electrolytes
A client is semiconscious and restless, and exhibits tremors and muscle weakness. Physical examination reveals a dry, swollen tongue, and body temperature of 99.8°F. The nurse anticipates that the serum sodium value for this client is most likely to be which of the following? 142 mEq/L 132 mEq/L 120 mEq/L 155 mEq/L
155 mEq/L
Which serum potassium (K+) level would the nurse expect to see in a client in the emergency department with a three-day history of diarrhea? 5.8 mEq/L 4.1 mEq/L 3.6 mEq/L 3.0 mEq/L
3.0 mEq/L
When caring for a 79-year-old client with a sodium level of 149 mEq/L, the nurse identifies that the client will be at increased risk to develop dehydration because of which factor? An increased level of aldosterone A decrease in muscle mass A diminished thirst drive ADH, antidiuretic hormone, is no longer produced.
A diminished thirst drive
The nurse determines that the intravenous (IV) administration of calcium gluconate to a client with hyperkalemia has been effective based on which assessment finding? Bowel sounds become less hyperactive. Bowel movements are loose. Cardiac dysrhythmia is corrected. Urine output increases.
Cardiac dysrhythmia is corrected.
A client receiving treatment for hypernatremia is being monitored for signs and symptoms of complications of therapy. The nurse would assess this client for which manifestation? Cellular dehydration Renal shutdown Cerebral edema Red blood cell (RBC) destruction
Cerebral edema
A client in the coronary care unit (CCU) is receiving 1000 mL normal saline with 40 mEq potassium chloride (KCl) every 8 hours for treatment of hypokalemia. Which assessment data would the nurse report to the physician? Muscle twitching, and ECG showing a flattened T wave Nausea and vomiting, with U waves evident on the monitor Reports of muscle weakness, and an ECG showing ST segment depression Dyspnea and tall, peaked T waves on the monitor
Dyspnea and tall, peaked T waves on the monitor
A client with hypercalcemia is receiving digoxin (Lanoxin). The nurse plans to incorporate which client assessments? Auscultation of bowel sounds Frequent pulse checks Checking for Trousseau's sign Inspection of skin for signs of bleeding
Frequent pulse checks
A client is admitted to the hospital with a serum potassium level of 2.8mEq/L. What does the nurse anticipate to find in the assessment? Irregular pulse rate, and shallow respirations Respiratory rate 16 with equal bilateral breath sounds, and two loose stools this morning Pink nail beds, and ECG showing a normal sinus rhythm with a rate of 76 Elastic skin turgor, and vomiting a small amount of bile-stained emesis
Irregular pulse rate, and shallow respirations
What should the nurse assess for when caring for a client who has a potassium level of 2.8 mEq/L? Paralytic ileus Diabetes mellitus Renal failure Perforated bowel
Paralytic ileus
The family of a client with hypercalcemia states that the client is "not acting like himself." The nurse focuses assessment on which manifestation? Anxiety Personality change Seizure activity Carpal spasms
Personality change
Which finding would the nurse expect to find when assessing a client with diabetes insipidus (DI)? Nausea and vomiting Polyuria and polydipsia Dysuria Confusion
Polyuria and polydipsia
A client with hypocalcemia has been started on intravenous (IV) corticosteroids. Which finding would indicate to the nurse a further decrease in calcium level in the client? Positive Chvostek's sign Muscle weakness Frequent urination Absence of Trousseau's sign
Positive Chvostek's sign
Which intervention should the nurse anticipate implementing in a client who is experiencing dilutional hyponatremia? Administration of hypotonic intravenous solutions Restriction of additional oral fluids Encouraging intake of tap water Increasing sodium intake in the diet
Restriction of additional oral fluids
The nurse includes in the plan of care to periodically monitor which item for a client who is at risk for developing hypocalcemia? Select all that apply. Serum magnesium level Fluid overload related to intravenous saline therapy Serum albumin level Constipation Blood urea nitrogen (BUN) and creatinine levels
Serum magnesium level Serum albumin level
A client has a potassium level of 6.8 mEq/L. Which manifestation should the nurse expect to find when assessing this client? Absence of bowel sounds Tall T wave on the cardiac monitor Change in level of consciousness Muscle cramping of the lower extremities
Tall T wave on the cardiac monitor
A client who is hemorrhaging is receiving massive blood transfusions. The nurse notes a low serum ionized calcium level, and concludes that what could be a probable cause for this calcium imbalance? Rapid infusion of crystalloids Development of metabolic acidosis. The citrate used as an anticoagulant in preserved blood. That hypomagnesemia has occurred.
The citrate used as an anticoagulant in preserved blood.
The nurse anticipates that which client would be at greatest risk to develop hyperkalemia? The client with intestinal and nasogastric suctioning The client just diagnosed with cirrhosis The client who has had diarrhea for the last four days The client with chronic renal failure
The client with chronic renal failure
A client is recovering from a parathyroidectomy to treat primary hyperparathyroidism. To ensure that nursing diagnosis goals have been met, the nurse monitors the level of serum ionized calcium and what other serum laboratory test? Serum creatinine The parathyroid hormone (PTH) level Serum magnesium Calcitriol
The parathyroid hormone (PTH) level
A client presents with a mildly elevated calcium level of 11.2 mg/dL. After completing a nursing history, the nurse identifies which of the following as a contributing factor to the abnormal calcium level? Use of a thiazide diuretic Recent reports of polyuria A high-protein diet Ingesting a bisphosphonates weekly
Use of a thiazide diuretic
For which manifestation should the nurse assess when developing a plan of care for a client with hypernatremia? Complaints of thirst Moist mucous membranes Muscle weakness Subnormal temperature
complaints of thirst
The nurse is providing care to a client experiencing hypotonic fluid volume excess. The nurse incorporates which dietary consideration in the menu for this client? Increased fluid intake Increased sodium intake Decreased sodium intake Intake of potassium-rich foods
increased sodium intake
For which complication related to electrolyte imbalance should the nurse assess in a client who has been taking furosemide (Lasix) for 2 years? Respiratory depression Tetany Nausea and vomiting Diabetes
tetany
When caring for an adult client diagnosed with hyponatremia, the nurse plans to restrict which of the following? Sodium Water Chloride Potassium
water
The nurse would report to the charge nurse that an assigned client has hyperkalemia after noting the serum potassium level drawn that morning was? 10.7 mg/dL 3.4 mEq/L 5.8 mEq/L 5.0 mEq/L
5.8 mEq/L
The client has a dietary deficiency of calcium. The nurse prepares to administer a dose of which type of medication as ordered? An aluminum-containing antacid A glucocorticoid A calcitriol supplement A bisphosphonate
A calcitriol supplement
Which client would not benefit from a hypertonic IV saline solution? A client in acute congestive heart failure (CHF) A client diagnosed with Addison's disease who is in adrenal crisis A client who has been NPO for several days A client with increased intracranial pressure
A client who has been NPO for several days
After receiving a change of shift report for the day shift at 07:00, the nurse is checking medications due to be administered during the shift. The nurse notes that alendronate (Fosamax) 70 mg weekly is scheduled to be administered at 09:00 with the other daily medications. Which action should the nurse take? Administer the Fosamax as ordered at 09:00, but be sure the client drinks at least 16 ounces of water. Administer the Fosamax at 07:30, separating it by at least 1 hour from breakfast or the other medications. Withhold the dose of Fosamax, and reschedule it to be given at bedtime. Adjust administration time of Fosamax to be given with breakfast.
Administer the Fosamax at 07:30, separating it by at least 1 hour from breakfast or the other medications.
A 56-year-old client with a history of heart failure and hypertension is postoperative for abdominal surgery. Vital signs have been stable, and D5 ½NS is infusing at 80 mL/hour. The client awakens in the middle of the night with trouble breathing. Which assessment by the nurse should take priority at this time? Assess extremities for edema. Review intake and output record. Count apical heart rate. Auscultate lung fields.
Auscultate lung fields.
A client is admitted to the intensive care unit (ICU) with metabolic alkalosis, hypokalemia, and hyponatremia. The nurse reviews results of which additional serum laboratory test that is likely to have an abnormal result? Ammonia Uric acid Creatinine Chloride
Chloride
A client admitted to the hospital with a 13.6 kg (30lb) weight gain over the past month has developed a moon-shaped face. Admission laboratory results indicate low serum potassium and magnesium, and high serum chloride and sodium levels. The nurse interprets that which disorder is most consistent with these electrolyte abnormalities? Syndrome of inappropriate ADH (SIADH) Cushing's syndrome Rhabdomyolysis Addison's disease
Cushing's syndrome
A 54-year-old client with liver failure due to cirrhosis comes to the clinic with a swollen abdomen and dizziness upon standing. The client is pale, with weak radial pulses, delayed hand vein filling, and distended abdomen. The nurse develops a care plan identifying which nursing diagnosis? Excess Fluid Volume: Intravascular related to third space fluid shifts Deficient Fluid Volume: Intravascular related to third space fluid shifts Excess Fluid Volume: Extravascular related to hormonal disturbances Deficient Fluid Volume: Extravascular related to hormonal disturbances
Deficient Fluid Volume: Intravascular related to third space fluid shifts
A client was brought to the hospital following a near-drowning experience in the ocean. In providing care to this client, the nurse plans to carefully monitor for which electrolyte imbalance? Hypercalcemia Hypernatremia Hypocalcemia Hyponatremia
Hypernatremia
Which serum electrolyte imbalances would the nurse assess for in a client admitted with a high fever and severe dehydration? Hypokalemia and hyponatremia Hypernatremia and hyperchloremia Hypercalcemia and hypophosphatemia Hypophosphatemia and hypocalcemia
Hypernatremia and hyperchloremia
The results of a clients laboratory tests show elevated ionized calcium and parathyroid hormone (PTH) levels. The nurse suspects that the cause is: Hypoparathyroidism. Hyperparathyroidism. Vitamin D deficiency. A malignancy.
Hyperparathyroidism.
A client is admitted with an ionized calcium level of 3.5 mg/dL. In anticipation of complications, the nurse should take which action? Prepare the client for dialysis. Initiate an intravenous infusion of normal saline. Perform an electrocardiogram to assess for shortening QT interval. Institute seizure precautions.
Institute seizure precautions.
Which client would the nurse identify as being at greatest risk to develop a sodium imbalance? An elderly client who drinks eight 8-ounce glasses of water each day A teenager who is drinking Gatorade during exercise workouts An adult client taking corticosteroid therapy A diabetic client who is under glycemic control
An adult client taking corticosteroid therapy
The nurse is overseeing the care of a client with syndrome of inappropriate antidiuretic hormone (SIADH). What instruction about water intake should the nurse give to the unlicensed assistant (UA)? It should be restricted. Given via intravenous fluids only. It can be taken according to the client's preference. It should be encouraged.
It should be restricted.
The nurse caring for a client with a calcium level of 7.5 mg/dL places highest priority on nursing interventions that help to manage which of the following? Neuromuscular clinical manifestations Hematologic disorders Renal signs and symptoms Cardiac changes
Neuromuscular clinical manifestations
Which medication reported by a client during a nursing history could be associated with the development of hypocalcemia? Hydrochlorothiazide Phenytoin Calcium carbonate Calcitriol
Phenytoin
A client with a nursing diagnosis of excess fluid volume has been treated with diuretics and fluid restriction. Which findings would indicate to the nurse that fluid volume balance has not yet been achieved? Skin tenting decreasing and conjunctiva of eyes moist Return to coherent conversation and appropriate behavior S3 heart sound and moist lung crackles present Urine output increasing and specific gravity decreasing
S3 heart sound and moist lung crackles present
A father telephones the clinic nurse asking what he should do for his 3-year-old son, who developed fever, vomiting, and diarrhea today. What would be an appropriate recommendation by the nurse? "Have him drink as much water as you can get him to swallow." "Provide frequent sips of fruit juice and commercial sports drinks." "Have him eat only bananas, rice, applesauce, and toast (BRAT diet)." "Give small sips of commercial oral rehydration fluids frequently."
"Give small sips of commercial oral rehydration fluids frequently."
A mother brings her 14-month-old to the emergency department, concerned that the infant has been vomiting for two days and "isn't keeping much down." Which question should the nurse ask next to elicit the most relevant information needed at this time? "How many diaper changes have you done in the last 24 hours?" "Did you take the baby's temperature?" "How much does your baby normally drink?" "What does your baby usually eat?"
"How many diaper changes have you done in the last 24 hours?"
The nurse evaluates that discharge teaching has been effective when the client with a calcium level of 7.2 mg/dL makes which statement? "I shouldn't take antacids, such as TUMS." "I should notify my healthcare provider if I start to feel tingling or numbness around my mouth." "I will watch my urine for signs of kidney stones." "I will need to cut down on the amount of protein I include in my diet each day."
"I should notify my healthcare provider if I start to feel tingling or numbness around my mouth."
Which statement made by a client indicates a need for further instruction regarding treatment for a potassium value of 3.1 mEq/L? "I will eat more bran flakes to increase my potassium level." "I will tell my doctor if I start having any of the symptoms on the list you gave me." "I will take my potassium in the morning after breakfast so it doesn't upset my stomach." "I will eat more bananas and cantaloupes for breakfast."
"I will eat more bran flakes to increase my potassium level."
A client hospitalized for gastrointestinal (GI) bleeding has orders for nasogastric tube (NGT) placement, with irrigations until the returns are clear. What solution should the nurse plan on using? 5% Dextrose in water (D5W) Sterile water 3% Sodium chloride (NaCl) 0.9% Sodium chloride (NaCl)
0.9% Sodium chloride (NaCl)
A 17-year-old client who sustained a head injury in a motorcycle collision 2 days ago is responsive only to pain. Which intravenous (IV) fluid order would the nurse question? Lactated Ringer's solution 0.9% sodium chloride (0.9% NaCl) Ringer's solution 5% dextrose in water (D5W)
5% dextrose in water (D5W)
The nurse identifies which client as being at the greatest risk for developing fluid volume deficit (FVD) and dehydration A 30-year-old with pneumonia A 2-month-old with vomiting A 70-year-old with arthritis A 45-year-old with diarrhea
A 2-month-old with vomiting
The nurse is caring for a client admitted with congestive heart failure (CHF). When assessing the client's risk for fluid imbalances, the nurse should check which laboratory values? Select all that apply. Liver enzymes Atrial natriuretic peptide (ANP) Hematocrit (Hct) Hemoglobin (Hgb) Blood glucose
ANP, HCT, HGB
The nurse is teaching a client on a low-sodium diet how to read food labels and check for hidden sodium content. The nurse informs the client that sodium is contained in higher amounts in which products? Select all that apply. Baking goods containing baking powder Salad oil Canned fruits Over-the-counter cold and cough preparations Seasonings using monosodium glutamate (MSG)
Baking goods containing baking powder Over-the-counter cold and cough preparations Seasonings using monosodium glutamate (MSG)
A client with hypocalcemia is taking supplemental vitamin D. When the client asks the purpose of this therapy, what should the nurse instruct the client? It directly opposes calcitonin. Calcium is absorbed in the intestines only under the influence of activated vitamin D. The only way to obtain vitamin D is with oral supplementation. It prevents renal disease in clients with hypocalcemia.
Calcium is absorbed in the intestines only under the influence of activated vitamin D.
The nurse concludes that a history of which condition places a client at risk for possible hypokalemia? Chronic renal failure (CRF) Cirrhosis Addison's disease Chronic obstructive pulmonary disease (COPD)
Cirrhosis
The nurse is caring for a client who is experiencing a steady decline in sodium level at 128 mEq/L. The nurse places the highest priority on which intervention? Providing oral hygiene and skin care Spacing activities to conserve energy Preventing weakness and fatigue Close monitoring of neurological status
Close monitoring of neurological status
The nurse is helping a client who recently was placed on a low-sodium diet to choose foods for lunch. The nurse recommends that which lunch menu would be best for this client? Ham and bean soup, fresh fruit salad, pickles, and a diet soda Cheeseburger, grapes, fresh pineapple, and tomato juice Grilled chicken sandwich on white bread, apple, salad, and iced tea Bologna sandwich on wheat bread, canned fruit cocktail, salad, and a soda
Grilled chicken sandwich on white bread, apple, salad, and iced tea
The nurse should include diet teaching regarding adding potassium-rich foods if which diuretics are ordered? Select all that apply. Spironolactone (Aldactone) Hydrochlorothiazide (HCTZ) Midamor (Amiloride) Maxizide (Triamterene with hydrochlorothiazide) Furosemide (Lasix)
Hydrochlorothiazide (HCTZ) Furosemide (Lasix)
A 45-year-old client is admitted with extreme thirst, frequent urination, tenting skin, sunken eyes, and a dry, furrowed tongue. Because serum sodium is normal and serum glucose is elevated, the nurse determines the client is experiencing which fluid imbalance? Isotonic fluid volume deficit Hypotonic overhydration Hypertonic dehydration Isotonic fluid volume excess
Hypertonic dehydration
A client has severe hyponatremia secondary to syndrome of inappropriate antidiuretic hormone (SIADH). The nurse concludes that the appropriate IV solution for this client would be a(n): Isotonic solution, such as normal saline (NS). Isotonic solution, such as D5W. Hypotonic solution, such as D5W. Hypertonic solution, such as 3% saline.
Hypertonic solution, such as 3% saline.
A 78-year-old client is admitted with dehydration and urinary tract infection. After an IV infusion of 750 mL NS, the client begins to cough, and asks for the head of the bed to be raised to ease breathing. The nurse assesses jugular vein distention (JVD) and increased respiratory rate. What interpretation should the nurse make? Hypervolemia is developing. Hypotonic water intoxication is beginning. The fluid volume deficit is worsening. Ascites is causing respiratory compromise.
Hypervolemia is developing.
When a client with pancreatitis reports numbness around the mouth and tingling in the hands and feet, the nurse should make it a priority to assess the client for which electrolyte imbalance? Hypokalemia Hypocalcemia Hypophosphatemia Hypercalcemia
Hypocalcemia
A client is being treated for diabetic ketoacidosis (DKA) with large doses of regular insulin. The nurse should observe for which electrolyte imbalance? Hyperkalemia Hypocalcemia Hypokalemia Hypernatremia
Hypokalemia
The nurse concludes that which sign reliably indicates that ascites fluid is being effectively mobilized in response to therapy? Select all that apply. Hand veins fill slowly Weight gain of 0.45 kg (1 lb) in 24 hours Increase in urine output Abdominal girth has decreased by 2.5 cm (1 in.) in 24 hours Drop in blood pressure
Increase in urine output Abdominal girth has decreased by 2.5 cm (1 in.) in 24 hours
The nurse notices that an older resident in a skilled nursing facility has not been eating or drinking as much as usual. Which assessment finding would best indicate the presence of fluid volume deficit (FVD)? Tenting and dry, flaky skin Clear lung fields with unlabored respirations Increased drowsiness, mild confusion, and concentrated urine Hand veins that fill within 3-5 seconds of being lowered below the heart
Increased drowsiness, mild confusion, and concentrated urine
A client presents to the walk-in clinic with nausea and vomiting for two days, and development of a mild headache this morning. Physical examination reveals BP of 100/70; pulse rate of 92; respiratory rate of 20; and pale, dry skin. What other priority information would help the nurse to evaluate this client relative to sodium balance? Whether the nausea continues throughout the day or is relieved after the client vomits Pain characteristics related to the headache Whether the client is experiencing any other symptoms Intake and output over the last two days
Intake and output over the last two days
A client with a diagnosis of bipolar disorder has been drinking copious amounts of water, and voiding frequently. The client is experiencing a bounding pulse, confusion, and is reporting a headache. The nurse checks laboratory test results for which finding? Low platelet count High serum osmolality High urine-specific gravity Low sodium level
Low sodium level
A client develops hypocalcemia as a result of prolonged nasogastric (NG) tube suctioning. The nurse concludes that the primary cause for hypocalcemia at this time is: Metabolic acidosis. Metabolic alkalosis. Hypermagnesemia. Fluid shifts from hypoalbuminemia.
Metabolic alkalosis.
A client with a feeding tube has been experiencing severe watery diarrhea. The client is lethargic, with decreased skin turgor, pulse rate of 110, and hyperactive reflexes. The nurse would include which of the following interventions on the client's plan of care? Administer salt tablets, and monitor hypertonic parenteral solutions. Avoid adding additional water before and after tube feedings. Withhold tube feedings until diarrhea subsides. Monitor and record intake, output, and daily weights.
Monitor and record intake, output, and daily weights.
The nurse should place highest priority on which nursing intervention for a client with renal failure who has a potassium level of 6.8 mEq/L? Measure urinary output. Evaluate level of consciousness. Obtain an electrocardiogram (ECG). Draw arterial blood gases.
Obtain an electrocardiogram (ECG).
A client with a 3-day history of severe nausea and vomiting with diarrhea is experiencing fatigue, anorexia, and muscle weakness. Which laboratory value should the nurse expect for this client? Sodium 144 mEq/L Potassium 2.9 mEq/L Blood urea nitrogen 8 mg/dL Calcium 11.6 mg/dL
Potassium 2.9 mEq/L
During change of shift report, the nurse is told that a client who has suffered a stroke has also developed diabetes insipidus. The nurse concludes this client is now at risk for which of the following? Severe deficient fluid volume because of excess urine output Severe excess fluid volume because of inadequate urine output Hyperglycemia because of poor insulin production Hypoglycemia because of excess insulin production
Severe deficient fluid volume because of excess urine output
When caring for a client with hypercalcemia who is on a cardiac monitor, the nurse checks the cardiac rhythm strip for which of the following typical changes? Shortening of the PR interval Peaked T wave Shortening of the QT interval Development of atrial fibrillation
Shortening of the QT interval
The nurse determines that which client finding most likely reflects edema related to inadequate heart pumping action? Swollen feet and sacral area of an elderly client upon awakening in the morning Swelling of legs and feet in a 45-year-old client after a ten-hour airplane flight Ankle swelling in 40-year-old waitress that resolves after sleeping all night Swelling in the arm of a client who has had axillary lymph nodes removed
Swollen feet and sacral area of an elderly client upon awakening in the morning
When caring for the client with signs of severe hypocalcemia, the nurse anticipates administration of which treatment? Ten percent calcium gluconate by slow IV push Intravenous phosphorus over 6-8 hours Ten percent calcium chloride by rapid IV push Isotonic normal saline as a rapid infusion
Ten percent calcium gluconate by slow IV push
Which intervention should the nurse perform when caring for a client on a fluid restriction? Select all that apply. Use an infusion pump to control the infusion of any required intravenous fluids. Provide unlimited ice chips to help keep the client's mouth and lips moist. Include ice chips in the client's oral intake measurement Do not include fluid taken with medications. Involve the client in dividing fluid allowances over the 24-hour period.
Use an infusion pump to control the infusion of any required intravenous fluids. Include ice chips in the client's oral intake measurement Involve the client in dividing fluid allowances over the 24-hour period.
A client who has a serum calcium level of 11.8 mg/dL is receiving a 0.9% sodium chloride infusion. The nurse determines that hydration has been effective when which of the following has occurred? Calcium level is 11-12 mg/dL. Volume status has been restored. Serum creatinine is elevated. Chvostek's sign is positive.
Volume status has been restored.
The nurse is caring for a client experiencing hypernatremia. The nurse concludes that it is important to administer which of the following? Lactulose. Cough suppressant to treat symptomatic cough. 3% saline solution. Water.
water
The nurse provides which instruction to a client going home with a prescription for spironolactone (Aldactone)? "Cut back on your intake of those foods on your list that are high in potassium." "Take this pill just before you go to bed." "You don't have to watch your intake of fluid while you are taking this medicine." "Be sure to take this medication on an empty stomach."
"Cut back on your intake of those foods on your list that are high in potassium."
The nurse is instructing a client diagnosed with hyperkalemia about foods to avoid. Which statement by the client indicates to the nurse a need for further instruction? "No more avocado salads for me." "I can still use my salt substitute instead of real salt." "I guess I can't eat all the tomatoes I want this summer." "I should avoid eating a lot of bananas."
"I can still use my salt substitute instead of real salt."
The nurse concludes that a client has an understanding of the side effects of furosemide (Lasix) and its relationship to potassium levels when the client states: "I don t need to eat bananas for breakfast any more, since I am taking this medication." "I don't need to take my pulse anymore when I take my Digoxin." "I should call my doctor if I feel myself becoming dizzy when I stand up." "I should call the doctor if I develop diarrhea."
"I should call my doctor if I feel myself becoming dizzy when I stand up."
The nurse determines that a client with a serum calcium level of 12 mg/dL understands client teaching when the client makes which statement? "If my stomach becomes upset, I can just take more TUMS." "I'll need to take my phosphorus supplements once a day." "I'll need to drink many more fluids than I have been, even up to 2-3 liters each day." "I'll need to be on strict bedrest to help with this problem."
"I'll need to drink many more fluids than I have been, even up to 2-3 liters each day."
A client with hypocalcemia asks the nurse why calcium is so important. The nurse makes which statement to describe the function that is unique to calcium? "It helps the body to maintain overall water balance." "It stimulates the heart muscle so it will produce a contraction." "It helps to regulate acid-base balance." "It activates enzymes responsible for producing cellular chemical reactions"
"It activates enzymes responsible for producing cellular chemical reactions"
The nurse is assisting in a health fair at a senior citizen center. Which instruction should the nurse include when giving the older adult client guidelines to remain hydrated in hot weather? "Drink only water or juices to keep yourself properly hydrated." "If your urine is clear yellow, you are drinking adequate fluids." "Popsicles, gelatin, and ice cream provide fluid intake as well as liquids you drink." "Use your thirst as a guide to the amount of fluid you should be drinking."
"Popsicles, gelatin, and ice cream provide fluid intake as well as liquids you drink."
In teaching a client the importance of potassium to the body's functioning, which statement should the nurse make? "Muscles are dependent on large amounts of potassium in order to work effectively."t; "It is vital that the body have enough potassium so that the kidneys can function effectively to prevent salt and fluid retention." "Potassium is vital to support the muscles by making them contract more effectively, including the muscles of the heart." "Potassium is important because it makes the muscle tissue work faster so the heart can pump effectively."
"Potassium is vital to support the muscles by making them contract more effectively, including the muscles of the heart."
A client with congestive heart failure (CHF) has come to the clinic for a prescription refill for a diuretic. The client reports a 5-pound weight gain in the past two days, and that his shoes are tight. What response by the nurse is most appropriate? "Such a rapid gain is probably water weight. Have you missed any days taking your pill?" "Your clothes still look good on you. Everyone's weight fluctuates during a week." "Five pounds isn't much. You can skip desserts and lose that." "Have you changed your eating habits lately?"
"Such a rapid gain is probably water weight. Have you missed any days taking your pill?"
Which statement should the nurse include when teaching a client about oral potassium supplementation? "You can continue to use salt substitute while you are taking your potassium supplement." "When you take your potassium pill, if you can't swallow it, you can crush it up and put it in orange juice." "Take your potassium tablet after you have eaten breakfast." "Potassium should only be taken in the morning on an empty stomach."
"Take your potassium tablet after you have eaten breakfast."
A client is admitted with chronic renal failure. The nurse would use which statement to explain the need to monitor for hypocalcemia? "Your calcium level can decrease because it goes down when the creatinine in the bloodstream is high." "Signs of hypocalcemia will appear before you experience pain from renal colic." "Your kidneys do not eliminate as much calcium, so we need to check for signs of hypocalcemia." "Your kidneys are unable to produce calcitriol, which is needed to regulate calcium levels in the bloodstream."
"Your kidneys are unable to produce calcitriol, which is needed to regulate calcium levels in the bloodstream."
A 45-year-old client with excess fluid volume (EFV) because of acute kidney dysfunction is placed on a 1,000 mL fluid restriction per 24-hour period. The client asks the nurse, "Why there is such a severe fluid restriction when I already have dry lips and mouth?" Which response by the nurse is best? "Your kidneys cannot eliminate extra fluid right now, so intake must be limited to protect your heart and lungs from being overloaded with fluid." "Too much fluid will cause your heart to fail and your lungs to fill with water, which could be fatal."ing." "The doctor ordered the fluid restriction, so it is important to comply with those orders." "You probably drank too much fluid before you got sick, so you can't compare your usual intake to your limitations now that your kidneys are not working."
"Your kidneys cannot eliminate extra fluid right now, so intake must be limited to protect your heart and lungs from being overloaded with fluid."
Which is the best response by the nurse to the adult daughter of a 46-year-old client was admitted with hypokalemia and reports being dizzy upon standing? "The level of your mother's potassium is making her dizzy." "Your mother is probably dizzy because her heart is not pumping as effectively, making her blood pressure low." "Your mother is dizzy because her nervous system isn't functioning correctly; once her potassium level goes up, she will improve." "Your mother has just stayed in bed too long, and when she stands up, she will get dizzy."
"Your mother is probably dizzy because her heart is not pumping as effectively, making her blood pressure low."
The nurse is monitoring the daily weight of a client with a sodium imbalance. The nurse interprets that fluid loss might be occurring when daily weight loss begins to exceed how much? 1 kilogram 0.25 pound 1 pound 0.5 pound
0.5 pound
A 28-year-old client is admitted with severe bleeding from a fractured femur. Which intravenous (IV) fluid does the nurse anticipate as the most appropriate to replace potential fluid losses? 5% dextrose in 0.225 sodium chloride (D51/4NS) 3% sodium chloride (3% NaCl) 0.9% sodium chloride (0.9% NaCl) 5% dextrose in water (D5W)
0.9% sodium chloride (0.9% NaCl)
Which potassium level would be of greatest concern to the nurse when seen in a client who is taking furosemide (Lasix)? 3.1 mEq/L 5.4 mEq/L 3.6 mEq/L 4.3mEq/L
3.1 mEq/L
The nurse is caring for a client with a sodium level of 149 mEq/L. The nurse anticipates that this client would benefit from which therapy? Cough suppressant 3-percent saline solution 5% dextrose in water solution Lactulose
5% dextrose in water solution
The nurse determines that which client is at greatest risk for developing a fluid volume deficit? A 1-year-old child being treated in the clinic for a runny nose and ear infection A thin, 55-year-old client who smokes and takes glucocorticoids for chronic lung disease A 76-year-old client who has a nasogastric (NG) tube on low suction following surgery for colon cancer A 30-year-old client jogging in 50-degree weather
A 76-year-old client who has a nasogastric (NG) tube on low suction following surgery for colon cancer
The nurse caring for the following clients considers which client to be at greatest risk for developing deficient fluid volume? A thin, 52-year-old female receiving steroid therapy for bronchitis A 60-year-old male who had a left inguinal herniorrhaphy 12 hours ago A 76-year-old male who has a nasogastric (NG) tube on intermittent suction following colon resection A 68-year-old female who is NPO for a flexible sigmoidoscopy procedure
A 76-year-old male who has a nasogastric (NG) tube on intermittent suction following colon resection
The nurse identifies which postoperative client to be at risk for developing a sodium imbalance? A client who has a right knee arthroscopy A client who has just had a tonsillectomy A client who has a transurethral resection of the prostate (TURP) A client who has a primary cesarean section for failure to progress in labor
A client who has a transurethral resection of the prostate (TURP)
The nurse identifies which hospitalized client as being at risk for developing hypokalemia? Select all that apply. A client with acute renal failure A client who has developed metabolic alkalosis The client with a nasogastric tube on low intermittent suction A client whose blood gases indicate metabolic acidosis A client with adult respiratory distress syndrome (ARDS)
A client who has developed metabolic alkalosis The client with a nasogastric tube on low intermittent suction
When caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH), the nurse plans to do which intervention to correct the fluid-and-electrolyte imbalance associated with this disorder? Encourage the client to drink plenty of water. Restrict dietary salt intake. Monitor infusion of hypotonic saline infusions. Administrate ordered loop diuretics.
Administrate ordered loop diuretics.
A client with abnormal sodium loss is receiving a regular diet. To encourage foods high in sodium, the nurse would recommend which food for lunch? Chicken salad on lettuce An American cheese and ham sandwich White fish and plain baked potato Tossed salad with vinegar dressing
An American cheese and ham sandwich
Which intervention would be appropriate for the client with hypokalemia who has a nursing diagnosis of risk for injury related to skeletal muscle weakness? Monitor the client's ECG for conduction changes. Administer KCl 20 mEq by mouth daily as ordered. Assist the client with ambulation. Encourage a diet intake high in fiber and fruit.
Assist the client with ambulation.
An adult client in the clinic has a cough, fever, nausea, and vomiting for three days. Examination reveals dry tongue and oral mucosa, and concentrated urine. The client also reports feeling weak and dizzy. To best assess the client's fluid status, the nurse checks which assessment parameter? Temperature Respiratory rate and depth BP and pulse in lying and standing positions Pulse oximetry reading at rest
BP and pulse in lying and standing positions
The nurse instructed a client with congestive heart failure (CHF) about dietary sodium modifications. Which menu selections indicates that the client needs further education? Salad Baked pork chop Toast with margarine Broiled chicken breast
Baked pork chop
A nurse prepares to administer calcium gluconate to a client post-thyroidectomy. The nurse explains to the licensed practical nurse (LPN) that this replacement therapy is needed: Due to hypophosphatemia after this type of surgery. Because of accidental removal of the parathyroid gland. To prevent complications from immobility postoperatively. Because it is related to increased parathyroid hormone (PTH) release during surgery.
Because of accidental removal of the parathyroid gland.
A client with cancer has a calcium level of 11.8 mg/dL. For which symptom should the nurse notify the health care provider? Peaked T waves on electrocardiogram Muscle spasms Bone pain Hyperactive bowel sounds
Bone pain
The nurse evaluates the hydration status of a client who has been receiving intravenous (IV) fluids at 150 mL/hour. The nurse identifies the client has excess fluid volume after which findings? Select all that apply. Peripheral pulses are rapid and weak. Client becomes short of breath when ambulating. Neck veins are distended when the head of the bed is elevated 45 degrees. Pitting edema is present over tibia. Hand veins are empty when the hand is raised above the heart.
Client becomes short of breath when ambulating. Neck veins are distended when the head of the bed is elevated 45 degrees. Pitting edema is present over tibia.
Which treatment option does the nurse anticipate will be most appropriate for a client with a potassium level of 3.5 mEq/L? Administer oral potassium chloride (KCl). Continue to monitor and offer foods high in potassium. Use salt substitutes in the diet. Give sodium polystyrene sulfate (Kayexalate) per rectum.
Continue to monitor and offer foods high in potassium.
Which change in urine characteristics would the nurse expect in a client with cardiac disease who is experiencing pitting edema? Select all that apply. Decreased sodium Decreased calcium Decreased chloride Increased osmolarity Increased phosphorus
Decreased sodium Decreased chloride
Which assessment of an adult client is a reliable indicator that therapy for fluid overload is achieving the desired outcome? Select all that apply. S3 heart sound clearly audible on auscultation Flat neck veins with the head of the bed elevated Hand vein emptying longer than 20 seconds Full, bounding peripheral pulses Lungs sounds are clear
Flat neck veins with the head of the bed elevated Lungs sounds are clear
A client's potassium level is 3.0 mEq/L. The nurse suspects that which prescribed medication might be contributing to this serum potassium level? Gentamicin (Garamycin) Acetylsalicylic acid (aspirin, ASA) Acetaminophen (Tylenol) Azithromycin (Zithromax)
Gentamicin (Garamycin)
When examining a client admitted with weakness and lethargy, the nurse notes that the client's respirations are deep and rapid. Upon further assessment, it is documented that the client is dehydrated from inadequate fluid intake for more than 4 days. The nurse should expect to administer which of the following as ordered? 3% saline solution Hypotonic IV fluids Salt tablets Isotonic saline with 10% dextrose
Hypotonic IV fluids
A client who is three hours post-tonsillectomy has had minimal blood loss. The client has consumed 12 cups of ice chips to soothe throat discomfort, and has received 3 liters of D5W during this time frame. The nurse recognizes the client is at risk for developing which fluid imbalance? Isotonic fluid volume excess Hypotonic overhydration Hypertonic dehydration Isotonic fluid volume deficit
Hypotonic overhydration
A client presents with complaints of fatigue, headache, and increasing muscle weakness, and has blood work drawn to evaluate the serum calcium level. The nurse anticipates medical management for an abnormal value to include which of the following? Vitamin D supplements Increased hydration Thiazide diuretics Fluid restriction
Increased hydration
Which of the following findings relative to calcium would the nurse expect to see in a client in renal failure? Decreased calcium and potassium Increased phosphate retention and decreased calcium production Increased calcium levels and decreased phosphate levels Increased calcium and decreased creatinine levels
Increased phosphate retention and decreased calcium production
When caring for an adult receiving an intravenous (IV) infusion of 3% sodium chloride (NaCl), the nurse places priority on monitoring which of the following to detect complications of therapy? Heart rate, blood pressure, and daily weights Pulse oximetry and peripheral edema in the legs Neurological status, lung sounds, and serum sodium levels Serum glucose levels and urine specific gravity
Neurological status, lung sounds, and serum sodium levels
A client's serum sodium level is 175 mEq/L. Which priority intervention should the nurse use to restore normal sodium balance? Consult with a dietician to eliminate additional sodium in the diet. Continue to hang ordered TPN solution and wait for further physician orders based on the current serum value. Correct rapidly using a 3% saline solution to restore intravascular deficits. Notify the physician of the client's current sodium level and other serum and urine electrolyte levels that will help to identify the clinical picture.
Notify the physician of the client's current sodium level and other serum and urine electrolyte levels that will help to identify the clinical picture.
Which intervention should the nurse complete when caring for a client admitted with a sodium level of 152 mEq/L? Observe the client for nausea and malaise. Observe and prepare for possible seizures. Restrict fluids to 1,200 mL per day. Provide extra blankets for warmth.
Observe and prepare for possible seizures.
A client has a serum calcium level of 11.5 mg/dL, an ionized calcium of 5.6 mg/dL, and a 24-hour urine calcium level greater than 400 mg/dL. The nurse expects that additional review of laboratory test results will show which associated electrolyte level? Parathyroid hormone (PTH) level of lower than 11 picograms/dL Alkaline phosphatase of 40 units/L Phosphorus lower than 2.5 mg/dL Potassium level of 4.2 mg/dL
Phosphorus lower than 2.5 mg/dL
The nurse assessing a client for signs of hypocalcemia would conclude that this electrolyte imbalance exists after noting which finding? Hypoactive bowel sounds Negative Chvostek's sign Positive Kernig's sign Positive Trousseau's sign
Positive Trousseau's sign
When developing a plan of care for a client with hypocalcemia, the nurse chooses which as a high-priority nursing diagnosis? Potential Complication: Electrolyte Excess Risk for Injury related to sensorium changes Deficient Fluid Volume Risk for Injury related to tetany and seizures
Risk for Injury related to tetany and seizures
A client with a history of sodium imbalances presents to the clinic for a monthly checkup. Which parameter should the nurse assess related to fluid and electrolyte balance? Select all that apply. Exercise tolerance Content of last meal Intake and output Skin turgor Blood pressure
Skin turgor Blood pressure
A 70-year-old hospitalized client with a past medical history of hypertension and myocardial infarction is postoperative following stomach surgery. Vital signs have been stable, and an IV of D5½ NS is infusing at 100 mL/hour. The client reports trouble breathing, and has a moist cough, and the pulse oximetry reading has fallen to 92%. What action should the nurse take first? Measure blood pressure and heart rate. Assess legs and arms for pitting edema. Telephone and notify the physician. Slow the intravenous rate to 10-20 mL/hour.
Slow the intravenous rate to 10-20 mL/hour.
The nurse plans to administer which prescribed intravenous (IV) treatment to a client for treatment of a potassium level of 6.2 mEq/L associated with a pH of 7.24? Insulin to make the client hypoglycemic Normal saline (NS), to provide extra sodium so the potassium will move out of the ICF into the ECF Sodium bicarbonate, to make the client alkalotic so the potassium will shift into the ICF. Calcium gluconate, to make the potassium shift from the intracellular fluid (ICF) to the extracellular fluid (ECF)
Sodium bicarbonate, to make the client alkalotic so the potassium will shift into the ICF.
A 10-month-old infant is admitted to the emergency department with a 102°F rectal temperature and a history of vomiting and diarrhea for 48 hours. For which signs should the nurse assess Weight loss, dilute urine, and peripheral edema Sunken eyes, lethargy, and dry, furrowed tongue Dry skin, thready pulse, and neck vein distention Bulging fontanels, tearless cry, and low urine output
Sunken eyes, lethargy, and dry, furrowed tongue
What instruction should the nurse include in an education program to prevent dehydration for a high school hiking club that is planning a 12-mile hike in early summer? Take salt tablets every 3-4 hours, and drink plenty of water while in the heat. Stop every 4 hours along the way, and drink a few ounces of water while resting. Drink large amounts of water, at least 0.47 L (16 oz) every hour, while hiking. Take water and commercial sports drinks to sip often along the way.
Take water and commercial sports drinks to sip often along the way.
The community health nurse makes a home visit to a client newly discharged from the hospital with resolving hypernatremia. During the initial interview, what information should the nurse further assess to determine an effective plan of care? The client needs to walk 100 feet each day to reach the mailbox for the apartment building. The client performs self-monitoring of blood glucose once a day. The client lives on the second floor of an apartment building that has an elevator. The client uses antacids on a frequent basis for gastrointestinal complaints.
The client uses antacids on a frequent basis for gastrointestinal complaints.
A client has a diagnosis of ovarian cancer, and is undergoing chemotherapy. Because the client's calcium level is now elevated, the nurse suspects which of the following? The client is not eating enough dairy products, as a result of decreased appetite. The ovarian cancer has metastasized, causing the increase in calcium. The client is developing pancreatitis. Antineoplastic medications are the cause for this elevation in calcium.
The ovarian cancer has metastasized, causing the increase in calcium.
The nurse notes that a client's serum calcium level is 7.9 mg/dL. Since the client has no symptoms of imbalance at this time, the nurse makes which interpretation of this value? The client's magnesium is high, resulting in false levels of calcium. This does not reflect the ionized calcium that results in symptomatology. Phosphorus is low, resulting in low serum calcium levels. This level reflects only the ionized calcium.
This does not reflect the ionized calcium that results in symptomatology.
A client with hypokalemia reports being constipated. Which instruction should the nurse provide prior to implementing treatment measures? "The level of potassium makes the stools very hard and difficult to expel." "The high potassium level causes the bowel to stop acting, resulting in constipation." "The potassium pulls the fluid from the bowel, leading to constipation." "Your potassium level makes your bowel less active, and might make you constipated."
Your potassium level makes your bowel less active, and might make you constipated."
A client with a history of bulimia is admitted for treatment of electrolyte imbalances. Recognizing the need to prevent further losses of sodium and chloride, the nurse instructs the client to limit the intake of: Processed foods and snacks. Bottled or tap water. Broths to two cups a day. Milk and dairy products.
bottled or tap water
Which question should the nurse ask when assessing a client with hypocalcemia? "Do you have to urinate frequently?" "Do you have any tingling sensation in your fingers or toes?" "Are you having a lot of headaches?" "Have you been constipated lately?"
do you have any tingling sensation in your fingers or toes?
The nurse assigned to a client with hyponatremia would conclude that which factor probably contributed to this electrolyte imbalance? Fluid retention Excessive hypertonic intravenous infusion Fever Osmotic diuretic therapy
fluid retention
When assessing a client with hypercalcemia, the nurse concludes that which finding in the neuromuscular examination is consistent with that electrolyte imbalance? Tetany Hyperactive deep tendon reflexes A positive Trousseau's sign Muscle weakness
muscle weakness
The nurse is caring for a client experiencing hyponatremia. As part of the plan of care, the nurse will restrict which of the following? Salt on the diet tray. Eggs and cheese products. Water. Gatorade.
water