Med Surg Advanced Org
Serum potassium levels will decrease as potassium ions shift from the extracellular fluid to the intracellular fluid compartment.
A nurse administers the prescribed regular insulin to a client in diabetic ketoacidosis. In addition, an intravenous (IV) solution with potassium is prescribed even though the serum potassium level is within normal limits. What does the nurse recognize as the reason for potassium administration?
K+2.8
A nurse is caring for a very ill medical surgical patient and the telemetry monitor shows flattening T waves and peaked P waves. What electrolyte finding should the nurse consider based on these ECG changes?
Muscle weakness Dysrhythmias
Following a major abdominal surgery, a client has a nasogastric tube attached to continuous low suction. The nurse caring for the client postoperatively monitors the client for what signs of hypokalemia? Select all that apply.
Encourage the client to cough and then take deep breaths between coughs
Surgery is performed on a client with a parotid tumor. Postoperative arterial blood gas values are pH 7.32, PCO 2 53 mm Hg, and HCO 3 25 mEq/L (25 mmol/L). Which action should the nurse take?
Weight loss
When obtaining the history of a client recently diagnosed with type 1 diabetes, what will the nurse expect to discover?
Diarrhea Seizures
When receiving hemodialysis, the client may develop hyponatremia. For which clinical findings associated with hyponatremia should the nurse assess the client? Select all that apply.
Use lemon juice to season meat
Which recommendation is most important for the nurse to include in a teaching program for a client who has been placed on a 2-gram sodium diet?
Hypotension Poor skin turgor Dry mucous membranes Decreased urine
Which symptoms indicate to the nurse that the client has an inadequate fluid volume? Select all that apply.
metabolic alkalosis
A client arrives in the emergency department with epigastric pain and prolonged vomiting. Assessment findings include rapid and shallow respirations, dry and flushed skin, weakness, and lethargy. Which is the primary nursing concern?
elevated ph, decreased pco2
A client develops respiratory alkalosis. When the nurse is reviewing the laboratory results, which finding is consistent with respiratory alkalosis?
Hyponatremia
A client has been admitted with a diagnosis of intractable vomiting and can only tolerate sips of water. The initial blood work shows a sodium level of 122 mEq/L (122 mmol/L) and a potassium level of 3.6 mEq/L (3.6 mmol/L). Based on the lab results and symptoms, what is the client experiencing?
Digoxin toxicity occurs rapidly in the presence of hypokalemia.
A client has been given a prescription for furosemide 40 mg every day in conjunction with digoxin. What would prompt the nurse to ask the provider about potassium supplements?
Wound drainage Gastrointestinal (GI) suction Inappropriate anti-diuretic hormone (ADH) secretion Diuretic therapy
A client is prone to hyponatremia. Which factors should the nurse identify that can precipitate hyponatremia? Select all that apply.
Nervousness Fatigue Weakness Increased perspiration
A client is taught how to recognize indications of a hypoglycemic reaction. Which signs and symptoms identified by the client indicate to the nurse that the teaching was effective? Select all that apply.
Serum glucose 60mg/dL
A client newly diagnosed with diabetes arrives at the emergency department complaining of dizziness and weakness. The client's spouse reports that the client has been confused since this morning. The spouse reports that the client administered the morning dose of 10 units of regular insulin and 25 units of NPH insulin with difficulty and did not eat much breakfast. What does the nurse identify as the most likely cause of the client's signs and symptoms?
Prevention of cardiac overload
An elderly client with c.diff experiences severe diarrhea and is given intravenous (IV) fluids. What is the most important reason for the nurse to closely monitor the IV flow rate?
Potassium follows insulin and glucose into the cells of the body, thereby raising the intracellular potassium level.
An intravenous solution containing potassium inadvertently has infused too rapidly. The healthcare provider prescribes insulin added to a 10% dextrose in water solution. What does the nurse identify as the purpose of the insulin?
Dry between the toes after bathing. Wear shoes when out of bed.
The nurse is providing instructions about foot care for a client with diabetes mellitus. What should the nurse include in the instructions? Select all that apply.
"The client would be suffering from paresthesias." "The client would show signs of anxiety and irritability." "The client's Trousseau sign would be positive."
The nurse is teaching a group of students about the manifestation of alkalosis in the central nervous system. Which statements by a student nurse are accurate? Select all that apply.
end-stage renal disease
The nurse reviews a medical record and is concerned that the client may develop hyperkalemia. Which disease increases the risk of hyperkalemia?
Peaked T waves and widened QRS complexes
The serum potassium level of a client who has diabetic ketoacidosis is 5.4 mEq/L (5.4 mmol/L). What would the nurse expect to see on the ECG tracing monitor?
Client A: Age 88 with bounding pulse rate
The nurse is caring for four different clients admitted with fluid overload. Which client should be considered a priority requiring immediate care?
Calcium
A client admitted to the hospital with a diagnosis of malabsorption syndrome exhibits signs of tetany. The nurse concludes that the tetany was precipitated by the inadequate absorption of which electrolyte?
Calcium gluconate
After a surgical thyroidectomy a client exhibits carpopedal spasm and some tremors. The client complains of tingling in the fingers and around the mouth. What medication should the nurse expect the primary health care provider to prescribe after being notified of the client's adaptations?
Presence of dependent edema Bounding pulse Neck vein distention in the upright position
The client is receiving high-flow intravenous (IV) fluid replacement therapy. Which nursing assessment findings are consistent with fluid volume overload? Select all that apply.
Administering sodium polystyrene sulfonate
A registered nurse teaches a student nurse regarding the management of increased potassium levels in a client. Which action performed by the student nurse indicates effective learning?
Metabolic acidosis caused by a concentration of cations in body fluids
A very ill adult exhibits Kussmaul respirations. What does the nurse suspect may be causing an increasing acid-base imbalance?
Depressed deep tendon reflexes Bone pain
A client who has been immobile for a prolonged time develops hypercalcemia. Which findings are consistent with this condition? Select all that apply.
Obesity leads to insulin resistance
A client who is 60 pounds (27.2 kilograms) more than the ideal body weight is admitted to the hospital with a diagnosis of type 1 diabetes. Which concept should the nurse include in teaching about diabetes when discussing strategies to lose weight?
Notify the primary healthcare provider of the critically low result.
A client with a diagnosis of uncontrolled diabetes began receiving furosemide 2 days ago. The nurse reviews the morning lab results and discovers that the client's potassium level is 2.8 mEq/L (Canada: 2.8 mmol/L). What is the most appropriate action for the nurse to take?
respiratory acidosis
After abdominal surgery a client should be encouraged to turn from side to side and to engage in deep breathing exercises. The nurse explains that these activities are essential to prevent which condition?
metabolic acidosis
An arterial blood gas report indicates the client's pH is 7.25, PCO 2 is 35 mm Hg, and HCO 3 is 20 mEq/L. Which disturbance should the nurse identify based on these results?
Rice
The nurse is providing dietary teaching to a client who is receiving hemodialysis. What should the nurse encourage the client to include in the dietary plan?
Hyperglycemia and urine negative for ketones
Which clinical indicator should the nurse identify as expected for a client with type 2 diabetes?
flabby muscles
A client is receiving furosemide. For which sign of hypokalemia should the nurse monitor the client?
metabolic alkalosis
A client is hospitalized after four days of epigastric pain, nausea, and vomiting. The nurse reviews the laboratory test results: plasma pH 7.51, Pco 2 50 mm Hg, bicarbonate 58 mEq/L (58 mmol/L), chloride 55 mEq/L (55 mmol/L), sodium 132 mEq/L (132 mmol/L), and potassium 3.8 mEq/L (3.8 mmol/L). What condition does the nurse determine the results to indicate?
The growth of new retina blood vessels or "neovascularization"
A client with diabetes mellitus complains of difficulty seeing. What would the nurse suspect as the causative factor?
Somogyi effect
A client with type 1 diabetes comes to the clinic because of concerns regarding erratic control of blood glucose with the prescribed insulin therapy. The client has been experiencing a sudden fall in the blood glucose level, followed by a sudden episode of hyperglycemia. Which complication of insulin therapy should the nurse conclude that the client is experiencing?
Check patient serum glucose levels
A client with type 1 diabetes has an above-the-knee amputation because of severe lower extremity arterial disease. What is the nurse's primary responsibility two days after surgery when preparing the client to eat dinner?
Hypoglycemic reaction
A client with type 1 diabetes receives 30 units of NPH insulin at 7 am. At 3:30 pm the client becomes diaphoretic, weak, and pale. What does the nurse determine that these physiologic responses are associated with?
A 65-year-old with pulmonary fibrosis
A client's arterial blood gas report indicates that pH is 7.25, Pco 2 is 60 mm Hg, and HCO 3 is 26 mEq/L (26 mmol/L). Which client should the nurse consider is most likely to exhibit these blood gas results?
Cardiac dysrhythmias Hypoactive bowel sounds
A client's laboratory values demonstrate an increased serum calcium level, and further diagnostic tests reveal hyperparathyroidism. What clinical manifestations might the nurse identify when assessing this client? Select all that apply.
Low grade fever
A client's urine specific gravity is being measured. For which condition should the nurse conduct a focused assessment when a client's specific gravity is increased?
100 mg/dL
A nurse is monitoring a client's fasting plasma glucose (FPG) level. At which FPG level should the nurse identify that the client has prediabetes?
126 to 140 mg/dL
A nurse is monitoring a client's laboratory results for a fasting plasma glucose level. Within which range of a fasting plasma glucose level does the nurse conclude that a client is considered to be diabetic?
