Passpoint- fluid and electrolyte balance

A client has experienced excessive losses of bicarbonate and has subsequently developed an acid-base imbalance. How will this lost bicarbonate be replaced?

Renal tubular cells will generate new bicarbonate.

A primary health care provider prescribes regular insulin 10 units intravenously (I.V.) along with 50 ml of dextrose 50% for a client with acute renal failure. What electrolyte imbalance is this client most likely experiencing?

hyperkalemia

The nurse is assessing a client who is restless and agitated, has dry mucous membranes, and has intense thirst. The nurse should assess the client further for which electrolyte imbalance?

hypernatremia

The nurse is caring for a client on the urinary unit. When providing report to the next shift, it is noted that the client has osteopenia and history of renal calculi. Which disorder would the nurse suspect?

hyperparathyroidism

A 176 lb (79.8 kg) client with minimal urine output has been prescribed dopamine at 5 µg/kg/minute. The premixed medication bag contains 800 mg of dopamine in 500 ml dextrose 5% in water. How many milliliters of solution would the nurse administer each hour? Record your answer using a whole number.

15

The nurse is preparing 1,000 mL D5/N5 to deliver over 6 hours. If the infusion set administers 15 gtt/mL, what is the required flow rate in gtt/min? (Round to the nearest whole number.)

42

A nurse is checking laboratory values on a client who has crackles in the lower lobes, 2+ pitting edema, and dyspnea with minimal exertion. Which laboratory value does the nurse expect to be abnormal?

B-type natriuretic peptide (BNP)

A client receiving digoxin has a serum magnesium level of 0.9 mg/dL (0.57 mmol/L). What is the nurse's best action?

Notify the healthcare provider.

The nurse is administering an IV potassium chloride supplement to a client who has heart failure. What should the nurse consider when developing a plan of care for this client?

The administration of the IV potassium chloride should not exceed 10 mEq/h or a concentration of 40 mEq/L.

Sodium polystyrene sulfonate is prescribed for a client following a crush injury. Which finding indicates the drug has been effective?

The serum potassium is 4.0 mEq/L (4.0 mmol/L).

A client has been diagnosed with septic shock. The nurse would anticipate implementing which order?

blood chemistry of serum lactate

A nurse provides care for a client with deep partial-thickness burns. What could cause a reduced hematocrit (HCT) in this client?

hemodilution

When instructing a client diagnosed with hyperparathyroidism about diet, the nurse should stress the importance of

encouraging fluids.

A client is exhibiting manifestations of tetany. Which nursing intervention is a priority?

establishing a patent intravenous site

Which indicator is the best for determining whether a client with Addison's disease is receiving the correct amount of glucocorticoid replacement?

daily weight

A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should assess the client for which alteration in fluid and electrolyte balance?

decreased serum sodium level

The nurse is planning care for a client who has just returned to the medical-surgical unit following repair of an aortic aneurysm. What is a priority assessment for this client?

decreased urinary output

A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which finding suggests that the client has developed hyperglycemia?

increased urine output

When caring for the neonate of a mother with gestational diabetes, which finding is most indicative of a hypoglycemic episode?

jitteriness

The nurse is caring for a client admitted with pyloric stenosis. A nasogastric tube placed upon admission is on low intermittent suction. Upon review of the morning's blood work, the nurse observes that the patient's potassium is below reference range. The nurse should recognize that the patient may be at risk for what imbalance?

metabolic alkalosis

When fluids by mouth are appropriate for the infant after surgery to correct intussusception, the nurse most likely would initiate which type of feeding?

oral electrolyte solution

During a follow-up visit to the physician, a client with hyperparathyroidism asks the nurse to explain the physiology of the parathyroid glands. The nurse states that these glands produce parathyroid hormone (PTH). PTH maintains the balance between calcium and

phosphorus

When caring for a client with preeclampsia during labor, the nurse should:

restrict the amount of fluid administered.

The nurse is caring for an adolescent client after an overdose on barbiturate drugs and alcohol. The client is hypotensive with a mean arterial pressure below 30 mm Hg and a urine output of 5 mL/hr. Serum creatinine and potassium are elevated. The parents of the client ask why there is so little urine in the indwelling catheter drainage bag. What is the best response by the nurse?

"There is not enough blood circulating to the kidneys."

A nurse is caring for a client with a low calcium level. Place the following options in chronological order to indicate the regulatory feedback mechanism of parathyroid hormone (PTH) release in relation to calcium levels. All options must be used.

-Low serum calcium level stimulates parathyroid gland. -Parathyroid gland releases PTH. -Calcium is reabsorbed. -High serum calcium level inhibits PTH secretion.

The physician has prescribed sodium chloride for a hospitalized 51-year-old client in metabolic alkalosis. Which nursing actions are required to manage this client? Select all that apply.

Compare ABG findings with previous results. Maintain intake and output records. Document presenting signs and symptoms.

A client has been diagnosed with right-sided heart failure. The nurse should assess the client further for:

Dependent edema.

Which nursing action is required before a client in labor receives an epidural anesthetic?

Give a fluid bolus.

Sulfamethoxazole/trimethoprim has been prescribed for a client who has a urinary tract infection. What should the nurse do when administering sulfonamides?

Instruct the client to drink at least eight glasses of water a day.

The nurse is caring for an alert 2-month-old child and assesses a sunken fontanelle. Which action would be most appropriate for the nurse to take based on the assessment?

Monitor fluid intake and output.

A client with acute kidney failure is placed on fluid restriction of 1000 mL of fluid over a 24-hour period. What is the priority nursing action?

Offer the client proportioned fluids in the day and less during the night.

A client who is blind is admitted for treatment of gastroenteritis. Which intervention takes highest priority for this client?

replacing fluid volume

The client with preeclampsia asks the nurse why she is receiving magnesium sulfate. The nurse's most appropriate response to is to tell the client that the priority reason for giving her magnesium sulfate is to

prevent seizures.

A client has been experiencing abdominal cramps, diarrhea, and concentrated urine for the past 2 days. Which signs would be included in a focused assessment?

signs of dehydration, including loss of weight; poor tissue turgor; and dry, cracked mucous membranes

A client with manic episodes is taking lithium. Which electrolyte level should the nurse check before administering this medication?

sodium

A client's intravenous catheter has become occluded. The nurse knows that the reason for the occlusion is:

thrombosis at the site.

The client has heart failure and is taking a diuretic to promote fluid loss. Which is the most accurate method of determining the extent of a client's fluid loss?

weighing the client

A client is at risk for excess fluid volume. Which nursing intervention ensures the most accurate monitoring of the client's fluid status?

weighing the client daily at the same time each day

A client with heart failure must be monitored closely after starting diuretic therapy. The best indicator for the nurse to monitor is

weight

The nurse is administering magnesium sulfate by IV drip for a client with preeclampsia at 32 weeks' gestation. Which findings indicate the medication is having a therapeutic effect? Select all that apply.

-urine output -over 30 mL/hr -blood pressure 120/60 mmHg -absence of seizures

A client with a diagnosis of schizophrenia spectrum disorder is admitted to the inpatient unit after developing water intoxication. Once the client is medically stable and no longer exhibiting the behavior of seeking water, which nursing interventions are appropriate at this time? Select all that apply.

-Provide gum for the client. -Weigh the client every day. -Monitor the client's intake and output. -Maintain a structured environment.

The nurse is flushing a peripheral intravenous access device. Place the steps in the order that the nurse should perform them. All options must be used.

1- Cleanse the end cap with an antimicrobial swab. 2-Insert the saline flush syringe into the cap on the extension tubing. 3- Pull back on saline flush syringe to aspirate the catheter for blood return. 4- Instill saline solution over 1 minute. 5- Remove the syringe and reclamp the extension tubing. 6- Remove gloves and perform hand hygiene.