Patho PrepU Ch. 8: Disorders of Fluid and Electrolyte and Acid Base Balance

Body weight consists of which percentage of body water?

60%

A nurse is providing care for several clients on an acute medicine unit. Which client should the nurse recognize as being at the highest risk for metabolic alkalosis?

A client on continuous nasogastric suction and whose hypertension is being treated with diuretics

Which assessment should be prioritized in the care of a client who is being treated for a serum potassium level of 2.7 mEq/L (2.7 mmol/L)?

Cardiac monitoring looking for prolonged PR interval and flattening of the T wave

A client is admitted after losing 44 lb (20 kg) over the past 3 months, largely due to frequent vomiting. What intervention should the nurse anticipate in the treatment of the client's resulting acid-base imbalance?

Fluid replacement with an intravenous solution containing electrolytes as prescribed

Respiratory alkalosis can be caused by a respiratory rate in excess of that which maintains normal plasma PCO2 levels. What is a common cause of respiratory alkalosis?

Hyperventilation

The nurse is caring for a client who is 1 day postoperative for a thyroidectomy. The client complains of tingling of the hands and feet and around his mouth. The nurse suspects these symptoms are a manifestation of which electrolyte disturbance?

Hypocalcemia

A client who has just completed running a marathon reports muscle weakness, cramping, and general fatigue despite drinking adequate amounts of water. The nurse suspects which type of hypotonic hyponatremia?

Hypovolemic

The nurse is caring for a client with ketoacidosis who is complaining of increasing lethargy and occasional confusion following several weeks of rigid adherence to a carbohydrate-free diet. The nurse understands which phenomenon is most likely occurring?

In the absence of carbohydrate energy sources, her body is metabolizing fat and releasing ketoacids.

Pressure generated as water moves across a membrane is also known as which of the following?

Osmotic pressure

Vitamin D, officially classified as a vitamin, functions as a hormone in the body. What other hormone is necessary in the body for vitamin D to work?

Parathyroid hormone

Which one of the following is associated with hydrostatic edema?

Pits to finger pressure

The nurse suspects that a client who had a colon resection 4 days ago, is unable to pass flatus, and has no audible bowel sounds has a paralytic ileus. The nurse recognizes that which abnormal laboratory result is consistent with this problem?

Potassium level of 2.8 mEq/L (2.8 mmol/L)

A nurse is caring for a client with a low sodium level and increased water retention. Hematocrit and blood urea nitrogen levels are decreased, urine osmolality is high, and serum osmolality is low. A chest x-ray shows a possible lung mass. Based on these findings, which problem could the client be diagnosed with?

Syndrome of inappropriate antidiuretic hormone (SIADH)

An adult client presents to the emergency department with a pounding headache, heart failure, and pulmonary and peripheral edema. The pulse is bounding, blood pressure is elevated, and the urine is scant and concentrated. Which endocrine disorder is the likely cause of these manifestations?

Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

Which clinical manifestation would lead the nurse to suspect a client has developed fluid volume excess?

Weight gain

A client with schizophrenia is admitted to the behavioral health department and is observed drinking copious amounts of water and voiding large amounts of dilute urine. The nurse recognizes this behavior is consistent with which problem?

psychogenic polydipsia

When caring for the client with hyperkalemia, the nurse recognizes the body should respond in which of these ways?

secrete potassium in the distal tubules for excretion

The nurse is evaluating a client's blood gases. The client has a pH of 7.35. How does the nurse interpret this value?

It is within normal range

The nurse is assessing a client for early manifestations of hyponatremia. The nurse would assess the client for:

Muscle weakness

The nurse is teaching an older adult about adapting to age-related physiologic changes. Which statement by the client prompts the nurse to provide additional teaching?

"I will reduce my total daily fluid intake."

In which client would the nurse be most likely to assess the signs and symptoms of an acid-base imbalance?

A client with chronic obstructive pulmonary disease (COPD) whose most recent arterial blood gases reveal a PCO2 of 51 mm Hg

The nurse is caring for a client who has developed hypoxemia and tissue hypoxia. Which of these interventions does the nurse set as a priority intervention?

Administration of supplemental oxygen

An older adult has had a "sour stomach" and has treated it at home by taking frequent doses of baking soda (sodium bicarbonate). What nursing action is most appropriate?

Assess the client for signs and symptoms of hypokalemia

A client is diagnosed with syndrome of inappropriate antidiuretic hormone as a result of an inoperable brain tumor. When assessing the laboratory results for this client, which finding does the nurse anticipate?

Increase in urine osmolality

A nurse is caring for a client whose serum potassium level is 2.6 mEq/l (2.6 mmol/l). The nurse anticipates which intervention will be prescribed?

Infuse intravenously 40 mEq (40 mmol) potassium chloride in 1 liter of normal saline over 4 hours.

Which condition is a cause of osmotic edema?

Low blood levels of albumin

The nurse is caring for a client with worsening respiratory acidosis. Which of these interventions does the nurse anticipate if the client's condition continues to deteriorate?

Mechanical ventilation

Magnesium levels are important indicators to a variety of bodily functions. What is severe hypermagnesemia associated with?

Muscle and respiratory paralysis

The nurse is caring for a client who has excessive diarrhea. Which acid-base disturbance does the nurse anticipate will result from having excessive diarrhea?

Metabolic acidosis

For which acid-base imbalance will the nurse monitor for a client taking large doses of loop diuretics?

Metabolic alkalosis

The nurse is reviewing the medication administration record (MAR) of a client with metabolic acidosis. Which medications in the MAR could contribute to the metabolic acidosis? Select all that apply.

Metformin Zidovudine Acetylsalicylic acid

A client with a long history of alcohol abuse has been admitted to the emergency department after several of days of heavy drinking. The nurse can best promote the restoration of the client's acid-base balance by:

administering intravenous sodium bicarbonate as prescribed.

The nurse is caring for a client with acute primary respiratory acidosis. When determining the cause of the acidosis the nurse is aware that which imbalance is most common?

impaired alveolar ventilation

Which unit of measure best describes the concentration of solute in a particular volume of fluid based on electrolyte equivalency?

mEq/L