Fluids, electrolytes, acid/base balances Flashcards
(104 cards)
The client is admitted complaining of nausea and vomiting for the past three days. The doctor has ordered D5 1/2NS with potassium added. Which action by the nurse is most appropriate?
A. obtain an IV controller
B. Check the client’s vital signs hourly
C. Check the sodium level
D. Obtain an 18 gauge cathlon to begin the infusion.
A. If potassium is added to IV fluids, a controller is required because a too-rapid infusion of potassium can lead to cardiac arrhythmias.
The client is admitted to the unit with third degree burns to his chest and neck. The nurse should be vigiliant to assess which of the following? A. Circulation B. Airway C. Urinary output D. Pain
B. Because the client has burns to the chest, it is likely that he has airway difficulty. The nurse should also assess the client for smoke inhalation.
The client with hypoparathyroidism has a lack of parathyroid hormone. This client will most likely have a serum calcium level of which of the following? A. 3.5 mg/dl B. 10.9 mg/dl C. 14.7 mg/dl D. 18.5 mg/dl
A. The normal calcium level is 8.5-10.5 mg/dl. B,C,D all indicate a higher than normal calcium level. Only A. indicates a lower level that is associated with hypoparathyroidism.
The client is admitted with a pH of 7.30, PaCO2 of 48mm Hg, and a HCO3 of 30. The nurse assesses these findings as which of the following? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis
C. When assessing arterial blood gases, the nurse should look at the pH. In this case the pH is low. After assessing the pH, the nurse should look at the PaCO2. In this case the PaCO2 is elevated. Finally look at the HCO3. In this case, the HCO3 is elevated.
The client is admitted following a motor vehicle accident. Extensive internal bleeding is suspected. The serum pH is 7.0, and the PaCO2 is 32 mm Hg, and the HCO3 is 20 mEq/dl. The nurse should assess the laboratory finding as which of the following? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis
A. The client with internal bleeding will most likely have metabolic acidosis. The laboratory findings reflect this suspicion. The pH is down, the PaCO2 is down, and the HCO3 is down.
Which of the following equipment should be obtained to safely administer magnesium sulfate? A. an internal fetal heart monitor B. an IV rate controller C. a blood administration set D a wall suction device
B. An IV rate controller must be obtained in order to safely administer magnesium sulfate. If magnesium sulfate is administered too quickly, toxicity can result, leading to respiratory arrest.
Which medication can potentiate a fluid volume deficit? A. Insulin B. Inderal (propanolol) C. Lasix (furosemide) D. Valium (diazepam)
C. Lasix is a non-potassium-sparing diuretic. This drug can potentiate fluid volume deficit.
The client is admitted to the unit with anorexia nervosa. The nurse is aware that this client might show signs of which of the following? A. Metabolic alkalosis B. Metabolic acidosis C. Respiratory alkalosis D. Respiratory acidosis
B. The client with anorexia nervosa is in a state of negative nitrogen balance. She is likely experiencing metabolic acidosis.
The client is admitted with a blood glucose level of 545 mg/dl. Which action by the nurse indicates that the nurse is aware of the client’s needs?
A. the nurse prepares an IV of D10W
B. the nurse prepares to administer insulin IV
C. the nurse obtains NPH insulin for administration
D. the nurse inserts a Foley catheter
B. The client with a blood glucose level of 545 mg/dl is in metabolic acidosis. An IV with insulin will be ordered.
The function of the lungs in the acid/base balance is to perform which of the following: A. control HCO3 levels B. retain or blow off CO2 C. regulate potassium levels D. maintain sodium levels
B. The lungs assist in the control of acid/base balance by regulating the amount of CO2 that is retained or exhaled.
The client is admitted with isotonic dehydration. The nurse would anticipate an order for which IV fluid? A. 5% dextrose and water B. 3% sodium chloride C. 0.9% sodium chloride D. 0.45% sodium chloride
C. To treat isotonic dehydration, the doctor will order fluids containing normal saline.
The client with COPD is admitted with a serum carbon-dioxide content level of 42 mEq/L, oxygen saturation of 86%, and a blood glucose level of 190mg/dl. The nurse is aware that the client’s condition might require which of the following?
A. an injection of NPH insulin
B. oxygen application with a venturi mask
C. renal dialysis using an arterio-venous shunt
D. a prescription for a bronchodilator
D. The normal serum carbon-dioxide level is 24-30. This is different from the normal arterial blood gas level of 35-45 mEq/L. A serum carbon dioxide level of 42 mEq/L is elevated. The client with COPD might require a prescription for a bronchodilator to assist with exhalation of carbon dioxide.
The nurse caring for a client admitted with a potassium level of 3.9 mEq/L, a blood glucose level of 98 mg/dL, a serum calcium levle of 10.0 mg/dL, and a blood urea nitrogen level of 30 mg/dL. Which of these values should be reported to the physician immediately? A. The potassium level of 3.9 B. the serum calcium level of 10. C. the blood glucose level of 98 D. the blood urea nitrogen level of 30
D. the normal BUN range is 7-22 mg/dl
The ICU nurse is assessing several clients assigned to his care. Which client should receive priority of care?
A. a 65 year old client with emphysema with an oxygen saturation level of 82%
B. a 45 year old motor vehicle accident client with chest tubes and a CO2 level of 48mE/L
C. an 80 year old diabetic with a blood glucose level of 430 mg/dl
D. a 50 year old client with cirrhosis of the liver and blood urea nitrogen level of 35 mg/dl
C. The client with a blood glucose of 430 mg/dl is at risk for diabetic coma.
The client admitted with hypokalemia has an order for potassium to be administered orally. Prior to administering the potassium the nurse should:
A. check the client’s creatinine level
B. ask the doctor to order an ECG
C. insert a nasogastric tube
D. acquire milk to give the oral potassium
A. Prior to adminstering potassium, the nurse should check renal function. This can be done by checking the client’s creatinine level. The normal creatinine level is 0.60-1.60 mg/dL. If the client’s creatinine level is elevated, the nurse should contact the physician prior to administering the potassium.
The nurse is preparing to administer potassium to the client with hypokalemia. The best liquid for the nurse to dilute the potassium in is: A. cranberry juice B. prune juice C. tomato juice D. chocolate milk
C. Potassium should be administered in a juice containing ascorbic acid. The liquid with the most ascorbic acid is the tomato juice. Other acceptable juices are orange, pineapple, and grape juice.
The client is admitted with a sodium level of 100 mEq/L. After checking the other laboratory values, the nurse should:
A. chart the finding
B. contact the doctor
C. teach the client about low-sodium meal options
D. check the client’s deep tendon reflexes for hyperflexia
B. The normal sodium level is 135-145 mEq/L.
The nurse is checking the client for a positive Trousseau's sign. Which finding indicates a positive Trousseau's sign? A. Facial grimacing B. Carpopedal spasms C. Nuchal rigidty D. Abdominal tenderness
B. A positive Trousseau’s sign would be indicated by jerking of the wrist when the blood pressure cuff is inflated. This indicates hypocalcemia.
The client with hypercholesterolemia asked about vitamins that can help to lower his cholesterol. Which vitamin has been shown to be helpful in lowering the client's cholesterol level? A. Cyanocbalamine B. Ascorbic acid C. Niacin D. Riboflavin
C. To facilitate lowering of the cholesterol level, the doctor might order that the client to supplement his diet with niacin or B3.
The client with hypoparathroidism is admitted with a calcium level of 7.6 mg/dL. The nurse should anticipate an order for which medication? A. Furosemide (Lasix) B. Levothyroxin (Synthyroid) C. PTH (Forteo) D. Propanolol (inderal)
C. The client with hypoparathyroidism will require supplementation with parathyroid hormone.
The client is admitted with a magnesium level of 10.0 mEq/L. Which sign indicates that the client has a toxic level of magnesium? A. hot flashes B. respirations of 10 per minute C. tendon reflexes of 2+ D. urinary output of 40 ml/hr
B. The signs of toxicity to magnesium include oliguria, absence of deep tendon reflexes, and decreased respiration (fewer than 12 per minute).
Which staff member would be least appropriate to assign to the client receiving magnesium intravenously? A. the nursing assistant B. the licensed practical nurse C. the graduate registered nurse D. the surgical resident
A. Magnesium can cause renal failure and apnea. The nursing assistant should not be assigned to care for this client. The licensed practical nurse can evaulate urinary output and report to the registered nurse alterations in renal function.
Which of the following should be kept available when intravenous magnesium is ordered? A. Protamine sulfate B. Calcium gluconate C. AquaMEPHYTON D. Aminocaproic acid
B. Calcium gluconate is the antidote for magnesium sulfate.
The client is admitted with a pH of 7.38, an HCO3 level of 34 mEq/L, and a CO2 level of 48 mEq/L. The nurse is aware that these laboratory values reveal: A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory alkalosis D. Respiratory acidosis
B. The pH is elevated, as are the HCO3 and CO2 levels. This indicates metabolic alkalosis.