Fluid, Electrolyte, and Acid-Base Balance in Nursing

A patient with heart failure is prescribed a diuretic. What is the MOST critical assessment a nurse should perform to monitor fluid balance?

A patient presents with muscle weakness, cardiac arrhythmias, and abdominal distension. Which electrolyte imbalance is MOST likely?

A patient with chronic obstructive pulmonary disease (COPD) is admitted with increased shortness of breath and confusion. Arterial blood gas (ABG) results show pH 7.30, PaCO2 60 mmHg, and HCO3- 26 mEq/L. How should a nurse interpret these results?

A nurse is preparing to administer intravenous potassium chloride (KCl) to a patient with hypokalemia. Which action is MOST important to ensure medication safety?

A patient receiving intravenous fluids develops signs of fluid overload, including dyspnea and edema. Which nursing intervention is the PRIORITY?

What is the MOST important step a nurse should take to prevent complications associated with PICC line insertion?

A nurse is caring for a patient with hypercalcemia secondary to malignancy. Which intervention is MOST likely to be prescribed to manage this electrolyte imbalance?

During the administration of a blood transfusion, a patient develops chills, back pain, and anxiety. What is the nurse's FIRST action?

A patient with a central venous catheter complains of pain and swelling in the arm on the side of the catheter. What is the nurse's MOST appropriate initial action?

A nurse is assessing a patient with severe vomiting and diarrhea. Which acid-base imbalance is the patient MOST at risk for developing?

A patient is prescribed furosemide (Lasix) for treatment of hypertension. What electrolyte imbalance should the nurse monitor for MOST closely?

A patient receiving total parenteral nutrition (TPN) suddenly develops hyperglycemia. Which nursing intervention is MOST appropriate?

A nurse is caring for a patient with syndrome of inappropriate antidiuretic hormone secretion (SIADH). What fluid and electrolyte imbalance is MOST likely to occur?

What is the MOST important nursing consideration when administering intravenous amphotericin B to a patient?

A patient is prescribed spironolactone for management of edema associated with liver cirrhosis. What electrolyte imbalance is the nurse's PRIORITY to monitor?

Which nursing intervention is MOST effective in preventing air embolism during central line removal?

A patient with end-stage renal disease is receiving hemodialysis. During the dialysis session, the patient complains of muscle cramps and nausea. What is the MOST likely cause?

A nurse is assessing a patient with a history of heart failure who presents with shortness of breath, edema, and jugular vein distension. Which assessment finding is MOST indicative of fluid volume excess?

A patient is receiving continuous tube feeding and develops diarrhea. What is the nurse's initial action?

A patient is prescribed intravenous magnesium sulfate for treatment of severe pre-eclampsia. What is the MOST important nursing assessment during the infusion?

A patient with a creatinine clearance of 30 mL/min is prescribed ampicillin. According to the guidelines, which dosage adjustment is MOST appropriate?

A nurse needs to administer Ampicillin IV push. What is the maximum concentration and rate that should be administered?

A patient receiving ampicillin IV develops a widespread, dull-red, macular rash. What is the MOST appropriate nursing action?

A nurse is preparing to administer ampicillin via intermittent IV infusion. Which intravenous solution is MOST appropriate for dilution?

A nurse is preparing to administer ampicillin 1 gram IV via minibag to a patient with a fluid restriction. What is the MINIMUM volume of normal saline to use for dilution?

Which of the following medications is INCOMPATIBLE with ampicillin when administered concurrently at the Y-site?

A nurse is preparing a dose of ampicillin 500 mg IV. After reconstituting a 500 mg vial, how much sterile water for injection (SWI) is needed to yield a concentration of 250 mg/mL for IM injection?

Following reconstitution, how long is a vial of ampicillin stable at room temperature before it must be used or discarded?

A patient reports a previous allergic reaction to penicillin. What is the MOST important action a nurse should take before administering ampicillin?

For an adult patient receiving ampicillin, what is the appropriate intramuscular (IM) injection technique?

A nurse is preparing to administer ampicillin 1g IV to a patient. After reconstitution, what is the concentration of the solution if 3.5mL of sterile water is added?

A patient on ampicillin develops diarrhea. What is the MOST likely cause, and what is the appropriate initial nursing action?

A patient with infectious mononucleosis is prescribed ampicillin for a secondary infection. What specific adverse effect is this patient at higher risk for?

A nurse is administering ampicillin IV push. What is the MOST important assessment to make during the administration?

A patient receiving ampicillin intravenously complains of pain at the insertion site. What is the MOST appropriate initial nursing intervention?

A patient receiving a continuous infusion of ampicillin develops new onset seizures. Besides stopping the infusion, what other immediate action should the nurse take?

A patient is ordered ampicillin 500mg IV q6h. The patient is currently NPO. Which route of administration should the nurse question and why?

A patient is on dialysis. What adjustment should be considered for a patient receiving ampicillin?

A nurse is educating a patient who will receive ampicillin IV at home via a peripherally inserted central catheter (PICC). Which statement is MOST important to include in the teaching?

The lab calls and says that the patient is hyponatremic. Per the notes, which content from the monograph would have alerted the nurse that this is a risk with ampicillin?

What is the MAXIMUM dose of dimenhydrinate that can be administered to a patient in a 24-hour period?

A patient receiving dimenhydrinate IV complains of pain at the IV site. According to the monograph, what is the MOST likely cause, assuming the medication was administered correctly?

Which of the following medications is INCOMPATIBLE with dimenhydrinate at the Y-site?

A nurse is preparing to administer dimenhydrinate 50 mg IV push. What is the MINIMUM amount of normal saline (NS) needed to dilute this dose?

A patient with a history of narrow-angle glaucoma is prescribed dimenhydrinate for nausea. What risk should the nurse anticipate?

How long is dimenhydrinate stable at room temperature when diluted in D5W?

What is a common systemic adverse effect associated with dimenhydrinate administration that patients should be educated about?

Considering the administration guidelines, which route of administration does NOT require dilution of dimenhydrinate?

A patient is ordered dimenhydrinate 75mg IV. Referring to the guardrails, is this dose within the recommended range?

A patient is receiving dimenhydrinate via a primary IV bag. What is the recommended dilution range?

Which of the following conditions would be a reason to administer dimenhydrinate?

A patient is prescribed dimenhydrinate. The patient has a history of prostatic hypertrophy. The nurse should monitor for which potential adverse effect?

A nurse is preparing to administer dimenhydrinate IV push. Over what time frame should the nurse administer the medication?

Which of the following assessments is MOST important for the nurse to perform when administering dimenhydrinate to an elderly patient?

A patient reports increased dizziness after receiving dimenhydrinate. Which intervention is MOST appropriate?

A patient is prescribed dimenhydrinate for postoperative nausea. The patient is also receiving other central nervous system depressants. What is the primary concern?

A nurse is preparing to administer dimenhydrinate via minibag. What is the appropriate volume of diluent to use?

What should the nurse do if a patient experiences drowsiness after receiving dimenhydrinate?

Which underlying patient condition would be a contraindication to administering Dimenhydrinate?

Which of the following assessments should the nurse prioritize after administering IV dimenhydrinate?

A nurse needs to calculate the infusion rate for an IV medication administered via an electronic pump. What information is REQUIRED to perform this calculation?

An order reads: "Administer 1500 mL Normal Saline IV over 12 hours." When programming the infusion pump, what rate in mL/hr should the nurse set?

A medication is to be infused over 45 minutes. To determine the correct mL/hr to program on the pump, which calculation would the nurse perform?

An order states: "Administer 2 L of IV fluids per day." What is the equivalent hourly rate in mL/hr?

When administering IV fluids via gravity, what information MUST the nurse know to calculate the flow rate?

A physician orders an IV to infuse at 150 mL/hr. Using IV tubing with a drop factor of 15 gtt/mL, how many drops per minute should the IV be set to deliver?

An IV is infusing via gravity, and the nurse needs to calculate the manual drip rate. Which formula is used to determine the flow rate in gtt/min?

An IV of D5W is ordered to infuse at 100 mL/hr. The available IV tubing has a drop factor of 10 gtt/mL. How many drops per minute should the IV be set to infuse?

What is the PRIMARY advantage of using a microdrip IV tubing set?

An order reads, "1000 mL Normal Saline IV to run at 150 mL/hr." Approximately how long will the IV take to infuse?

An IV fluid is ordered to run at 80 mL/hr. After 6 hours, how much fluid will the patient have received?

An IV is infusing at 30 gtt/min using a microdrip set. How much fluid (in mL) will the patient receive in one hour?

An IV of D5W is infusing at 25 gtt/min. The drop factor is 15 gtt/mL. Over an 8-hour shift, approximately how much fluid will the client receive?

Which area of knowledge is MOST crucial for nurses to accurately administer medications?

Prior to administering any medication, what is an ESSENTIAL step in ensuring patient safety?

The nurse is verifying the medication before administration. What does the 'third accuracy check' consist of?

A nurse draws up medication from an ampule. What special equipment is REQUIRED when withdrawing medication from an ampule, and why?

Following the administration of an IV medication via mini-infusion pump, what is the purpose of flushing the IV line with normal saline?

Which statement BEST describes the purpose of using volume-control sets, such as a buretrol or volutrol, for IV medication administration?

What is the MOST important consideration when preparing to administer a medication via intravenous piggyback (IVPB)?

What is the MOST important step to perform before administering medication through existing IV tubing?

When reconstituting a medication, what is the PRIMARY resource the nurse should consult for correct dilution and administration guidelines?

A nurse is preparing to administer medication via a mini-infusion pump. After connecting the prefilled syringe to the pump tubing, what is the next step?

When providing IV therapy in a community setting, what is a CRITICAL aspect of patient education?

What is the BEST position for the secondary IV bag when administering medications via piggyback infusion?

A patient with a CVAD is to be discharged home on IV antibiotics. What MUST the nurse teach the patient regarding the CVAD?

When administering IV medications to older adults, why is it important to use the smallest gauge needle or cannula possible?

When performing venipuncture on an elderly patient, what is the recommended insertion angle?

When administering IV medications to patients with fragile veins, how should the nurse modify the application of a tourniquet?

A nurse reviews the patient chart. The patient has difficult intravenous access and requires long term IV antibiotics. What type of venous access device is MOST appropriate for this patient?

Compare and contrast a PICC line to a CVAD?

What is the appropriate maintenance of a central line? Select all that apply.

A patient is being discharged with a CVAD in place. The nurse teaches the patient what signs and symptoms to look for at home. Select all the apply.

A patient is being discharged home on IV medications through a CVAD. The nurse would include which of the following elements in his teaching?

What is the MOST important education consideration to avoid infection?

A nurse receives a prescription for cefazolin 225mg IV q6h. Prior to administering the medication, the nurse needs to reconstitute the cefazolin 500mg vial. What is the first step?

A nurse is reconstituting the Cefazolin IV medication, and adds 2 mL of normal saline into the 500mg vial of Cefazolin. What volume (in mL) provides the ordered dosage of 225mg

What key piece of information, beyond the ordered volume or dosage and time frame, is crucial for calculating manual IV drip rates?

A physician orders 1000 mL of Lactated Ringer's to be infused at 125 mL/hr. How long will the infusion take to complete?

An IV is infusing at 30 gtt/min using microdrip tubing. How much fluid (in mL) will the patient receive in one hour?

When calculating IV flow rates, which formula is used to determine the flow rate in gtt/min?

Why is knowledge of pharmacokinetics essential for nurses administering medications?

What is the BEST way to guarantee understanding when teaching a patient about a new IV medication for home administration?

When discontinuing an IV infusion, what step ensures maintenance of sterility of the IV between intermittent infusions?

What assessment finding should the nurse prioritize when a patient is prescribed IV therapy in the community setting?

Why should a nurse avoid applying excessive pressure when using a tourniquet for venipuncture in elderly patients?

An elderly patient with fragile veins requires frequent IV medication. What is the MOST suitable strategy for venipuncture?

Before administering IV medications, what is the purpose of checking compatibility?

What is a key consideration when administering IV medications to older adults, as they often have reduced body water percentage?

Prioritize the sequence of steps for administering medication via a mini-infusion pump:

What information needs to be included when labeling IV bags?

What is the rationale for using a filter needle (if required) when withdrawing medication from an ampule?

What would be the next step, after administering IV medication, to keep the vein patent and prevent contact between incompatible medications?

Why are volume-control sets (e.g., Buretrol) particularly useful in IV medication administration?

You need to make sure the IVPB runs to completion. What is the appropriate position to hang them at?

Which maintenance activities are required to protect a CVAD?

What assessment findings would indicate a potential central line catheter infection?

Select all of the steps needed to teach family and patient safety when discharging home with a CVAD:

What does ANNT stand for?

What is one nursing skill the nurse can do to reduce catheter associated infection?

A nurse is preparing to teach a patient how to care for their peripherally inserted central catheter (PICC) at home. Which of the following is the MOST important teaching point?

A patient with a CVAD is being discharged home on IV antibiotics and asks why they can’t take baths anymore. What is the correct response?

Which of the following is the MOST important consideration when determining whether to use a peripheral or central venous access device?

After observing redness and swelling at the CVAD site during routine assessment, what is the nurse's priority action?

A patient with a CVAD suddenly develops shortness of breath and chest pain. What immediate action should the nurse take FIRST?

What is the PRIMARY reason for flushing a PICC line daily?

When measuring the 'wing-to-wing' tip of a PICC line during dressing changes, what is the PRIMARY purpose?

Why is a chest X-ray required after PICC line placement?

A patient receiving TPN exhibits rapid weight gain, dyspnea, and increased blood pressure. Which complication should the nurse suspect?

How is the solution for TPN formulated to meet the individual needs of the client?

A patient is receiving TPN at home. Which instruction is MOST critical for the nurse to emphasize regarding potential complications?

A nurse preparing to administer parenteral nutrition should take which action FIRST?

During home visits for community IV therapy, what is the nurse's MOST important assessment related to patient safety?

Why is it important for patients receiving IV therapy at home to teach back the signs and symptoms of complications?

A client preparing for discharge on home IV therapy should be instructed to take which PRIMARY action should the catheter fall out?

For a patient being discharged home on IV therapy, what is the MOST important instruction regarding the purpose of IV therapy?

What should the nurse instruct a client about showering while having home IV therapy?

What should the nurse teach the client who is being discharged home with IV therapy about ambulation, performing hygiene, and participating in other activities of daily living?

What is the BEST reason for storing lipids at room temperature if receiving nutrition via parenteral infusion?

A client asks the nurse why they have blood draws from their CVAD routinely. What would the nurse explain?

Prior to discontinuing the parenteral nutrition infusion that has been running for 24 hours, the nurse would take what action FIRST?

While administering a TPN infusion, the nurse notices a break in the lipid emulsion. What is the most appropriate action?

What nursing actions are most critical to maintaining and managing a CVAD?

What is the priority nursing intervention for a patient experiencing phlebitis related to CVAD therapy?

What key signs and symptoms would alert a nurse to a CVAD infection, requiring prompt intervention?

What should the nurse teach the caregiver regarding protecting the IV site when returning home?

Which of the following statements BEST describes the difference between a PICC line and a CVAD?