cellular regulations saunders

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Questions and Answers

What assessment finding would a nurse most likely note in a client suspected of experiencing fluid volume deficit?

Increased respirations and increased blood pressure

Weight loss and poor skin turgor

Lung congestion and increased heart rate

Decreased hematocrit and increased urine output (correct)

Who among the following clients would be at highest risk for developing fluid volume excess?

The client with kidney disease that developed as a complication of diabetes mellitus (correct)

The client taking diuretics who has tenting of the skin

The client who requires intermittent gastrointestinal suctioning

The client with an ileostomy from a recent abdominal surgery

Which client is at highest risk for developing a potassium level of 5.5 mEq/L (5.5 mmol/L)?

The client with colitis

The client with Cushing’s syndrome (correct)

The client who has been overusing laxatives

The client who has sustained a traumatic burn

Which laboratory finding would most support a diagnosis of fluid volume excess in a client?

High BUN and creatinine levels Signup and view all the answers

Which assessment finding would be inconsistent with a diagnosis of fluid volume deficit in a client?

Bounding pulses Signup and view all the answers

Which client should the nurse prioritize assessment for fluid volume excess?

The client with ascites from liver cirrhosis Signup and view all the answers

What additional sign would the nurse expect to note in a client with hyponatremia?

Muscle twitches Signup and view all the answers

Which condition most likely caused a serum phosphorus level of 1.8 mg/dL (0.58 mmol/L)?

Renal insufficiency Signup and view all the answers

Through which type of excretion does insensible fluid loss occur?

Integumentary output Signup and view all the answers

In a group of clients, who is most likely at risk for a fluid volume deficit?

A client with an ileostomy Signup and view all the answers

Which symptom would not typically be observed in a client with hyponatremia?

Flushed skin Signup and view all the answers

Which electrolyte imbalance is commonly associated with generalized muscle weakness?

Hypomagnesemia Signup and view all the answers

What is the normal serum calcium level?

9 to 10.5 mg/dL Signup and view all the answers

What electrocardiographic changes occur in a client with hypocalcemia?

Prolonged QT interval and prolonged ST segment Signup and view all the answers

What electrocardiographic changes are indicative of hypercalcemia?

Shortened ST segment and widened T wave Signup and view all the answers

In a client with Crohn’s disease, what calcium level indicates hypocalcemia?

9 mg/dL Signup and view all the answers

What type of waves occur with myocardial infarction?

Peaked T waves Signup and view all the answers

Which electrolyte imbalance is associated with ST depression and prominent U waves on an ECG?

Hypocalcemia Signup and view all the answers

What electrocardiographic changes are expected when hyperkalemia exists?

Tall peaked T waves, flat P waves, widened QRS complexes, and prolonged PR interval Signup and view all the answers

What serum sodium level range is considered normal?

135 to 145 mEq/L Signup and view all the answers

Which condition is indicated by a serum sodium level of 130 mEq/L?

Hyponatremia Signup and view all the answers

Who is at risk for hypernatremia among the following?

Client with hyperaldosteronism Signup and view all the answers

Which of the following changes is NOT associated with hyperkalemia?

Narrow QRS complexes Signup and view all the answers

What cognitive skill is required to recognize the expected electrocardiographic changes in hyperkalemia?

Clinical Judgment/Cognitive Skill Signup and view all the answers

What are insensible losses?

Losses that occur through skin and lungs Signup and view all the answers

Why are urination, wound drainage, and gastrointestinal tract losses considered sensible losses?

Because they are comparable and alike Signup and view all the answers

Which of the following is an example of sensible fluid loss?

Fluid loss through urination Signup and view all the answers

Why can't fluid loss through the skin be measured accurately?

It can only be approximated Signup and view all the answers

What distinguishes insensible losses from sensible losses?

Awareness of the person experiencing the loss Signup and view all the answers

Why are insensible losses considered difficult to measure accurately?

Because they are non-voluntary and unconscious Signup and view all the answers

Which clinical manifestation would the nurse expect to note in a client with hypocalcemia and lactose intolerance?

Twitching Signup and view all the answers

In a client with Crohn’s disease and a calcium level of 8 mg/dL (2 mmol/L), which electrocardiogram pattern should the nurse monitor for?

Peaked T wave Signup and view all the answers

For a client with chronic kidney disease and a potassium level of 5.7 mEq/L (5.7 mmol/L), what ECG change might the nurse observe?

Tall peaked T waves Signup and view all the answers

Which client is at risk for the development of a sodium level at 130 mEq/L (130 mmol/L)?

The client with hyperaldosteronism Signup and view all the answers

What would be a concerning sign in a client with chronic kidney disease and a potassium level of 5.7 mEq/L (5.7 mmol/L)?

Widened QRS complexes Signup and view all the answers

Which electrolyte imbalance is associated with prolonged ST segment and tall peaked T waves on an ECG?

Hypokalemia Signup and view all the answers

What additional sign would the nurse expect to note in a client with hyponatremia?

Muscle twitches Signup and view all the answers

Which client is most likely at risk for a fluid volume deficit?

A client with an ileostomy Signup and view all the answers

What condition most likely caused the serum phosphorus level of 1.8 mg/dL?

Hypoparathyroidism Signup and view all the answers

What type of excretion does insensible fluid loss occur through?

Integumentary output Signup and view all the answers

What electrolyte imbalance is commonly associated with generalized muscle weakness?

Hypophosphatemia Signup and view all the answers

Through which type of excretion does insensible fluid loss NOT occur?

Urinary output Signup and view all the answers

What is the main reason why potassium chloride should always be diluted in IV fluid and infused via an infusion pump?

To avoid cardiac arrest Signup and view all the answers

Why should the nurse carefully monitor the IV site during the administration of potassium chloride?

To monitor for vein irritation and phlebitis Signup and view all the answers

What action should the nurse take if the urinary output during potassium chloride administration falls below 30 mL/hr?

Contact the physician Signup and view all the answers

Why is giving potassium chloride by IV push considered dangerous?

It can result in cardiac arrest Signup and view all the answers

What is the primary reason for the nurse to ensure that the IV bag containing potassium chloride is accurately labeled?

To know the quantity of potassium in the fluid Signup and view all the answers

Why is it important for the nurse to monitor for infiltration during the administration of potassium chloride?

To detect potential complications early Signup and view all the answers

Which electrocardiographic changes are expected in a client with hyperkalemia?

Peaked T waves, flat P waves, widened QRS complexes, prolonged PR interval Signup and view all the answers

What serum sodium level indicates hyponatremia?

130 mEq/L (130 mmol/L) Signup and view all the answers

Which client is at risk for hypernatremia?

A client with hyperaldosteronism Signup and view all the answers

What is the normal serum sodium level range?

135 to 145 mEq/L (135 to 145 mmol/L) Signup and view all the answers

Which condition can cause a serum sodium level of 130 mEq/L?

Hyponatremia Signup and view all the answers

What cognitive skill is required to recognize the expected electrocardiographic changes in hyperkalemia?

Recognizing cues Signup and view all the answers

Which condition is most likely to cause a client to be at risk for fluid volume excess based on the text?

Hypothyroidism Signup and view all the answers

What electrolyte imbalance is associated with prolonged QT interval on an ECG?

Hypokalemia Signup and view all the answers

Which client condition would most likely lead to a serum phosphorus level of 1.8 mg/dL (0.58 mmol/L)?

Diabetic ketoacidosis (DKA) Signup and view all the answers

In a client with Crohn’s disease, what calcium level indicates hypercalcemia?

$12$ mg/dL Signup and view all the answers

Which electrolyte imbalance is commonly associated with muscle tetany and Chvostek's sign?

Hypomagnesemia Signup and view all the answers

What cognitive skill is required to anticipate the effects of increased intravenous fluid replacement on a client's fluid balance?

Analysis Signup and view all the answers

Study Notes

Fluid and Electrolyte Imbalance

A fluid volume deficit occurs when the fluid intake is insufficient to meet the fluid needs of the body
Causes of fluid volume deficit:
- Vomiting
- Diarrhea
- Conditions that cause increased respirations or increased urinary output
- Insufficient intravenous fluid replacement
- Draining fistulas
- Presence of an ileostomy or colostomy

Hyponatremia

Normal serum sodium level: 135-145 mEq/L (135-145 mmol/L)
Serum sodium level of 130 mEq/L (130 mmol/L) indicates hyponatremia
Can occur in clients taking diuretics
Clients taking corticosteroids and clients with hyperaldosteronism or Cushing's syndrome are at risk for hypernatremia

Hypocalcemia

Normal serum calcium level: 9-10.5 mg/dL (2.25-2.75 mmol/L)
Serum calcium level lower than 9 mg/dL (2.25 mmol/L) indicates hypocalcemia
Electrocardiographic changes:
- Prolonged QT interval
- Prolonged ST segment
Clients with Crohn's disease are at risk for hypocalcemia

Hyperkalemia

Electrocardiographic changes:
- Tall peaked T waves
- Flat P waves
- Widened QRS complexes
- Prolonged PR interval
Clients with chronic kidney disease are at risk for hyperkalemia

Insensible Fluid Loss

Occurs daily through the skin and lungs
Cannot be measured accurately, only approximated
Example: 800 mL daily

Potassium Chloride Administration

Must be diluted in IV fluid and infused via an infusion pump
Never given by IV push
Monitor for signs of infiltration or phlebitis
Monitor urinary output and contact physician if less than 30 mL/hr

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Test your knowledge on the signs and symptoms of hyponatremia in a client with heart failure receiving high doses of diuretics. Choose the additional sign that the nurse would expect to note in a client with hyponatremia.

cellular regulations saunders

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Questions and Answers

What assessment finding would a nurse most likely note in a client suspected of experiencing fluid volume deficit?

Who among the following clients would be at highest risk for developing fluid volume excess?

Which client is at highest risk for developing a potassium level of 5.5 mEq/L (5.5 mmol/L)?

Which laboratory finding would most support a diagnosis of fluid volume excess in a client?

Which assessment finding would be inconsistent with a diagnosis of fluid volume deficit in a client?

Which client should the nurse prioritize assessment for fluid volume excess?

What additional sign would the nurse expect to note in a client with hyponatremia?

Which condition most likely caused a serum phosphorus level of 1.8 mg/dL (0.58 mmol/L)?

Through which type of excretion does insensible fluid loss occur?

In a group of clients, who is most likely at risk for a fluid volume deficit?

Which symptom would not typically be observed in a client with hyponatremia?

Which electrolyte imbalance is commonly associated with generalized muscle weakness?

What is the normal serum calcium level?

What electrocardiographic changes occur in a client with hypocalcemia?

What electrocardiographic changes are indicative of hypercalcemia?

In a client with Crohn’s disease, what calcium level indicates hypocalcemia?

What type of waves occur with myocardial infarction?

Which electrolyte imbalance is associated with ST depression and prominent U waves on an ECG?

What electrocardiographic changes are expected when hyperkalemia exists?

What serum sodium level range is considered normal?

Which condition is indicated by a serum sodium level of 130 mEq/L?

Who is at risk for hypernatremia among the following?

Which of the following changes is NOT associated with hyperkalemia?

What cognitive skill is required to recognize the expected electrocardiographic changes in hyperkalemia?

What are insensible losses?

Why are urination, wound drainage, and gastrointestinal tract losses considered sensible losses?

Which of the following is an example of sensible fluid loss?

Why can't fluid loss through the skin be measured accurately?

What distinguishes insensible losses from sensible losses?

Why are insensible losses considered difficult to measure accurately?

Which clinical manifestation would the nurse expect to note in a client with hypocalcemia and lactose intolerance?

In a client with Crohn’s disease and a calcium level of 8 mg/dL (2 mmol/L), which electrocardiogram pattern should the nurse monitor for?

For a client with chronic kidney disease and a potassium level of 5.7 mEq/L (5.7 mmol/L), what ECG change might the nurse observe?

Which client is at risk for the development of a sodium level at 130 mEq/L (130 mmol/L)?

What would be a concerning sign in a client with chronic kidney disease and a potassium level of 5.7 mEq/L (5.7 mmol/L)?

Which electrolyte imbalance is associated with prolonged ST segment and tall peaked T waves on an ECG?

What additional sign would the nurse expect to note in a client with hyponatremia?

Which client is most likely at risk for a fluid volume deficit?

What condition most likely caused the serum phosphorus level of 1.8 mg/dL?

What type of excretion does insensible fluid loss occur through?

What electrolyte imbalance is commonly associated with generalized muscle weakness?

Through which type of excretion does insensible fluid loss NOT occur?

What is the main reason why potassium chloride should always be diluted in IV fluid and infused via an infusion pump?

Why should the nurse carefully monitor the IV site during the administration of potassium chloride?

What action should the nurse take if the urinary output during potassium chloride administration falls below 30 mL/hr?

Why is giving potassium chloride by IV push considered dangerous?

What is the primary reason for the nurse to ensure that the IV bag containing potassium chloride is accurately labeled?

Why is it important for the nurse to monitor for infiltration during the administration of potassium chloride?

Which electrocardiographic changes are expected in a client with hyperkalemia?

What serum sodium level indicates hyponatremia?

Which client is at risk for hypernatremia?

What is the normal serum sodium level range?

Which condition can cause a serum sodium level of 130 mEq/L?

What cognitive skill is required to recognize the expected electrocardiographic changes in hyperkalemia?

Which condition is most likely to cause a client to be at risk for fluid volume excess based on the text?

What electrolyte imbalance is associated with prolonged QT interval on an ECG?

Which client condition would most likely lead to a serum phosphorus level of 1.8 mg/dL (0.58 mmol/L)?

In a client with Crohn’s disease, what calcium level indicates hypercalcemia?

Which electrolyte imbalance is commonly associated with muscle tetany and Chvostek's sign?

What cognitive skill is required to anticipate the effects of increased intravenous fluid replacement on a client's fluid balance?

Study Notes

Fluid and Electrolyte Imbalance

Hyponatremia

Hypocalcemia

Hyperkalemia

Insensible Fluid Loss

Potassium Chloride Administration

Studying That Suits You

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