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Questions and Answers
The nurse is caring for a patient with dehydration. The patient asks the nurse about the cause, Which dose the nurse identify as the most likely cause?
The nurse is caring for a patient with dehydration. The patient asks the nurse about the cause, Which dose the nurse identify as the most likely cause?
The nurse is caring for a patient with fluid volume excess. Which medical treatment can the nurse anticipate?
The nurse is caring for a patient with fluid volume excess. Which medical treatment can the nurse anticipate?
The nurse is told to administer IV fluid that is isotonic. Which fluid can the nurse expect to administer?
The nurse is told to administer IV fluid that is isotonic. Which fluid can the nurse expect to administer?
An older adult with diarrhea is weak and confused. The client's labs show an elevated hematocrit( Hct ) and blood urea nitrogen(BUN). What is the nurse's priority concern?
An older adult with diarrhea is weak and confused. The client's labs show an elevated hematocrit( Hct ) and blood urea nitrogen(BUN). What is the nurse's priority concern?
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The nurse is teaching a patient about a low-sodium diet and has them choose from a menu their dinner options. Which choice indicates that more teaching is required?
The nurse is teaching a patient about a low-sodium diet and has them choose from a menu their dinner options. Which choice indicates that more teaching is required?
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The nurse caring for an older adult in a care center who frequently becomes dehydrated. What is a reason for this?
The nurse caring for an older adult in a care center who frequently becomes dehydrated. What is a reason for this?
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The nurse is reviewing laboratory results for a group of patients. Which value requires additional action by the nurse?
The nurse is reviewing laboratory results for a group of patients. Which value requires additional action by the nurse?
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The nurse is caring for a group of patient. Which finding requires reporting to the health-care provider(HCP)?
The nurse is caring for a group of patient. Which finding requires reporting to the health-care provider(HCP)?
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The nurse is preparing to administer furosemide to a patient with a potassium level of 2.5 mEq/L. Which action should the nurse take?
The nurse is preparing to administer furosemide to a patient with a potassium level of 2.5 mEq/L. Which action should the nurse take?
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The nurse is caring for a group of patients. Which patient should be monitored for signs of hyponatremia?
The nurse is caring for a group of patients. Which patient should be monitored for signs of hyponatremia?
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A patient develops an irregular heart rate, hypotension, abdominal cramping, and diarrhea after a thyroidectomy. Which emergency medication should the nurse anticipate being prescribed for this patient?
A patient develops an irregular heart rate, hypotension, abdominal cramping, and diarrhea after a thyroidectomy. Which emergency medication should the nurse anticipate being prescribed for this patient?
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The nurse is using Chvostek sign to assess for hypocalcemia. Which statement correctly describes this test?
The nurse is using Chvostek sign to assess for hypocalcemia. Which statement correctly describes this test?
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The nurse is concerned that an older adult patient is at risk for dehydration. Changes in which body system leads to the risk?
The nurse is concerned that an older adult patient is at risk for dehydration. Changes in which body system leads to the risk?
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While assessing an older adult patient with fluid excess, the nurse notes the following: T=98.6F P=92 R=18 BP=166/88 mm Hg, bilateral crackles, oxygen saturation = 95% . Which action should the nurse take first
While assessing an older adult patient with fluid excess, the nurse notes the following: T=98.6F P=92 R=18 BP=166/88 mm Hg, bilateral crackles, oxygen saturation = 95% . Which action should the nurse take first
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The nurse reviews the following results for an arterial blood gas(ABG): pH=7.46, PCO2=34 HCO3=26 PAO2=88% How does the nurse interpret these results
The nurse reviews the following results for an arterial blood gas(ABG): pH=7.46, PCO2=34 HCO3=26 PAO2=88% How does the nurse interpret these results
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An older patient is admitted for treatment of fluid volume excess with severe hyponatremia. Which complication should the nurse monitor for?
An older patient is admitted for treatment of fluid volume excess with severe hyponatremia. Which complication should the nurse monitor for?
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The nurse is caring for a patient who is being treating for fluid volume excess. Which assessment finding indicates that treatment has been effective?
The nurse is caring for a patient who is being treating for fluid volume excess. Which assessment finding indicates that treatment has been effective?
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Which serum pH can the nurse expect to see in a patient with uncompensated chronic obstructive pulmonary disease(COPD)?
Which serum pH can the nurse expect to see in a patient with uncompensated chronic obstructive pulmonary disease(COPD)?
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The nurse is caring for a patient with arterial blood gas results of: pH=7.18, PCO2=42, HCO3=15 PaO2=84% The patient has a blood glucose level of 545. How should the nurse interpret these results
The nurse is caring for a patient with arterial blood gas results of: pH=7.18, PCO2=42, HCO3=15 PaO2=84% The patient has a blood glucose level of 545. How should the nurse interpret these results
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A patient with uncontrolled diabetes mellitus develops metabolic acidosis. What finding indicates that the patient has compensated
A patient with uncontrolled diabetes mellitus develops metabolic acidosis. What finding indicates that the patient has compensated
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A patient has an overactive thyroid and the arterial blood gas result shows respiratory alkalosis. Which nursing action should the nurse take first?
A patient has an overactive thyroid and the arterial blood gas result shows respiratory alkalosis. Which nursing action should the nurse take first?
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The nurse is evaluating a group of patients for their risk for dehydration. Which patient is the greatest concern?
The nurse is evaluating a group of patients for their risk for dehydration. Which patient is the greatest concern?
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The nurse is teaching a patient with a calcium level of 7.8 mg/dL about food choices. Which food choice made by the patient indicates an understanding of the teaching?
The nurse is teaching a patient with a calcium level of 7.8 mg/dL about food choices. Which food choice made by the patient indicates an understanding of the teaching?
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The nurse is caring for a group of patients. Which patient should the nurse monitor for signs of metabolic alkalosis?
The nurse is caring for a group of patients. Which patient should the nurse monitor for signs of metabolic alkalosis?
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The nurse is teaching a patient about taking oral potassium supplements. Which topics should the nurse cover in the teaching?(Select all that apply)
The nurse is teaching a patient about taking oral potassium supplements. Which topics should the nurse cover in the teaching?(Select all that apply)
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The nurse is planning care for a patient with a fluid volume excess and a serum sodium level of 125 mg/dL. Which actions should the nurse include when providing care?(Select all that apply)
The nurse is planning care for a patient with a fluid volume excess and a serum sodium level of 125 mg/dL. Which actions should the nurse include when providing care?(Select all that apply)
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During an assessment , the nurse learns that an older patient has been taking twice the prescribed amount of calcium supplements. Which physical assessment findings should the nurse identify as being consistent with this patient's intake of calcium? (select all that apply)
During an assessment , the nurse learns that an older patient has been taking twice the prescribed amount of calcium supplements. Which physical assessment findings should the nurse identify as being consistent with this patient's intake of calcium? (select all that apply)
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The nurse is caring for a patient with hypokalemia. Which finding are anticipated?(select all that apply)
The nurse is caring for a patient with hypokalemia. Which finding are anticipated?(select all that apply)
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A nurse is monitoring a patient who has been admitted for fluid volume deficit .Which finding indicates hypovolemia rather than dehydration is occurring?
A nurse is monitoring a patient who has been admitted for fluid volume deficit .Which finding indicates hypovolemia rather than dehydration is occurring?
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A nurse is providing fluids to an older patient who is being treated for fluid volume deficit. PO fluids along with hydration via intravenous route are being provided. It is 8 hours into therapy. Which finding indicates nursing intervention is required
A nurse is providing fluids to an older patient who is being treated for fluid volume deficit. PO fluids along with hydration via intravenous route are being provided. It is 8 hours into therapy. Which finding indicates nursing intervention is required
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A nurse transferring a patient to the intensive care unit(ICU)documents the presence of S3 heart sounds. Which first action would the ICU nurse expect to take?
A nurse transferring a patient to the intensive care unit(ICU)documents the presence of S3 heart sounds. Which first action would the ICU nurse expect to take?
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A nurse is counseling a young female patient who is a long-distance runner. Which factor would the nurse recognize is the highest risk for this patient to develop dehydration?
A nurse is counseling a young female patient who is a long-distance runner. Which factor would the nurse recognize is the highest risk for this patient to develop dehydration?
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A nurse is caring for multiple adult patients in an acute care setting. The nurse should consider which patient has a decreased risk for an electrolyte imbalance?
A nurse is caring for multiple adult patients in an acute care setting. The nurse should consider which patient has a decreased risk for an electrolyte imbalance?
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A nurse revies a patient's electrolyte levels on a laboratory report and notes hyponatremia. Which symptoms would the nurse expect to find during assessment?
A nurse revies a patient's electrolyte levels on a laboratory report and notes hyponatremia. Which symptoms would the nurse expect to find during assessment?
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A nurse is providing care for a patient with a history of cardiac problems. The nurse notes the patient's potassium level is 3.6 mEq/L. The nurse understands that which reason supports the physician's order for a daily dose of potassium?
A nurse is providing care for a patient with a history of cardiac problems. The nurse notes the patient's potassium level is 3.6 mEq/L. The nurse understands that which reason supports the physician's order for a daily dose of potassium?
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A nurse is caring for multiple patients on a medical floor. Which patient should the nurse see first?
A nurse is caring for multiple patients on a medical floor. Which patient should the nurse see first?
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A patient has been prescribed spironolactone therapy. Which priority information should the nurse include in the teaching plan?
A patient has been prescribed spironolactone therapy. Which priority information should the nurse include in the teaching plan?
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A nurse is providing discharge teaching for a patient who has been diagnosed with hypertension(HTN). Which food selection should the nurse instruct the patient to limit in their diet?
A nurse is providing discharge teaching for a patient who has been diagnosed with hypertension(HTN). Which food selection should the nurse instruct the patient to limit in their diet?
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A nurse is caring for a patient taking the diuretic furosemide. The nurse would be most concerned about which assessment finding?
A nurse is caring for a patient taking the diuretic furosemide. The nurse would be most concerned about which assessment finding?
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Which action if observed by the nurse manager requires immediate intervention for a patient who has potassium level of 2.0 mEq/L
Which action if observed by the nurse manager requires immediate intervention for a patient who has potassium level of 2.0 mEq/L
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A health-care provider(HCP) has written an order for 20 mEq potassium chloride to be added to the patient's intravenous solution. Which initial action should the nurse take if the patient's IV bad has 500 mL of fluid in it at the present time?
A health-care provider(HCP) has written an order for 20 mEq potassium chloride to be added to the patient's intravenous solution. Which initial action should the nurse take if the patient's IV bad has 500 mL of fluid in it at the present time?
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While taking a patient's blood pressure, a nurse notes that the patient's hand and wrist are contracting. What finding would the nurse suspect
While taking a patient's blood pressure, a nurse notes that the patient's hand and wrist are contracting. What finding would the nurse suspect
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A nurse is receiving a patient who is being admitted through the emergency department following confusion and disorientation while working outside during the heat of the day. The nurse would anticipate that which IV fluid may be included in the treatment plan?
A nurse is receiving a patient who is being admitted through the emergency department following confusion and disorientation while working outside during the heat of the day. The nurse would anticipate that which IV fluid may be included in the treatment plan?
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During change of shift report, a nurse is informed that a patient has new orders for sodium polystyrene(Kayexalate). After providing the treatment later in the shift. Which documentation should the nurse make in regard to the patient's care
During change of shift report, a nurse is informed that a patient has new orders for sodium polystyrene(Kayexalate). After providing the treatment later in the shift. Which documentation should the nurse make in regard to the patient's care
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A nurse is monitoring a patient who is scheduled to receive magnesium replacement therapy. Which additional electrolyte would the nurse anticipate being ordered by the health-care provider(HCP)?
A nurse is monitoring a patient who is scheduled to receive magnesium replacement therapy. Which additional electrolyte would the nurse anticipate being ordered by the health-care provider(HCP)?
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A patient has hypomagnesemia and hypercalcemia. What electrolyte abnormality should the nurse anticipate that may also be present
A patient has hypomagnesemia and hypercalcemia. What electrolyte abnormality should the nurse anticipate that may also be present
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A nurse is providing care for a patient whose arterial blood gas results are pH=7.48 CO2=44 NaHCO3= 29
Which conclusion about the patient's condition would the nurse draw from the testing results?
A nurse is providing care for a patient whose arterial blood gas results are pH=7.48 CO2=44 NaHCO3= 29 Which conclusion about the patient's condition would the nurse draw from the testing results?
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A nurse is providing care for an individual admitted with acute asthma attack. Arterial blood gas(ABG) results indicate pH= 7.33; CO2=49 and HCO3=26 Oxygen saturation is 87% After initiating treatment with IV fluids, bronchodilators, and oxygen therapy at 4 L via nasal cannula(NC), the patient's repeat ABG results are pH= 7.35 CO2=47 AND HCO3=26 Oxygen saturation is 89% Which action should the nurse take next?
A nurse is providing care for an individual admitted with acute asthma attack. Arterial blood gas(ABG) results indicate pH= 7.33; CO2=49 and HCO3=26 Oxygen saturation is 87% After initiating treatment with IV fluids, bronchodilators, and oxygen therapy at 4 L via nasal cannula(NC), the patient's repeat ABG results are pH= 7.35 CO2=47 AND HCO3=26 Oxygen saturation is 89% Which action should the nurse take next?
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A nurse is reviewing hormone regulation of fluid and electrolytes. Which finding should the nurse anticipate to occur in response to a high blood pressure reading?
A nurse is reviewing hormone regulation of fluid and electrolytes. Which finding should the nurse anticipate to occur in response to a high blood pressure reading?
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A nurse is caring for a patient admitted with fluid volume deficit. Which diagnostic test results would the nurse identify as supporting the patient's diagnosis? Select all that apply
A nurse is caring for a patient admitted with fluid volume deficit. Which diagnostic test results would the nurse identify as supporting the patient's diagnosis? Select all that apply
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A patient is being treated of hypercalcemia. Which etiologies could contribute to this clinical diagnosis? Select all that apply
A patient is being treated of hypercalcemia. Which etiologies could contribute to this clinical diagnosis? Select all that apply
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A nurse is monitoring a patient who has chronic alcoholism. Which fluid and electrolyte abnormalities should the nurse anticipate being present? Select all that apply
A nurse is monitoring a patient who has chronic alcoholism. Which fluid and electrolyte abnormalities should the nurse anticipate being present? Select all that apply
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Study Notes
Dehydration Causes
- Dehydration is a common condition
- The most likely cause of dehydration is fluid loss due to diarrhea, vomiting, sweating, or inadequate fluid intake.
Fluid Volume Excess Treatment
- The nurse can anticipate medical treatment for fluid volume excess to include fluid restriction, diuretics, and sodium restriction.
- Diuretics are medications that help the body remove excess fluid.
- Sodium restriction is a dietary measure that helps reduce fluid retention.
Isotonic IV Fluids
- Isotonic IV fluids have the same salt concentration as the body’s fluids.
- Isotonic fluids are used to replace fluids lost due to dehydration.
- Examples of isotonic IV fluids include normal saline (0.9% sodium chloride) and lactated Ringer's solution.
Priority Concern for Dehydration
- The nurse's priority concern for an older adult with diarrhea, weakness, and confusion, is the potential for dehydration.
- Dehydration can lead to serious complications, such as electrolyte imbalances, kidney failure, and shock.
- The elevated hematocrit and blood urea nitrogen (BUN) levels, as well as the symptoms, indicate that the patient is likely dehydrated.
Low-Sodium Diet Teaching
- A patient who chooses a meal with a high sodium content, despite receiving teaching on a low-sodium diet, indicates a need for further education.
- The nurse should repeat the information on the low-sodium diet and address any questions the patient may have.
Dehydration in Older Adults
- Older adults are at higher risk for dehydration, as their thirst mechanism may be less effective, and they may have decreased mobility.
- It is important to monitor older adults for signs of dehydration, such as dry mouth, thirst, decreased urine output, and confusion.
Laboratory Values Requiring Action
- The nurse should take action on any laboratory values that are outside of the normal range.
- For example, a low potassium level may require additional monitoring and intervention by the nurse.
Findings Requiring Reporting to HCP
- The nurse should report any findings to the HCP that could indicate a worsening of the patient's condition or the development of a new problem.
- Examples include changes in blood pressure, heart rate, respiratory rate, oxygen saturation, level of consciousness, or urine output.
Furosemide Administration with Hypokalemia
- The nurse should hold the furosemide (a diuretic) if the potassium level is below 3.5 mEq/L.
- Furosemide can lower potassium levels, worsening hypokalemia.
Monitoring for Hyponatremia
- The patient who is at risk for hyponatremia is a patient that has had surgery, as surgery can lead to fluid loss.
- The nurse should monitor the patient for signs of hyponatremia, which include nausea, vomiting, headache, confusion, and seizures.
Emergency Medication for Hypocalcemia
- The nurse can anticipate the HCP to prescribe calcium gluconate for the patient.
- The nurse is caring for a patient with a potassium level of 2.5 mEq/L.
Chvostek Sign
- Chvostek sign is a test used to assess for hypocalcemia.
- It involves tapping on the facial nerve.
- A positive Chvostek sign is characterized by a twitching of the facial muscles.
Dehydration Risk in Older Adults
- The integumentary system, which includes skin, hair, and nails, is vulnerable to dehydration. It is important to monitor for signs of dehydration in the skin, such as decreased turgor (elasticity) and dry skin.
Fluid Volume Excess Assessment
- The nurse should prioritize addressing the patient's elevated blood pressure, which indicates fluid overload, over any other assessment finding.
ABG Results Interpretation
- The ABG results indicate a normal pH, normal PCO2, and normal HCO3.
- The nurse should interpret the results as normal.
Complications of Hyponatremia
- The nurse should closely monitor the patient for seizures, which is a serious complication of hyponatremia.
- It is important to identify and treat hyponatremia early to prevent seizures.
Fluid Volume Excess Treatment Effectiveness
- Diuresis can be an indication that the treatment for fluid volume excess is effective.
- The nurse should monitor the patient's urine output closely and report any significant changes to the provider.
Uncompensated COPD
- The nurse should expect to see a low serum pH in a patient with uncompensated COPD.
- This is because COPD can lead to respiratory acidosis.
ABG with High Blood Glucose
- The nurse should interpret the ABG results as metabolic acidosis with a superimposed diabetic ketoacidosis.
- The patient is not compensating for the acidosis as the pH is low, and the bicarbonate level is low.
Compensated Metabolic Acidosis
- The compensated metabolic acidosis can be indicated by a normal pH.
- This is because the body has compensated for the acidosis by increasing the bicarbonate level.
Respiratory Alkalosis Action
- The nurse should first assess and monitor the patient's respiratory rate and depth.
- Hyperventilation, a common symptom of respiratory alkalosis, can lead to a decrease in carbon dioxide levels.
Dehydration Risk Assessment
- The patient with a history of excessive diuretic use is at greatest risk for dehydration.
- Diuretics can lead to fluid loss, which can increase the risk of dehydration, especially in older adults.
Calcium Level food choices
- The patient who chooses a meal with a calcium-rich food, such as a glass of milk, indicates an understanding of the teaching.
Metabolic Alkalosis Monitoring
- The patient with vomiting is at risk for metabolic alkalosis.
- This is because vomiting can lead to a loss of stomach acid, which can cause a rise in the pH.
Oral Potassium Supplement Teaching
- The nurse should instruct the patient on the proper dosage, frequency, and timing of the potassium supplements.
- The nurse should also teach the patient about the potential side effects of potassium supplements.
Fluid Volume Excess Management Actions
- The nurse should monitor the patient's fluid intake and output closely.
- The nurse should also assess the patient for signs and symptoms of fluid volume excess, such as edema, weight gain, and shortness of breath.
Assessment Findings for Calcium Toxicity
- The nurse should assess for constipation, abdominal pain, and dehydration.
Hypokalemia Findings
- The nurse should anticipate finding muscle weakness, fatigue, and leg cramps in a patient with hypokalemia.
Hypovolemia vs. Dehydration
- Hypovolemia is characterized by a decrease in plasma volume.
- It is indicated by a rapid heart rate (tachycardia) and a low blood pressure (hypotension).
- Dehydration is characterized by a loss of body water.
- It is indicated by a dry mouth, thirst, decreased urine output, and constipation.
Nursing Intervention for Fluid Volume Deficit
- The nurse should assess the patient for signs and symptoms of dehydration.
- If signs are present, the nurse is required to provide fluids and electrolyte replacement.
S3 Heart Sound Action
- The nurse should notify the HCP.
- Assessment of S3 sounds, a sign of fluid overload, requires communication with the HCP.
Risk for Dehydration in Athletes
- Long-distance runners are at high risk of dehydration due to sweating.
- The nurse is counseling a young female patient who is a long-distance runner.
Decreased Risk for Electrolyte Imbalance
- Patients with well-functioning kidneys are at decreased risk for an electrolyte imbalance.
Hyponatremia Symptoms
- The nurse should expect to find confusion, headache, and nausea in a patient with hyponatremia.
Potassium Level for Cardiac Patients
- A potassium level of 3.6 mEq/L is a normal potassium level.
- It is important to keep the potassium levels within the normal range for patients with cardiac problems, as potassium plays a key role in heart function.
Patient to See First
- The nurse should see the patient who has a heart rate of 120 beats/min.
- Tachycardia (rapid heart rate) can be a sign of a serious condition.
Spironolactone Teaching
- The nurse should teach the patient about the potential side effects of spironolactone and the importance of reporting any side effects to the healthcare provider (HCP).
Food Selection for Hypertension
- The nurse should limit the intake of processed foods that are high in sodium.
Furosemide Assessment Finding
- The nurse should be most concerned about a low potassium level.
- Furosemide can lower potassium levels, which can lead to life-threatening arrhythmias.
Potassium Level Intervention
- The nurse should stop the infusion of potassium chloride and notify the HCP immediately when the patient's potassium level is 2.0 mEq/L.
- Hypokalemia can cause potentially life-threatening arrhythmias.
Potassium Chloride Administration
- The nurse should determine the patient's current potassium level before proceeding with the administration of IV potassium chloride.
- It is important to avoid giving potassium chloride to a patient with hypokalemia, which can worsen the condition.
Hand and Wrist Contraction
- The nurse should suspect hypocalcemia.
- Hypocalcemia can cause tetany, which is a condition characterized by muscle spasms and cramping.
IV Fluids for Heat Exhaustion
- The nurse would anticipate that a patient admitted for heat exhaustion would receive intravenous fluids.
- IV fluids are typically isotonic to replace lost fluids and electrolytes.
Documentation for Kayexalate Treatment
- The nurse should document the time, date, quantity administered, and patient response to the treatment.
- This information will help to monitor the patient's progress and ensure safe and effective treatment.
Electrolyte with Magnesium Replacement Therapy
- The nurse should expect the HCP to order potassium replacement therapy with magnesium replacement therapy.
- Hypomagnesemia can cause hypokalemia.
Electrolyte Abnormality with Hypomagnesemia and Hypercalcemia
- The nurse should anticipate hypokalemia may be present.
- Hypomagnesemia can lead to hypokalemia.
ABG Results Conclusion
- The patient's blood gas results are abnormal, indicating metabolic alkalosis.
- The nurse should assess the patient for causes of metabolic alkalosis and intervene appropriately.
Asthma Attack Management
- The nurse should continue monitoring the patient's oxygen saturation, respiratory rate, ABG results, and clinical status.
- The nurse should also continue treatment with bronchodilators, oxygen therapy, and IV fluids.
Hormone Regulation
- The nurse should anticipate that a high blood pressure reading will stimulate the release of antidiuretic hormone (ADH).
- ADH helps the body retain water.
Fluid Volume Deficit Diagnostic Tests
- The nurse should identify the following diagnostic tests as supporting the patient's diagnosis of fluid volume deficit:
- Elevated hematocrit (Hct).
- Elevated blood urea nitrogen (BUN).
- Increased urine specific gravity.
- Decreased urine output.
Hypercalcemia Etiologies
- Hypercalcemia can be caused by:
- Hyperparathyroidism.
- Malignancy (such as multiple myeloma or lung cancer).
- Vitamin D toxicity.
- Prolonged immobilization.
Fluid and Electrolyte Abnormalities in Alcoholic Patients
- Alcohol withdrawal can lead to several fluid and electrolyte abnormalities, including:
- Hypokalemia.
- Hypomagnesemia.
- Hyponatremia.
- Hypoglycemia.
- Alcoholic patients are also at risk for dehydration.
- The nurse should monitor for signs and symptoms of these electrolyte abnormalities and implement appropriate interventions.
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