Lewis Chapter 17: Fluid, Electrolyte, and
Acid-Base Imbalances, Lewis Med-Surg
Ch 17, Lewis Ch 17: Fluid/Electrolyte/
Acid-Base Imbalances
The nurse obtains all the following evaluation records approximately a affected person with
deficient fluid volume because of a massive burn damage. Which of the subsequent evaluation
records may be of greatest problem?
A. The blood pressure is ninety/40 mm Hg.
B. Urine output is 30 ml over the last hour.
C. Oral fluid intake is one hundred ml for the final 8 hours.
D. There is extended pores and skin tenting over the sternum.
ANS: A The blood strain is ninety/forty mm Hg.
The blood stress shows that the affected person may be growing hypovolemic surprise due to
fluid loss. This would require instant intervention to prevent the complications related to
systemic hypoperfusion. The poor oral intake, decreased urine output, and pores and skin
tenting all imply the need for growing the patient's fluid consumption but not as urgently as the
hypotension.
A currently admitted affected person has a small cell carcinoma of the lung, that is causing the
syndrome of irrelevant antidiuretic hormone (SIADH). The nurse will display cautiously for
a. Elevated overall urinary output.
B. Elevation of serum hematocrit.
C. Reduced serum sodium stage.
D. Fast and surprising weight reduction.
ANS: C decreased serum sodium degree.
,SIADH causes water retention and a decrease in serum sodium level. Weight loss, increased
urine output, and improved serum hematocrit can be associated with excessive loss of water,
however not with SIADH and water retention.
When the nurse is comparing the fluid stability for a patient admitted for hypovolemia associated
with more than one draining wounds, the most accurate evaluation to include is
a. Skin turgor.
B. Daily weight.
C. Presence of edema.
D. Hourly urine output.
ANS: B each day weight.
Daily weight is the most without difficulty obtained and correct approach of assessing extent
popularity. Skin turgor varies appreciably with age. Considerable excess fluid volume may be
gift earlier than fluid movements into the interstitial space and causes edema. Hourly urine
outputs do no longer take account of fluid intake or of fluid loss through insensible loss,
sweating, or loss from the gastrointestinal tract or wounds.
When worrying for an alert and orientated aged patient with a records of dehydration, the home
fitness nurse will teach the affected person to boom fluid intake
a. Within the late nighttime hours.
B. If the oral mucosa feels dry.
C. While the patient feels thirsty.
D. As quickly as adjustments in level of attention (LOC) arise.
ANS: B if the oral mucosa feels dry.
An alert, elderly patient will be capable of self-check for signs of oral dryness such as thick oral
secretions or dry-performing mucosa. The thirst mechanism decreases with age and is not an
accurate indicator of volume depletion. Many older sufferers favor to limit fluids barely within the
evening to improve sleep first-rate. The patient will now not be probably to observe and act
correctly whilst changes in LOC occur.
,We have an professional-written solution to this problem!
A affected person is taking a potassium-losing diuretic for remedy of high blood pressure. The
nurse will train the patient to report signs and symptoms of detrimental consequences inclusive
of
a. Character modifications.
B. Frequent loose stools.
C. Facial muscle spasms.
D.Generalized weak spot.
ANS: D generalized weak spot.
Generalized weak spot progressing to flaccidity is a manifestation of hypokalemia. Facial
muscle spasms may arise with hypocalcemia. Loose stools are associated with hyperkalemia.
Personality modifications are not related to electrolyte disturbances, although changes in
intellectual reputation are common manifestations with sodium excess or deficit.
Spironolactone (Aldactone), an aldosterone antagonist, is prescribed for a affected person as a
diuretic. Which statement by means of the affected person suggests that the teaching
approximately this remedy has been powerful?
A. "I will try and drink at least 8 glasses of water each day."
b. "I will use a salt alternative to lower my sodium intake."
c. "I will boom my consumption of potassium-containing ingredients."
d. "I will drink apple juice as opposed to orange juice for breakfast."
ANS: D "I will drink apple juice in preference to orange juice for breakfast."
Since spironolactone is a potassium-sparing diuretic, sufferers should be trained to select low
potassium meals consisting of apple juice in preference to ingredients that have higher ranges
of potassium, which include citrus fruits. Because the patient is the usage of spironolactone as a
diuretic, the nurse might not encourage the patient to increase fluid consumption. Teach
sufferers to keep away from salt substitutes, which are excessive in potassium.
, We have an professional-written option to this hassle!
When caring for a patient admitted with hyponatremia, which actions will the nurse anticipate
taking?
A. Restrict patient's oral unfastened water consumption.
B. Avoid use of electrolyte-containing drinks.
C. Infuse an answer of 5% dextrose in 0.45% saline.
D. Administer vasopressin (antidiuretic hormone, [ADH]).
ANS: A Restrict patient's oral unfastened water intake.
To help enhance serum sodium stages, water consumption is confined. Electrolyte-containing
liquids will improve the patient's sodium level. Administration of vasopressin or hypotonic IV
answers will decrease the serum sodium level further.
We have an professional-written method to this hassle!
Intravenous potassium chloride (KCl) 60 mEq is prescribed for remedy of a patient with
excessive hypokalemia. Which motion ought to the nurse take?
A. Administer the KCl as a rapid IV bolus.
B. Infuse the KCl at a rate of 20 mEq/hour.
C. Give the KCl handiest via a central venous line.
D. Add no more than 40 mEq/L to a liter of IV fluid.
ANS: B
ANS: B Infuse the KCl at a charge of 20 mEq/hour.
Intravenous KCl is run at a maximal rate of 20 mEq/hr. Rapid IV infusion of KCl can reason
cardiac arrest. Although the preferred awareness for KCl is not any more than forty mEq/L,
concentrations up to eighty mEq/L may be used for a few sufferers. KCl can purpose
inflammation of peripheral veins, however it can be administered by way of this route.
A postoperative patient who has been receiving nasogastric suction for three days has a serum
sodium stage of 125 mEq/L (a hundred twenty five mmol/L). Which of those prescribed
treatment options that the affected person has been receiving need to the nurse question?
Acid-Base Imbalances, Lewis Med-Surg
Ch 17, Lewis Ch 17: Fluid/Electrolyte/
Acid-Base Imbalances
The nurse obtains all the following evaluation records approximately a affected person with
deficient fluid volume because of a massive burn damage. Which of the subsequent evaluation
records may be of greatest problem?
A. The blood pressure is ninety/40 mm Hg.
B. Urine output is 30 ml over the last hour.
C. Oral fluid intake is one hundred ml for the final 8 hours.
D. There is extended pores and skin tenting over the sternum.
ANS: A The blood strain is ninety/forty mm Hg.
The blood stress shows that the affected person may be growing hypovolemic surprise due to
fluid loss. This would require instant intervention to prevent the complications related to
systemic hypoperfusion. The poor oral intake, decreased urine output, and pores and skin
tenting all imply the need for growing the patient's fluid consumption but not as urgently as the
hypotension.
A currently admitted affected person has a small cell carcinoma of the lung, that is causing the
syndrome of irrelevant antidiuretic hormone (SIADH). The nurse will display cautiously for
a. Elevated overall urinary output.
B. Elevation of serum hematocrit.
C. Reduced serum sodium stage.
D. Fast and surprising weight reduction.
ANS: C decreased serum sodium degree.
,SIADH causes water retention and a decrease in serum sodium level. Weight loss, increased
urine output, and improved serum hematocrit can be associated with excessive loss of water,
however not with SIADH and water retention.
When the nurse is comparing the fluid stability for a patient admitted for hypovolemia associated
with more than one draining wounds, the most accurate evaluation to include is
a. Skin turgor.
B. Daily weight.
C. Presence of edema.
D. Hourly urine output.
ANS: B each day weight.
Daily weight is the most without difficulty obtained and correct approach of assessing extent
popularity. Skin turgor varies appreciably with age. Considerable excess fluid volume may be
gift earlier than fluid movements into the interstitial space and causes edema. Hourly urine
outputs do no longer take account of fluid intake or of fluid loss through insensible loss,
sweating, or loss from the gastrointestinal tract or wounds.
When worrying for an alert and orientated aged patient with a records of dehydration, the home
fitness nurse will teach the affected person to boom fluid intake
a. Within the late nighttime hours.
B. If the oral mucosa feels dry.
C. While the patient feels thirsty.
D. As quickly as adjustments in level of attention (LOC) arise.
ANS: B if the oral mucosa feels dry.
An alert, elderly patient will be capable of self-check for signs of oral dryness such as thick oral
secretions or dry-performing mucosa. The thirst mechanism decreases with age and is not an
accurate indicator of volume depletion. Many older sufferers favor to limit fluids barely within the
evening to improve sleep first-rate. The patient will now not be probably to observe and act
correctly whilst changes in LOC occur.
,We have an professional-written solution to this problem!
A affected person is taking a potassium-losing diuretic for remedy of high blood pressure. The
nurse will train the patient to report signs and symptoms of detrimental consequences inclusive
of
a. Character modifications.
B. Frequent loose stools.
C. Facial muscle spasms.
D.Generalized weak spot.
ANS: D generalized weak spot.
Generalized weak spot progressing to flaccidity is a manifestation of hypokalemia. Facial
muscle spasms may arise with hypocalcemia. Loose stools are associated with hyperkalemia.
Personality modifications are not related to electrolyte disturbances, although changes in
intellectual reputation are common manifestations with sodium excess or deficit.
Spironolactone (Aldactone), an aldosterone antagonist, is prescribed for a affected person as a
diuretic. Which statement by means of the affected person suggests that the teaching
approximately this remedy has been powerful?
A. "I will try and drink at least 8 glasses of water each day."
b. "I will use a salt alternative to lower my sodium intake."
c. "I will boom my consumption of potassium-containing ingredients."
d. "I will drink apple juice as opposed to orange juice for breakfast."
ANS: D "I will drink apple juice in preference to orange juice for breakfast."
Since spironolactone is a potassium-sparing diuretic, sufferers should be trained to select low
potassium meals consisting of apple juice in preference to ingredients that have higher ranges
of potassium, which include citrus fruits. Because the patient is the usage of spironolactone as a
diuretic, the nurse might not encourage the patient to increase fluid consumption. Teach
sufferers to keep away from salt substitutes, which are excessive in potassium.
, We have an professional-written option to this hassle!
When caring for a patient admitted with hyponatremia, which actions will the nurse anticipate
taking?
A. Restrict patient's oral unfastened water consumption.
B. Avoid use of electrolyte-containing drinks.
C. Infuse an answer of 5% dextrose in 0.45% saline.
D. Administer vasopressin (antidiuretic hormone, [ADH]).
ANS: A Restrict patient's oral unfastened water intake.
To help enhance serum sodium stages, water consumption is confined. Electrolyte-containing
liquids will improve the patient's sodium level. Administration of vasopressin or hypotonic IV
answers will decrease the serum sodium level further.
We have an professional-written method to this hassle!
Intravenous potassium chloride (KCl) 60 mEq is prescribed for remedy of a patient with
excessive hypokalemia. Which motion ought to the nurse take?
A. Administer the KCl as a rapid IV bolus.
B. Infuse the KCl at a rate of 20 mEq/hour.
C. Give the KCl handiest via a central venous line.
D. Add no more than 40 mEq/L to a liter of IV fluid.
ANS: B
ANS: B Infuse the KCl at a charge of 20 mEq/hour.
Intravenous KCl is run at a maximal rate of 20 mEq/hr. Rapid IV infusion of KCl can reason
cardiac arrest. Although the preferred awareness for KCl is not any more than forty mEq/L,
concentrations up to eighty mEq/L may be used for a few sufferers. KCl can purpose
inflammation of peripheral veins, however it can be administered by way of this route.
A postoperative patient who has been receiving nasogastric suction for three days has a serum
sodium stage of 125 mEq/L (a hundred twenty five mmol/L). Which of those prescribed
treatment options that the affected person has been receiving need to the nurse question?
