ATI med surg fluid, electrolyte, and acid-base

A nurse is planning care for a client who has experienced excessive fluid loss. Which of the following interventions should the nurse include in the plan of care? A. Administer IV fluids evenly over 24 hr. B. Provide the client with a salt substitute. C. Assess for pitting edema. D. Encourage the client to rise slowly when standing up. E. Weigh the client every 8 hr. A, D, E A nurse is caring for a client who has a serum sodium level of 155 mEq/L. Which of the following IV fluid prescriptions should the nurse anticipate administering? a. Dextrose 5% in 0.9% sodium chloride b. dextrose 5% in lactated ringer's c. 3% sodium chloride d. 0.45% sodium chloride D. this pt is hypernatremic, so want to give a hypotonic solution The 0.45% sodium chloride is a hypotonic solution used to provide free water and treat cellular dehydration, which promotes waste elimination by the kidneys. A nurse is reviewing the lab report of a client who has fluid volume excess. Which of the following lab values should the nurse expect? a. Hemoglobin 20 g/dL. b. Hematocrit 34%. c. BUN 25 mg/dL. d. Urine specific gravity 1.050. b. hematocrit 34% fluid volume excess will cause what in hemoglobin levels? Hgb reference range = 13.5-17.5 for males & 12-15.5 for females, therefore, the listed value is above the reference range. Fluid volume excess can cause hemodilution and a decreased Hgb level. fluid volume excess will do what to the BUN level? why? Fluid volume excess can cause a decrease in BUN (normal reference range = 10-20 mg/dL). The BUN level listed is increased, which is associated with dehydration. Fluid volume excess will do what to specific gravity of urine? why? Fluid volume excess can cause a decrease in urine specific gravity (normal reference range = 1.010-1.025). The urine specific gravity listed is increased, which is associated with dehydration. A nurse is caring for a client who is receiving furosemide daily. During the morning assessment, the client tells the nurse that he is "feeling weak in the legs." Which of the following actions should the nurse take first? a. Monitor the client's bowel sounds. b. Review the client's daily laboratory results. c. Auscultate the client's lungs. d. Palpate the client's peripheral pulses. C. an adverse affect of many diuretics is hypokalemia; so check lungs for any respi changes due to weakness of the respi muscles A nurse is caring for a client who reports difficulty breathing and tingling in both hands. His respirations are 36/min and he appears very restless. Which of the following values should the nurse anticipate to be outside the expected reference range if the client is experiencing respiratory alkalosis? A. PaO2 B. PaCO2 C. Sodium D. Bicarbonate B. paCO2 due to hyperventilation A nurse is assessing a client who has a serum calcium level of 8.1 mg/dL. Which of the following findings is the priority for the nurse to assess? A. Deep-tendon reflexes B. Cardiac rhythm C. Peripheral sensation D. Bowel sounds B. Cardiac rhythm rationale: Calcium levels below the expected reference range can cause ECG changes, bradycardia, or tachycardia. While reviewing a client's laboratory results, a nurse notes a serum calcium level of 8.0 mg/dL. Which of the following actions should the nurse take? A. Implement seizure precautions B. Administer phosphate C. Initiate diuretic therapy D. Prepare client for hemodialysis calcemias do the opposite of the prefix; so decreased calcium means seizures A nurse is providing teaching for a client who is at risk for developing respiratory acidosis following surgery. Which of the following statements by the client indicates an understanding of the teaching?A. "I should conserve energy by limiting my physical activity." B. "I will wait until my pain is at least 6 out of 10 before I use the PCA." C. "I will limit my daily fluid intake to 2 to 3 glasses." D. "I will use the incentive spirometer every hour." D. respiratory depression and limited chest expansion are both causes of respi acidosis. so using an incentive spirometer will promote adequate chest expansion. A nurse is assessing a client who has a serum phosphorus level of 2.4 mg/dL. Which of the following findings should the nurse expect? A. Hepatic failure B. Abdominal pain C. Slow peripheral pulsations D. Increase in cardiac output C. phosphate is the opp of calcium, and since calcium does the opp of its prefix that means phosphate would do the same as its prefix SO hypo = slow HR! A nurse is caring for a client who requires continuous cardiac monitoring. The nurse identifies a prolonged PR interval and a widened QRS complex. Which of the following laboratory values supports this finding? A. Sodium 152 mEq/L B. Chloride 102 mEq/L C. Magnesium 1.8 mEq/L D. Potassium 6.1 mg/L D. hyperkalemia can cause a prolonged PR interval, a wide QRS complex, flat or absent P waves, and tall, peaked T waves When assessing a client with dehydration, what assessment is a priority? a. skin turgor b. urine output c. mental status d. weight c. mental status cus not safe A nurse is evaluating a client who is receiving IV fluids to treat isotonic dehydration. Which of the following laboratory findings indicates that the fluid therapy has been effective? A. BUN 26 mg/dL B. Serum sodium 142 mEq/L C. Hct 56% D. Urine specific gravity 1.035 B. because 142 is within expected range!