Lewis: Medical-Surgical
Nursing~Chapter 17
A nurse inside the outpatient sanatorium who notes that a patient has a reduced magnesium
degree have to ask the patient approximately:
a. Day by day alcohol consumption
b. Consumption of dietary protein
c. Multivitamin/mineral use
d. Use of over-the-counter (OTC) laxatives - ANS-Answer: a. Every day alcohol consumption.
Hypomagnesemia is associated with alcoholism. Protein intake might not have a good sized
effect on magnesium degree. OTC laxatives (including milk of magnesia) and use of
multivitamin/mineral supplements could have a tendency to increase magnesium stage.
A patient has the following arterial blood fuel (ABG) outcomes: pH 7.32, PaO2 88 mm Hg,
PaCO2 37 mm Hg, and HCO3 sixteen mEq/L. The nurse interprets these results as:
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis - ANS-Answer: a. Metabolic acidosis.
The pH and HCO3 indicate that the patient has a metabolic acidosis. The ABGs are inconsistent
with the alternative responses.
A patient is receiving three% NaCl answer for correction of hyponatremia. During management
of the answer, the most essential evaluation for the nurse to monitor is:
a. Lung sounds.
B. Urinary output.
C. Peripheral pulses.
D. Peripheral edema. - ANS-Answer: a. Lung sounds.
Hypertonic solutions motive water retention, so the affected person need to be monitored for
signs and symptoms of fluid excess. Crackles inside the lungs might also suggest the onset of
pulmonary edema and are the maximum serious of the symptoms of fluid excess listed.
Bounding peripheral pulses, peripheral edema, or modifications in urine output are also
important to display whilst administering hypertonic solutions, but they do now not suggest
acute breathing or cardiac decompensation.
, A affected person is taking potassium-wasting diuretic for treatment of high blood pressure. The
nurse will educate the patient to file signs and symptoms of unfavourable effects which include:
a. Character changes.
B. Common loose stools.
C. Facial muscle spasms.
D. Generalized weakness. - ANS-Answer: d. Generalized weak point.
Generalized weak point progressing to flaccidity is a manifestation of hypokalemia. Facial
muscle spasms would possibly arise with hypocalcemia. Loose stools are associated with
hyperkalemia. Personality modifications aren't associated with electrolyte disturbances, even
though adjustments in intellectual popularity are common manifestations with sodium extra or
deficit.
A affected person receiving isoosmolar continuous tube feedings develops restlessness,
agitation, and weak spot. Which laboratory result is most vital to report to the fitness care
company?
A. K+three.4 mEq/L (3.Four mmol/L)
b. Ca+27.8 mg/dl (1.95 mmol/L)
c. Na+154 mEq/L (154 mmol/L)
d. PO4-3 four.Eight mg/dl (1.Fifty five mmol/L) - ANS-Answer: c. Na+154 mEq/L (154 mmol/L)
The improved serum sodium level is steady with the patients neurologic signs and indicates a
need for immediate action to prevent similarly severe complications together with seizures. The
potassium and calcium levels vary slightly from the regular but do no longer require any on the
spot movement through the nurse. The phosphate stage is in the regular parameters.
A patient who has an infusion of fifty% dextrose prescribed asks the nurse why a peripherally
inserted central catheter must be inserted. Which clarification by using the nurse is accurate?
A. The prescribed infusion may be given a great deal more unexpectedly when the patient has a
significant line.
B. There is a reduced danger for contamination while 50% dextrose is infused via a relevant
line.
C. The 50% dextrose is hypertonic and will be extra swiftly diluted when given through a
important line.
D. The required blood glucose tracking is extra correct whilst samples are obtained from a
central line. - ANS-Answer: c. The 50% dextrose is hypertonic and can be more unexpectedly
diluted while given via a important line.
Shrinkage of purple blood cells can occur when answers with dextrose concentrations greater
than 10% are administered intravenously. Blood glucose checking out isn't more correct whilst
samples are obtained from a important line. The contamination risk is higher with a crucial
catheter than with peripheral IV strains. Hypertonic or concentrated IV answers are not given
hastily.
Nursing~Chapter 17
A nurse inside the outpatient sanatorium who notes that a patient has a reduced magnesium
degree have to ask the patient approximately:
a. Day by day alcohol consumption
b. Consumption of dietary protein
c. Multivitamin/mineral use
d. Use of over-the-counter (OTC) laxatives - ANS-Answer: a. Every day alcohol consumption.
Hypomagnesemia is associated with alcoholism. Protein intake might not have a good sized
effect on magnesium degree. OTC laxatives (including milk of magnesia) and use of
multivitamin/mineral supplements could have a tendency to increase magnesium stage.
A patient has the following arterial blood fuel (ABG) outcomes: pH 7.32, PaO2 88 mm Hg,
PaCO2 37 mm Hg, and HCO3 sixteen mEq/L. The nurse interprets these results as:
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis - ANS-Answer: a. Metabolic acidosis.
The pH and HCO3 indicate that the patient has a metabolic acidosis. The ABGs are inconsistent
with the alternative responses.
A patient is receiving three% NaCl answer for correction of hyponatremia. During management
of the answer, the most essential evaluation for the nurse to monitor is:
a. Lung sounds.
B. Urinary output.
C. Peripheral pulses.
D. Peripheral edema. - ANS-Answer: a. Lung sounds.
Hypertonic solutions motive water retention, so the affected person need to be monitored for
signs and symptoms of fluid excess. Crackles inside the lungs might also suggest the onset of
pulmonary edema and are the maximum serious of the symptoms of fluid excess listed.
Bounding peripheral pulses, peripheral edema, or modifications in urine output are also
important to display whilst administering hypertonic solutions, but they do now not suggest
acute breathing or cardiac decompensation.
, A affected person is taking potassium-wasting diuretic for treatment of high blood pressure. The
nurse will educate the patient to file signs and symptoms of unfavourable effects which include:
a. Character changes.
B. Common loose stools.
C. Facial muscle spasms.
D. Generalized weakness. - ANS-Answer: d. Generalized weak point.
Generalized weak point progressing to flaccidity is a manifestation of hypokalemia. Facial
muscle spasms would possibly arise with hypocalcemia. Loose stools are associated with
hyperkalemia. Personality modifications aren't associated with electrolyte disturbances, even
though adjustments in intellectual popularity are common manifestations with sodium extra or
deficit.
A affected person receiving isoosmolar continuous tube feedings develops restlessness,
agitation, and weak spot. Which laboratory result is most vital to report to the fitness care
company?
A. K+three.4 mEq/L (3.Four mmol/L)
b. Ca+27.8 mg/dl (1.95 mmol/L)
c. Na+154 mEq/L (154 mmol/L)
d. PO4-3 four.Eight mg/dl (1.Fifty five mmol/L) - ANS-Answer: c. Na+154 mEq/L (154 mmol/L)
The improved serum sodium level is steady with the patients neurologic signs and indicates a
need for immediate action to prevent similarly severe complications together with seizures. The
potassium and calcium levels vary slightly from the regular but do no longer require any on the
spot movement through the nurse. The phosphate stage is in the regular parameters.
A patient who has an infusion of fifty% dextrose prescribed asks the nurse why a peripherally
inserted central catheter must be inserted. Which clarification by using the nurse is accurate?
A. The prescribed infusion may be given a great deal more unexpectedly when the patient has a
significant line.
B. There is a reduced danger for contamination while 50% dextrose is infused via a relevant
line.
C. The 50% dextrose is hypertonic and will be extra swiftly diluted when given through a
important line.
D. The required blood glucose tracking is extra correct whilst samples are obtained from a
central line. - ANS-Answer: c. The 50% dextrose is hypertonic and can be more unexpectedly
diluted while given via a important line.
Shrinkage of purple blood cells can occur when answers with dextrose concentrations greater
than 10% are administered intravenously. Blood glucose checking out isn't more correct whilst
samples are obtained from a important line. The contamination risk is higher with a crucial
catheter than with peripheral IV strains. Hypertonic or concentrated IV answers are not given
hastily.
