Fundamentals of Nursing: Fluid and
Electrolyte Imbalance
A sixty eight-year-antique guy is admitted to the hospital with dehydration. He has a records of
atrial fibrillation, congestive heart failure (CHF), and hypertension. His current medicinal drugs
are digoxin (Lanoxin), chlorothiazide (Diuril), and oral potassium supplements. He tells the
nurse that he has had flulike signs for the beyond week and has been unable to drink for the
beyond forty eight hours. The health care provider requests laboratory specimens to be drawn
and an isotonic IV to be commenced. Which IV fluid does the nurse administer?
A. 0.Forty five% saline
B. Five% dextrose in 0.45% saline
C. 5% dextrose in Ringer's lactate
D. Five% dextrose in water (D5W) - ANS-D
five% dextrose in water (D5W) is an isotonic solution. 0.Forty five% saline is a hypotonic
solution, at the same time as five% dextrose in 0.Forty five% saline and five% dextrose in
Ringer's lactate are hypertonic solutions.
A 68-yr-vintage guy is admitted to the sanatorium with dehydration. He has a history of atrial
traumatic inflammation, congestive coronary heart failure, and high blood pressure. His
cutting-edge medications are digoxin (Lanoxin), chlorothiazide (Diuril), and potassium dietary
supplements. He tells a nurse that he has had flulike signs and symptoms for the beyond week
and has been unable to drink for the past 48 hours. The nurse starts the client's IV and receives
laboratory outcomes, which include a potassium degree of two.7 mEq/L. The health practitioner
orders an IV potassium complement. How does the nurse administer this remedy?
A. Added to an IV, no longer to exceed 20 mEq/hr
B. Added to an IV, no longer to exceed 30 mEq/hr
C. Rapid IV push, a 25-mEq dose
D. Slow IV push, a 30-mEq dose - ANS-A
The maximum encouraged infusion charge of potassium is five to 10 mEq/hr. This price is by no
means to exceed 20 mEq/hr below any situations. Potassium should never be administered via
IV push.
A 70-12 months-vintage female is admitted to the hospital with coronary heart failure, shortness
of breath, and three+ pitting edema in her lower extremities. Her modern medicines are
furosemide (Lasix), digoxin (Lanoxin), and an angiotensin-changing enzyme inhibitor (Lotensin).
She states that she stopped taking her Lasix because she did not assume that it was supporting
her heart failure. Her fitness care issuer orders furosemide (Lasix) 5 mg IV push. Which patron
assessment determines that the medication is operating?
A. Decreased blood strain (BP)
B. Increased coronary heart charge
C. Increased urine output
, D. Weight advantage - ANS-C
When giving Lasix, the nurse video display units the client for reaction to drug remedy,
particularly weight reduction and extended urine output. Although a fall within the patron's BP
can also occur with the decrease in body fluid, this is not the most important evaluation to be
monitored. Urinary output is maximum crucial. Lasix might also purpose a decrease in heart
charge because it lowers the purchaser's frame fluid, however this impact might take the time to
notice. Weight loss, in place of weight advantage, is regularly the effect of Lasix, however it
does no longer arise immediately.
A 70-year-vintage woman is admitted to the sanatorium with coronary heart failure, shortness of
breath, and three+ pitting edema in her decrease extremities. Her medications are furosemide
(Lasix), digoxin (Lanoxin), and an angiotensin-converting enzyme inhibitor (Lotensin). She
states that she stopped taking her Lasix because she did no longer assume that it turned into
assisting her heart failure. Her health care provider orders furosemide (Lasix) 5 mg IV push. Ten
hours after receiving the Lasix, the customer's potassium (K+) degree is 2.5 mEq/L. Knowing all
the consumer's medicinal drugs, what trouble does the nurse assume on this consumer?
A. Clinical manifestations of digoxin toxicity
B. Increased coronary heart price and blood strain (BP)
C. Increased signs of congestive coronary heart failure (CHF)
D. Signs and signs of hypernatremia - ANS-A
Hypokalemia increases the sensitivity of cardiac muscle to digoxin and can result in digoxin
toxicity, even if the digoxin stage is in the therapeutic variety. Heart rate and BP could be much
more likely to decrease with the medicinal drugs that the consumer is receiving coupled
together with her low potassium level. Use of a diuretic has a tendency to lower the signs of
CHF. High serum sodium stages might no longer be expected in this state of affairs.
A 77-12 months-antique girl is introduced to the emergency department via her circle of
relatives after she has had diarrhea for three days. The circle of relatives tells the nurse that she
has not been consuming or consuming properly, however that she has been taking her diuretics
for congestive coronary heart failure (CHF). Her laboratory consequences consist of a
potassium level of seven.0 mEq/L. What does the nurse include inside the customer's
medication coaching? (Select all that apply.)
A. Daily weights are a terrible indicator of fluid loss or gain.
B. Diuretics can lead to fluid and electrolyte imbalances.
C. Diuretics growth fluid retention.
D. Laxatives can cause fluid imbalance.
E. It is critical to weigh every day at the identical time. - ANS-B,D,E
Diuretics decrease fluid retention and growth lack of fluids, consequently can result in fluid and
electrolyte imbalances. Laxatives can also result in fluid imbalance. Daily weight recording is a
great indicator of fluid retention. Clients have to gain knowledge of to weigh themselves at the
same time, within the identical garb, and at the equal scale.
A seventy seven-12 months-antique woman is brought to the emergency branch by means of
her own family after she has had diarrhea for 3 days. The circle of relatives tells the nurse that
she has not been eating or ingesting well, but that she has been taking her diuretics for
congestive coronary heart failure (CHF). She is receiving lactated Ringer's solution IV for
Electrolyte Imbalance
A sixty eight-year-antique guy is admitted to the hospital with dehydration. He has a records of
atrial fibrillation, congestive heart failure (CHF), and hypertension. His current medicinal drugs
are digoxin (Lanoxin), chlorothiazide (Diuril), and oral potassium supplements. He tells the
nurse that he has had flulike signs for the beyond week and has been unable to drink for the
beyond forty eight hours. The health care provider requests laboratory specimens to be drawn
and an isotonic IV to be commenced. Which IV fluid does the nurse administer?
A. 0.Forty five% saline
B. Five% dextrose in 0.45% saline
C. 5% dextrose in Ringer's lactate
D. Five% dextrose in water (D5W) - ANS-D
five% dextrose in water (D5W) is an isotonic solution. 0.Forty five% saline is a hypotonic
solution, at the same time as five% dextrose in 0.Forty five% saline and five% dextrose in
Ringer's lactate are hypertonic solutions.
A 68-yr-vintage guy is admitted to the sanatorium with dehydration. He has a history of atrial
traumatic inflammation, congestive coronary heart failure, and high blood pressure. His
cutting-edge medications are digoxin (Lanoxin), chlorothiazide (Diuril), and potassium dietary
supplements. He tells a nurse that he has had flulike signs and symptoms for the beyond week
and has been unable to drink for the past 48 hours. The nurse starts the client's IV and receives
laboratory outcomes, which include a potassium degree of two.7 mEq/L. The health practitioner
orders an IV potassium complement. How does the nurse administer this remedy?
A. Added to an IV, no longer to exceed 20 mEq/hr
B. Added to an IV, no longer to exceed 30 mEq/hr
C. Rapid IV push, a 25-mEq dose
D. Slow IV push, a 30-mEq dose - ANS-A
The maximum encouraged infusion charge of potassium is five to 10 mEq/hr. This price is by no
means to exceed 20 mEq/hr below any situations. Potassium should never be administered via
IV push.
A 70-12 months-vintage female is admitted to the hospital with coronary heart failure, shortness
of breath, and three+ pitting edema in her lower extremities. Her modern medicines are
furosemide (Lasix), digoxin (Lanoxin), and an angiotensin-changing enzyme inhibitor (Lotensin).
She states that she stopped taking her Lasix because she did not assume that it was supporting
her heart failure. Her fitness care issuer orders furosemide (Lasix) 5 mg IV push. Which patron
assessment determines that the medication is operating?
A. Decreased blood strain (BP)
B. Increased coronary heart charge
C. Increased urine output
, D. Weight advantage - ANS-C
When giving Lasix, the nurse video display units the client for reaction to drug remedy,
particularly weight reduction and extended urine output. Although a fall within the patron's BP
can also occur with the decrease in body fluid, this is not the most important evaluation to be
monitored. Urinary output is maximum crucial. Lasix might also purpose a decrease in heart
charge because it lowers the purchaser's frame fluid, however this impact might take the time to
notice. Weight loss, in place of weight advantage, is regularly the effect of Lasix, however it
does no longer arise immediately.
A 70-year-vintage woman is admitted to the sanatorium with coronary heart failure, shortness of
breath, and three+ pitting edema in her decrease extremities. Her medications are furosemide
(Lasix), digoxin (Lanoxin), and an angiotensin-converting enzyme inhibitor (Lotensin). She
states that she stopped taking her Lasix because she did no longer assume that it turned into
assisting her heart failure. Her health care provider orders furosemide (Lasix) 5 mg IV push. Ten
hours after receiving the Lasix, the customer's potassium (K+) degree is 2.5 mEq/L. Knowing all
the consumer's medicinal drugs, what trouble does the nurse assume on this consumer?
A. Clinical manifestations of digoxin toxicity
B. Increased coronary heart price and blood strain (BP)
C. Increased signs of congestive coronary heart failure (CHF)
D. Signs and signs of hypernatremia - ANS-A
Hypokalemia increases the sensitivity of cardiac muscle to digoxin and can result in digoxin
toxicity, even if the digoxin stage is in the therapeutic variety. Heart rate and BP could be much
more likely to decrease with the medicinal drugs that the consumer is receiving coupled
together with her low potassium level. Use of a diuretic has a tendency to lower the signs of
CHF. High serum sodium stages might no longer be expected in this state of affairs.
A 77-12 months-antique girl is introduced to the emergency department via her circle of
relatives after she has had diarrhea for three days. The circle of relatives tells the nurse that she
has not been consuming or consuming properly, however that she has been taking her diuretics
for congestive coronary heart failure (CHF). Her laboratory consequences consist of a
potassium level of seven.0 mEq/L. What does the nurse include inside the customer's
medication coaching? (Select all that apply.)
A. Daily weights are a terrible indicator of fluid loss or gain.
B. Diuretics can lead to fluid and electrolyte imbalances.
C. Diuretics growth fluid retention.
D. Laxatives can cause fluid imbalance.
E. It is critical to weigh every day at the identical time. - ANS-B,D,E
Diuretics decrease fluid retention and growth lack of fluids, consequently can result in fluid and
electrolyte imbalances. Laxatives can also result in fluid imbalance. Daily weight recording is a
great indicator of fluid retention. Clients have to gain knowledge of to weigh themselves at the
same time, within the identical garb, and at the equal scale.
A seventy seven-12 months-antique woman is brought to the emergency branch by means of
her own family after she has had diarrhea for 3 days. The circle of relatives tells the nurse that
she has not been eating or ingesting well, but that she has been taking her diuretics for
congestive coronary heart failure (CHF). She is receiving lactated Ringer's solution IV for
