CHAPTER 28 - FLUID AND ELECTROLYTES - PrepU

Endurance athletes who exercise for long periods of time and consume only water may experience a sodium deficit in their extracellular fluid. This electrolyte imbalance is known as: hyperkalemia. hypokalemia. hypernatremia. hyponatremia. - hyponatremia p. 849, 871 Rationale: Hyponatremia refers to a sodium deficit in the extracellular fluid caused by a loss of sodium or a gain of water. Hypernatremia refers to a surplus of sodium in the ECF. Hypokalemia refers to a potassium deficit in the ECF. Hyperkalemia refers to a potassium surplus in the ECF. A client's most recent blood work indicates a K+ level of 7.2 mEq/L, a finding that constitutes hyperkalemia. For what signs and symptoms should the nurse vigilantly monitor? - metabolic acidosis - increased intracranial pressure (ICP) - cardiac irregularities - muscle weakness - cardiac irregularities p. 862, Table 28-6 Rationale: Hyperkalemia compromises the normal functioning of the sodium-potassium pump and action potentials. The most serious consequence of this alteration in homeostasis is the risk for potentially fatal cardiac dysrhythmias. By which route do oxygen and carbon dioxide exchange in the lung? filtration osmosis diffusion active transport - diffusion p. 851 Rationale: Oxygen and carbon dioxide exchange in the lung's alveoli and capillaries by diffusion. Diffusion is the tendency of solutes to move freely throughout a solvent by moving from an area of higher concentration to an area of lower concentration. A nurse measures a client's 24-hour fluid intake and documents the findings. To be an accurate indicator of fluid status, what must the nurse also do with the information? - Compare the client's intake with the normal range of adult fluid intake. - Report the exact milliliter of intake to the physician's office nurse. - Ensure that the information is included in the verbal end-of-shift report. - Compare the total intake and output of fluids for the 24 hours. - - Compare the total intake and output of fluids for the 24 hours. p. 866 Rationale: The nurse must pay attention to certain parameters when assessing a client's fluid status. This means comparing the total intake and output of fluids for a given period of time. A physician writes an order to "force fluids." What will be the first action the nurse will take in implementing this order? Tell the client and family to increase oral intake. Decide how much fluid to increase every 8 hours. Divide the intake so the largest amount is at night. Explain to the client why this is needed. - Explain to the client why this is needed p. 871 Rationale: Several techniques are recommended to help the client drink greater than average amounts of fluids. Begin by explaining to the client in understandable terms the rationale for the increased fluids and the specific goal of taking the daily amount of fluids prescribed. A home care nurse is teaching a client and family about the importance of a balanced diet. The nurse determines that the education was successful when the client identifies which of the following as a rich source of potassium? Processed meat Bread products Dairy products Apricots - Apricots p. 856 Rationale: Apricots are a rich source of potassium. Dairy products are rich sources of calcium. Processed meat and bread products provide sodium. A home care nurse is visiting a client with renal failure who is on fluid restriction. The client tells the nurse, "I get thirsty very often. What might help?" What would the nurse include as a suggestion for this client? Use regular gum and hard candy. Eat crackers and bread. Use an alcohol-based mouthwash to moisten your mouth. Avoid salty or excessively sweet fluids. - Avoid salty or excessively sweet fluids. p. 873 Rationale: To minimize thirst in a client on fluid restriction, the nurse should suggest the avoidance of salty or excessively sweet fluids. Gum and hard candy may temporarily relieve thirst by drawing fluid into the oral cavity because the sugar content increases oral tonicity. Fifteen to 30 minutes later, however, oral membranes may be even drier than before. Dry foods, such as crackers and bread, may increase the client's feeling of thirst. Allowing the client to rinse the mouth frequently may decrease thirst, but this should be done with water, not alcohol-based, mouthwashes, which would have a drying effect. The student nurse studying fluid and electrolyte balance learns that which of the following is a function of water? Select all that apply. - provides a medium for transporting wastes to cells and nutrients from cells - helps maintain normal body temperature - acts as a buffer for electrolytes and nonelectrolytes - facilitates digestion and promotes elimination