Exam 38: Fluids, Electrolytes, Acidbase Balance

The nurse is aware that a balance between fluid intake and output is essential to maintain homeostasis. Excesses or deficits of intake can lead to severe disorders. In a healthy adult, which of the following regulate body fluids? Select all that apply.

A client has a continuous IV infusion at 60 mL/hr. The right-hand IV has infiltrated, and the nurse has started a new IV line on the left forearm. Which of the following interventions should the nurse also perform?

A client is receiving an IV infusion of lactated Ringer's solution and 40 mEq of potassium chloride (KCl) at 100 mL/hr. When assessing the IV site, the nurse notes swelling, erythema, and warmth. There is a palpable cord along the vein, and the infusion is sluggish. The client is complaining of pain at the site. The nurse would recognize these findings to be consistent with which of the following?

The nurse gathers the following data: blood pressure (BP) = 150/94 mm Hg; neck veins distended; pulse (P) = 104 beats/min; pulse bounding; respiratory rate (RR) = 20 breaths/min; temperature (T) = 37 $\degree$ C (98.6 $\degree$ F). What disorder should the nurse suspect?

Which of the following is the most appropriate goal for a client with the nursing diagnosis of Deficient Fluid Volume?

A client's blood group is B. The nurse knows the client can receive blood only from donors with what group of blood? Select all that apply.

Which of the following best describes the sodium-potassium pump that maintains the unique composition of extracellular and intracellular compartments?

A client has been diagnosed with hypovolemia. Which prescriptions for hydration should the nurse question? Select all that apply.

The nurse has started to infuse the first of two units of packed red blood cells (PRBCs) on her client. What is the nurse's next best action?

A client has been admitted to the nursing unit with a diagnosis of chronic renal failure. The client is scheduled for the first dialysis session in the morning. Which of the following are appropriate nursing interventions for the client? Select all that apply.

A 60-year-old woman complains of muscle weakness, constipation, nausea, and frequent urination and is displaying bizarre behavior. The woman takes prescribed thiazide diuretics and steroids for asthma. What statement made by the client might indicate an additional cause of her symptoms?

The nurse is assessing the client in the long-term care facility and notes that client has bilateral pedal pitting edema. The nurse knows that this signifies excess volume in which fluid compartment?

A client is admitted to the emergency department (ED) in respiratory distress. The results of the arterial blood gases are the following: pH = 7.30; partial pressure of carbon dioxide (PCO₂) = 40; bicarbonate (HCO₃) = 19 mEq/L; partial pressure of oxygen (PO₂) = 80. The nurse interprets the findings as which of the following?

When a client has metabolic acidosis; which body system influences the acid-base imbalance to produce the compensatory changes in the arterial blood gases?

The nurse assesses that her client's intravenous solution has infiltrated into the tissues. What action should she take first?

The nurse is caring for a client with metabolic acidosis secondary to renal failure caused by poor glucose regulation. The client reports a headache, weakness, and nausea. The nurse assesses an elevated blood sugar, Kussmaul's breathing, and peripheral vasodilation. What collaborative interventions will the nurse anticipate to restore pH balance? Select all that apply.

The client presents to the emergency department with a bicarbonate (HCO_3-) level of 14 mEq/L. What may be the explanation for this laboratory result?

The nurse is assessing the client with renal failure and notes that the client's respirations are depressed, the client is lethargic with depressed respirations. His blood pressure (BP) is 80/40 mm Hg; pulse (P) is 58 beats/min; respiration rate (RR) is 12 breaths/min; and hypoactive reflexes are present. Which of the following may be the cause of these symptoms?

The nurse is caring for a client who has the following lab results: sodium (Na) 147; potassium (K) 3.6; calcium (Ca) 8.8; magnesium (Mg) 1.9. The following prescriptions are written in the client's electronic health record. Which one should the nurse question?

Which electrolyte is the primary regulator of fluid volume?