Exam 38: Fluids, Electrolytes, Acidbase Balance

The nurse is assessing a client who has been vomiting for 2 days and has not been able to eat or drink anything during this time. The client's mucous membranes are dry, there is decreased skin turgor, and the client complains of weakness. The client's vital signs are blood pressure (BP) 80/52; temperature (T) = 99.6°F (37.6°C) orally; pulse (P) = 110 beats/min, weak and thready. Her skin and mucous membranes are dry, and there is decreased skin turgor. The following are the laboratory results: Sodium 138 mEq/L Potassium 3.7 mEq/L Calcium 9.2 mg/dL Magnesium 1.8 mg/dL Chloride 99 mEq/L Blood urea nitrogen (BUN) 29 mg/dL Which of the following is an appropriate nursing diagnosis for this client?

The nurse is caring for a client with no spontaneous respiratory effort who requires mechanical ventilation. The first blood gas after initiating the ventilator shows a pH of 7.52 and partial pressure of carbon dioxide (PCO₂) of 20. What intervention is required to correct this pH imbalance?

Identify the mechanisms involved in acid-base balance. Select all that apply.

When performing a central venous catheter dressing change, which of the following steps is correct?

A client had gastric surgery 10 days ago and continues to require gastric suction because of a paralytic ileus. The client reports tingling in the fingers, has hypertonic reflexes, and has a respiratory rate of 8 breaths per minute that are deep in nature. The nurse recognizes that these symptoms are consistent with which diagnosis?

A nurse is caring for a client with a peripheral IV line located in the right forearm. The client informs the nurse that the IV site is burning. Upon assessment the nurse determines that the IV solution has infiltrated. What site(s) is/are appropriate to consider when restarting the IV line? Select all that apply.

Which laboratory result on a client's health record should alert the nurse to a potential problem?

A client's arterial blood gas results are as follows: pH = 7.30; partial pressure of carbon dioxide (PCO₂) = 40; bicarbonate (HCO₃) = 19 mEq/L; partial pressure of oxygen (PO₂) = 80. An appropriate nursing diagnosis for the client is which of the following?

The nurse is to administer an intravenous (IV) solution to a client with diffuse edema. Which of the following prescriptions for this client would the nurse question?

A healthcare provider prescribes 250 mL of 0.9% sodium chloride to be infused over 2 hours. A micro-drip infusion set is being used. What is the drip rate (drops/min) that the nurse should monitor?

The nurse records a client's hourly urine output from an indwelling catheter as follows: 0700: 36 mL 0800: 45 mL 0900: 85 mL 1000: 62 mL 1100: 50 mL 1200: 48 mL 1300: 94 mL 1400: 78 mL 1500: 60 mL The nurse can conclude that the client's urine output should be described as which of the following?

The nurse is assessing a client in the acute care unit. The client's blood pressure is 80/40 mm Hg, pulse 120 beats/min and thready, has poor skin turgor, and has dry mucus membranes. Which of the following IV fluids would the nurse expect the healthcare provider to prescribe for this client's condition?

The nurse examines the electrocardiography (ECG) tracing of a client and notes tall T waves. What electrolyte imbalance should the nurse suspect?

An 82-year-old woman was brought to the emergency department by her granddaughter. She is a widow and lives alone, although her granddaughter checks on her daily. She has been vomiting for 2 days and has not been able to eat or drink anything during this time. She has not urinated for 12 hours. Physical examination reveals the following: temperature (T) = 99.6°F (37.6°C) orally; pulse (P) = 110 beats/min, weak and thready; blood pressure (BP) = 80/52 mm Hg. Her skin and mucous membranes are dry, and there is decreased skin turgor. The client states that she feels very weak. The following are her laboratory results: Sodium 138 mEq/L Potassium 3.7 mEq/L Calcium 9.2 mg/dL Magnesium 1.8 mg/dL Chloride 99 mEq/L Blood urea nitrogen (BUN) 29 mg/dL The nurse recognizes that the client is displaying symptoms associated with which of the following?

At a first aid station on a marathon route, a client complains of headache, muscle cramps, weakness, nausea, and confusion after the race. Which statement made by the client might explain these symptoms?

A client is admitted to the emergency department in respiratory distress. The initial arterial blood gases (ABGs) results are pH = 7.30; partial pressure of carbon dioxide (PCO₂) = 40; bicarbonate (HCO₃) = 19 mEq/L; partial pressure of oxygen (PO₂) = 80. The nurse evaluates the client's treatment plan by examining repeat ABGs. The results are pH = 7.38; PCO₂ = 32; HCO₃ = 19 mEq/L. The nurse concludes which of the following?

The nurse recognizes that a balance of fluid and electrolytes is essential to maintain homeostasis. Excesses or deficits can lead to severe disorders. Which of the following is the principal site for regulation of fluid and electrolyte balance?

A new father begins to hyperventilate as his baby is about to be born; he becomes light headed. The nurse instructs him to breathe into the paper bag until his breathing slows down. When he feels better he asks the nurse why using the paper bag helped him. What is the nurse's best response? "Breathing into the paper bag allowed you to

The nurse is caring for a client who is normally healthy but is experiencing dehydration secondary to acute diarrhea and vomiting. What assessment findings would indicate a return to fluid homeostasis? Select all that apply.

The nurse is caring for a client with heart failure. The client has chronic fluid volume excess secondary to ineffective pumping action of the heart. When teaching this client about fluid and electrolyte balance, which diet is most important for the nurse to explain?