Fundamentals of Nursing

Nursing

Quiz 52 :

Fluid, Electrolyte, and Acidbase Balance

Quiz 52 :

Fluid, Electrolyte, and Acidbase Balance

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A man brings his elderly wife to the emergency department. He states that she has been vomiting and has had diarrhea for the past 2 days. She appears lethargic and is complaining of leg cramps. What should the nurse do first? 1) Start an IV. 2) Review the results of serum electrolytes. 3) Offer the woman foods that are high in sodium and potassium content. 4) Administer an antiemetic.
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Starting intravenous administration of fluids and electrolytes can be done only after reviewing the concentrations of various electrolytes in the serum. Only the deficient electrolyte should be administered to the patient.
Providing food that is rich in sodium and potassium and administration of antiemetics are some of the interventions that are to be performed only after assessing the serum electrolyte state of the patient. Antiemetic drugs are administered to the patients to treat nausea and vomiting.
Hence, the options 1, 3 and 4 are incorrect.
Before performing the required interventions, the nurse firstly have to review the results of various electrolytes present in the serum of the patient. The concentration of serum electrolytes will help in deciding for the intervention to be performed by the nurse.
Hence, the correct answer is option
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The client's arterial blood gas results are pH 7.32; PaCO 2 58; HCO 3 32. The nurse knows that the client is experiencing which acid-base imbalance? 1) Metabolic acidosis 2) Respiratory acidosis 3) Metabolic alkalosis 4) Respiratory alkalosis
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Metabolic acidosis is a medical condition that results from gain of hydrogen ion and loss of HCO 3 (bicarbonate). This condition arises in cases of bicarbonate infusion, diarrhea and kidney failure.
It is characterized by pH value of less than 7.35, partial pressure of carbon dioxide (paCO 2 ) between 35-45 mmHg (millimeters of mercury) and HCO 3 concentration of less than 22 mEq/L (milliequivalents per liter). Respiratory alkalosis results due to decreased level of acid and retention of bicarbonate.
It is characterized by pH value of more than 7.45, paCO 2 of less than 38 mmHg and HCO 3 concentration of more than 26 mEq/L. Metabolic alkalosis results from loss of hydrogen ions and gain of bicarbonate which can occur due to gastric suction and vomiting.
Hence, the options 1, 3 and 4 are incorrect.
Respiratory acidosis involves retention of carbon dioxide. Hence, this condition can be identified with pH reading of less 7.35, paCO 2 more than 42 mmHg and varying readings of HCO 3 concentration. A recording of arterial blood with pH of 7.32, paCO 2 of 58 mmHg and HCO 3 concentration to be 32 mEq/L indicates a condition of respiratory acidosis.
Hence, the correct answer is option
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The intake and output (l O) record of a client with a nasogastric tube who has been attached to suction for 2 days shows greater output than input. Which nursing diagnoses are most applicable? Select all that apply. 1) Deficient Fluid Volume 2) Risk for Deficient Fluid Volume 3) Impaired Oral Mucous Membranes 4) Impaired Gas Exchange 5) Decreased Cardiac Output
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The patient is supplied with a nasogastric tube and is attached to suction for 2 days. The output of the client is recorded to be greater than the input. This indicates a condition of fluid volume deficit.
Risk for deficient fluid volume does not diagnose this problem. Impaired gas exchange is a symptom of a condition of fluid volume excess in which the intake of fluid exceeds the output of fluids.
Hence, the options 2 and 4 are incorrect.
A recording of more output than input indicates deficiency of fluid volume. In the early stage of this condition, the mucous membrane of the mouth becomes dry with sunken eyeballs. Also, the pulse rate in such clients is recorded to be slow. Therefore, a decreased cardiac output can help in diagnosis of fluid volume deficit.
Hence, the correct answers are options
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Chapman asks why you weigh her every morning. How do you respond?
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A client is admitted to the hospital for hypocalcemia. Nursing interventions relating to which system would have the highest priority? 1) Renai 2) Cardiac 3) Gastrointestinal 4) Neuromuscular
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Offer suggestions for ways to help Mrs. Chapman increase her oral intake.
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The nurse administers an IV solution of D 5 1/2NS to a postoperative client. This is classified as what type of intravenous solution? __________
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The nurse would assess for signs of hypomagnesemia in which of the following clients? Select all that apply. 1) A client with renal failure 2) A client with pancreatitis 3) A client taking magnesium-containing antacids 4) A client with excessive nasogastric drainage 5) A client with chronic alcoholism
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An older man is admitted to the medical unit with a diagnosis of dehydration. Which sign or symptom is most representative of a sodium imbalance? 1) Hyperreflexia 2) Mental confusion 3) Irregular pulse 4) Muscle weakness
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An older nursing home resident has refused to eat or drink for several days and is admitted to the hospital. The nurse should expect which assessment finding? 1) Increased blood pressure 2) Weak, rapid pulse 3) Moist mucous membranes 4) Jugular vein distention
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Which client statement indicates a need for further teaching regarding treatment for hypokalemia? 1) "I will use avocado in my salads." 2) "I will be sure to check my heart rate before I take my digoxin." 3) "I will take my potassium in the morning after eating breakfast." 4) "I will stop using my salt substitute."
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An older client comes to the emergency department experiencing chest pain and shortness of breath. An arterial blood gas is ordered. Which of the following ABG results indicates respiratory acidosis? 1) pH 7.54; PaCO 2 28 mmHg; HCO 3 22 mEq/L 2) pH 7.32; PaCO 2 46 mmHg; HCO 3 24 mEq/L 3) pH 7.31; PaCO 2 35 mmHg; HCO 3 20 mEq/L 4) pH 7.50; PaCO 2 37 mmHg; HCO 3 28 mEq/L
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