Deck 16: Caring for Clients With Fluid, Electrolyte,and Acid base imbalances

Question 1

A client was admitted to your unit with a diagnosis of hypovolemia. When it is time to complete discharge teaching, which of the following will the nurse teach the client and their family? Select all that apply.

A) Drink at least 8 glasses of fluid each day.
B) Drink caffeinated beverages to retain fluid.
C) Drink carbonated beverages to help balance fluid volume.
D) Drink water as an inexpensive way to meet fluid needs.
E) Respond to thirst.

Answer 1

Drink at least 8 glasses of fluid each day.
Drink water as an inexpensive way to meet fluid needs.
Respond to thirst.

Question 2

The nurse is caring for a client who is exhibiting symptoms of tachypnea and circumoral paresthesias. What should be the nurse's first course of action?

A) Stop mechanical ventilation.
B) Administer cardiopulmonary resuscitation (CPR).
C) Give a dose of aspirin.
D) Find and correct the cause of tachypnea.

Answer 2

Find and correct the cause of tachypnea.

Question 3

A nursing instructor is teaching her class about burns. The instructor relates the following scenario: A nurse is caring for a severely burned client who now has elevated hematocrit and blood cell counts. What consequences should the nurse expect in this client?

A) Slow heart rate
B) Kidney stones and blood clots
C) Imbalance in electrolytes
D) Elevated central venous pressure (CVP)

Answer 3

Kidney stones and blood clots

Question 4

You are caring for a client with severe hypokalemia. The physician has ordered IV potassium to be administered at 10 mEq/hr. The client complains of burning along their vein. What should you do?

A) Dilute the infusion.
B) Switch to an oral formulation.
C) Increase the speed of transfusion.
D) Change the electrolyte.

Question 5

The Emergency Department (ED) nurse is caring for a client who is known to make excessive use of laxatives who is showing signs of bradycardia. The client is admitted for hemodialysis. The ED nurse knows that a major goal of managing this client is what?

A) Flush out excess magnesium
B) Prevent magnesium sulfate reactions
C) Provide mechanical ventilation
D) Stop all laxatives

Question 6

Your clients lab values are sodium 166 mEq/L, potassium 5.0 mEq/L, chloride 115 mEq/L, and bicarbonate 35 mEq/L. What condition is this client likely to have, judging by anion gap?

A) Metabolic acidosis
B) Respiratory alkalosis
C) Metabolic alkalosis
D) Respiratory acidosis

Question 7

You are caring for a new client on your unit who is third-spacing fluid. You know to assess for what type of edema?

A) Generalized
B) Dependent
C) Brassy
D) Pitting

Question 8

The Emergency Department (ED) nurse is caring for a client with a possible acid-base imbalance. The physician has ordered an arterial blood gas (ABG). What is one of the most important indications of an acid-base imbalance that is shown in an ABG?

A) PaO₂
B) PO₂
C) Carbonic acid
D) Bicarbonate

Question 9

The nursing instructor is talking with her junior nursing class about fluid and electrolyte balance. What would the instructor tell her students is the average daily fluid intake for an adult?

A) 2000 mL
B) 2500 mL
C) 3000 mL
D) 3500 mL

Question 10

A client is brought in by ambulance in a nauseous and confused state and demonstrating carpopedal spasm. Initial arterial blood gasesshow increased pH and HCO3and normal PaCO₂ levels. Breathing is slow and shallow. As the nurse caring for this client, you know that potassiumsalt should be a part of the treatment for this client when?

A) Always
B) When hypokalemia is present
C) When there is volume depletion
D) When base bicarbonate accumulates

Question 11

Which of the following conditions does the nurse need to confirm when he or she taps the facial nerve of a client who has dysphagia?

A) Hypervolemia
B) Hypercalcemia
C) Hypomagnesemia
D) Hypermagnesemia

Question 12

You are an ICU nurse who has just admitted a new client with an acid/base imbalance. What would you do to provide accurate baseline data for this client?

A) Record intake and output
B) Monitor lab values
C) Document presenting signs and symptoms
D) Implement medication ordered

Question 13

The ICU nurse is precepting a nursing student. They are caring for a client who is in acute renal failure and anuric. The student asks the nurse how this client loses fluid from their body. What should the nurse respond? Select all that apply.

A) Drooling
B) Bleeding
C) Breathing
D) Bowel elimination
E) Perspiration

Question 14

What is one process by which dissolved chemicals from one area of the body to another?

A) Passive osmosis
B) Free flow
C) Passive elimination
D) Active transport

Question 15

A fluid volume deficit can be caused by either dehydration or hypovolemia. What is the distinction between the two?

A) In hypovolemia all fluid compartments have decreased volumes.
B) In dehydration intracellular fluid volume is depleted.
C) In hypovolemia only blood volume is low.
D) In dehydration only blood volume is low.

Question 16

You are caring for a client that has been admitted with a possible clotting disorder. The client is complaining of excessive bleeding and bruising without cause. You know that you should take extra care to check for signs of bruising or bleeding in what condition?

A) Dehydration
B) Hypokalemia
C) Hypocalcemia
D) Hypomagnesemia

Question 17

You are caring for a 72-year-old client who has been admitted to your unit for a fluid volume imbalance. You know which of the following is the most common fluid imbalance in older adults?

A) Hypovolemia
B) Dehydration
C) Hypervolemia
D) Fluid volume excess

Question 18

A 64-year-old client is brought in to the clinic with thirsty, dry, sticky mucous membranes, decreased urine output, fever, a rough tongue, and lethargy. Serum sodium level is above 145 mEq/L. Should the nurse start salt tablets when caring for this client?

A) Yes, this will correct the sodium deficit.
B) Yes, along with the hypotonic IV.
C) No, start with the sodium chloride IV.
D) No, sodium intake should be restricted.

Question 19

In a pre-nursing pathophysiology class the instructor is teaching about the regulation of fluid volume. How is fluid volume primarily regulated?

A) Urine excretion
B) Breathing
C) Bowel elimination
D) Perspiration

Question 20

You are making rounds on your clients. You find one of your clients struggling to breathe, appears confused, has tachycardia, and the skin appears dusky. What should you do to restore normal pH if ventilation efforts are not very successful?

A) Give bronchodilators.
B) Administer sodium bicarbonate IV.
C) Start potassium IV.
D) Infuse magnesium sulfate.

Question 21

You notify the physician that your client is third-spacing fluid. What orders would you expect the physician to give you?

A) Restrict fluids
B) Administer diuretics
C) Start IV fluids and blood products
D) Increase sodium in diet

Question 22

A group of nursing students are studying for a test over acid-base imbalance. One student asks another what the major chemical regulator of plasma pH is. What should the second student respond?

A) Renin-angiotensin-aldosterone system
B) Bicarbonate-carbonic acid buffer system
C) Sodium-potassium pump
D) ADH-ANP buffer system

Question 23

You are caring for a client diagnosed with a pituitary tumor. Surgery was performed and the tumor was removed along with a portion of the pituitary gland. As the nurse, you know that your client is at increased risk for what?

A) Electrolyte deficit
B) Fluid volume excess
C) Third-spacing of fluid
D) Electrolyte excess

Question 24

The nursing student asks their instructor what the term is for the amount of hydrogen ions in a solution. What should the instructor respond?

A) pH
B) ATP
C) DTATP
D) H+

Question 25

Your client has a diagnosis of hypervolemia. What would be an important intervention that you would initiate?

A) Give medications that promote fluid retention.
B) Limit sodium and water intake.
C) Assess for dehydration.
D) Teach client behaviors that decrease urination.