Deck 26: Alterations in Fluid and Electrolyte Balance

Question 1

Potassium phosphate IV has been prescribed for a patient who has hypophosphatemia.Which nursing interventions are indicated when administering this medication?

A)Dilute the dose in 100 mL of normal saline (NS)and administer over 20 minutes.
B)Monitor the patient for respiratory distress.
C)Monitor for the development of hypotension.
D)Ensure that pharmacy has mixed the medication with a local anesthetic.

Answer 1

Monitor the patient for respiratory distress.

Question 2

A patient is receiving several units of packed red blood cells over several days to replace the blood lost during an active gastrointestinal bleed.The nurse would assess this patient for findings associated with which electrolyte imbalance?

A)Hyponatremia
B)Hypercalcemia
C)Hypokalemia
D)Hypomagnesaemia

Answer 2

Hypomagnesaemia

Question 3

A patient diagnosed with chronic renal failure has a magnesium level of 6 mg/dL.Which history data would the nurse evaluate as contributing to this electrolyte imbalance?

A)The patient had an episode of nasal congestion last week and took decongestant.
B)The patient had a recent sprain injury treated with rest and compression wrapping.
C)The patient has been trying to reduce intake of caffeine-containing fluids.
D)The patient has been taking over-the-counter laxative for chronic constipation.

Answer 3

The patient has been taking over-the-counter laxative for chronic constipation.

Question 4

A patient in the intensive care unit has developed gastrointestinal hemorrhage.The nurse would prepare to fluid resuscitate this patient with which intravenous fluid?

A)5% dextrose and 0.45% normal saline
B)2.5% dextrose
C)0.45% normal saline
D)0.9% normal saline

Question 5

The nurse caring for a patient receiving digoxin plans to monitor which electrolyte because of increased risk of digitalis toxicity?

A)Potassium
B)Chloride
C)Calcium
D)Sodium

Question 6

A patient's electrocardiogram reveals a prolonged P-R interval and ST segment depression.The nurse should review laboratory results for which electrolyte imbalance?

A)Hypokalemia
B)Hyperkalemia
C)Hypocalcemia
D)Hypernatremia

Question 7

A patient with fluid volume excess has a hemoglobin level of 9 mg/dL.How would the nurse explain the more likely cause of this laboratory value?

A)An undiagnosed bleeding disorder exists.
B)The patient has chronic anemia.
C)The patient has iron deficiency anemia.
D)Plasma dilution has occurred due to excess fluid.

Question 8

A hospitalized patient has a phosphorus level of 4.8 mg/dL.The nurse would review this patient's history for the presence of which conditions? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Chronic kidney failure
B)Hyperthyroidism
C)Recent cardiac surgery
D)Alcoholism
E)Treatment for gram-negative sepsis

Question 9

A patient is demonstrating tremors and a positive Chvostek's sign even though the serum calcium level is low normal.The nurse would review the medical record for which electrolyte imbalance?

A)Low phosphate
B)Low potassium
C)Low magnesium
D)Elevated sodium

Question 10

A patient has a serum calcium level of 7.9 mg/dL.Which nursing interventions would be appropriate for this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Treat tachycardia.
B)Monitor for the development of hypertension.
C)Place on seizure precautions.
D)Strain all urine.
E)Reorient as indicated.

Question 11

The nurse is planning the care of a 50-year-old patient with the risk of developing fluid volume deficit.Which assessment finding would have the greatest contribution to this risk?

A)Loose bowel movement one per day
B)First-degree steam burn on hand and forearm
C)Temperature of 99.6°F
D)Diuretic therapy two doses per day

Question 12

The nurse is assessing the effectiveness of fluid replacement therapy in a patient who has a fluid volume deficit.Which assessment findings would indicate the therapy is effective? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Blood pressure 90/48 mm Hg
B)Weight gain of 2 pounds since yesterday
C)Urine output increase to 40 mL per hour
D)Tenting of skin
E)Serum osmolality of 284 mOm/kg

Question 13

A patient with a history of heart failure is admitted with dehydration,malnutrition,and fatigue.The nurse learns that the patient has been taking multiple doses of a thiazide diuretic.The nurse would review laboratory reports for which electrolyte imbalance?

A)Hypernatremia
B)Hypophosphatemia
C)Hypocalcemia
D)Hypermagnesemia

Question 14

A patient admitted with hyperphosphatemia is to be treated with the administration of intravenous fluids.Which fluid would the nurse anticipate providing?

A)0.9% normal saline
B)Lactated Ringer's solute
C)5% dextrose and 0.25% normal saline
D)5% dextrose and water

Question 15

A patient has a serum calcium level of 11 mg/dL.The nurse would review this patient's medical record for which conditions? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)History of taking thiazide diuretics
B)Diagnosis of hyperparathyroidism
C)Diagnosis of acute pancreatitis
D)Low serum magnesium level
E)Long-term bedrest

Question 16

A patient who was admitted to the intensive care unit has a magnesium level of 8.4 mg/dL.The nurse would prepare for which interventions? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Maintenance of strict bedrest
B)Administration of insulin
C)Observation for fluid volume excess
D)Intravenous administration of magnesium
E)Initiation of dialysis

Question 17

The nurse is concerned that a patient's arterial blood carbon dioxide level is increasing because this can contribute to the development of which electrolyte imbalance?

A)Hyperkalemia
B)Hypokalemia
C)Hypercalcemia
D)Hypocalcemia

Question 18

The nurse is preparing intravenous fluids for a patient whose serum sodium is 156 mmol/L.Which types of fluid would the nurse select?

A)10% dextrose in water
B)Lactated Ringer's
C)0.45% normal saline
D)5% dextrose and 0.45% normal saline

Question 19

A patient comes into the emergency department with complaints of feeling weak,confused,and having abdominal cramps after spending several hours in the hot sun attending a baseball game.The patient's blood pressure is 96/58 mm Hg.The nurse would conduct additional assessment for which condition?

A)Hyponatremia
B)Hypercalcemia
C)Hypernatremia
D)Hypocalcemia

Question 20

A patient being treated for fluid volume excess has blood glucose elevation.The nurse would review the patient's medication history for which medication?

A)Furosemide (Lasix)
B)Spironolactone (Aldactone)
C)Potassium chloride (K-Dur)
D)Hydrochlorothiazide (Esidrix)