NR226-Fluids & Electrolytes-Chapter
42 Question and answers verified to
pass 2025/2026
Assessment - correct answer ✔Assess risk factors for fluid and electrolyte balances
Determine patient experience and attitudes regarding fluid imbalances and fluid therapy
Monitor laboratory results
Assess cultural preferences regarding fluid intake
Identify signs and symptoms of patient's imbalances and how they change over time
Assessment - correct answer ✔Age
Infants/young children have greater water needs and immature kidneys
Increased risk of extracellular volume deficit and hypernatremia
Environment
Hot environment->sweating->
hypernatremia/dehydration
Assessment - correct answer ✔Dietary Intake
Assess fluid and po intake
Assess ability to chew/swallow
,Lifestyle
Ask about chronic alcohol use
Can cause low Mg levels
Medications
Laxative/antacid use
You assess four Clients. Which Client has greatest risk for hypomagnesemia? - correct answer ✔A 72-
year-old with chronic alcoholism
An experienced LPN reports to you that a client's blood pressure and heart rate have decreased, and
when his face is assessed, one side twitches. What action should you take at this time? - correct answer
✔Review the client's morning calcium level.
Older Adults-Assessment - correct answer ✔• Body composition changes, causing a decreased
percentage of body weight as water (50%), which increases risk of extracellular fluid volume (ECV) deficit
and dehydration
• Some older adults restrict fluid intake because of impaired mobility or concerns about bladder control;
this increases their risk of hypernatremia and ECV deficit.
• Decreased elasticity of skin alters skin turgor even with normal fluid balance; do not rely on skin turgor
to assess ECV deficit or dehydration in older adults.
Older Adults-Assessment - correct answer ✔• Decreased thirst sensation increases risk of
hypernatremia and dehydration; do not rely on thirst to assess hypernatremia, ECV deficit, or
dehydration in older adults
, • Baroreceptors become sluggish with age, often causing brief postural hypotension; have older adults
arise slowly when you take orthostatic blood pressure measurements.
• Cardiovascular changes with aging often decrease the ability to adapt to a sudden increase in vascular
volume, increasing risk of pulmonary edema with rapid infusion of isotonic intravenous fluids.
Older Adults-Assessment - correct answer ✔• Older-adult kidneys are less able to concentrate urine,
making them less able to conserve fluid when needed; this increases the risk of hypernatremia, ECV
deficit, and dehydration
• Kidney changes of normal aging make it more difficult to excrete a large acid load, increasing the risk
of metabolic acidosis.
• Increased sensitivity to anticholinergic effects of medications causes dry mouth; use several different
assessments for ECV deficit and dehydration rather than relying solely on dry mouth
• The combined effects of normal aging, chronic diseases, and multiple medications often pose
challenges to maintaining fluid and electrolyte balance.
Assessment (Medical History) - correct answer ✔Recent Surgeries
-surgery causes an increased stress response for 24-48 hrs
-Increased secretion of aldosterone, glucocorticoids, and ADH
-Decreased osmolality
-Increased potassium secretion
Gastrointestinal Output
-Vomiting
-Diarrhea
42 Question and answers verified to
pass 2025/2026
Assessment - correct answer ✔Assess risk factors for fluid and electrolyte balances
Determine patient experience and attitudes regarding fluid imbalances and fluid therapy
Monitor laboratory results
Assess cultural preferences regarding fluid intake
Identify signs and symptoms of patient's imbalances and how they change over time
Assessment - correct answer ✔Age
Infants/young children have greater water needs and immature kidneys
Increased risk of extracellular volume deficit and hypernatremia
Environment
Hot environment->sweating->
hypernatremia/dehydration
Assessment - correct answer ✔Dietary Intake
Assess fluid and po intake
Assess ability to chew/swallow
,Lifestyle
Ask about chronic alcohol use
Can cause low Mg levels
Medications
Laxative/antacid use
You assess four Clients. Which Client has greatest risk for hypomagnesemia? - correct answer ✔A 72-
year-old with chronic alcoholism
An experienced LPN reports to you that a client's blood pressure and heart rate have decreased, and
when his face is assessed, one side twitches. What action should you take at this time? - correct answer
✔Review the client's morning calcium level.
Older Adults-Assessment - correct answer ✔• Body composition changes, causing a decreased
percentage of body weight as water (50%), which increases risk of extracellular fluid volume (ECV) deficit
and dehydration
• Some older adults restrict fluid intake because of impaired mobility or concerns about bladder control;
this increases their risk of hypernatremia and ECV deficit.
• Decreased elasticity of skin alters skin turgor even with normal fluid balance; do not rely on skin turgor
to assess ECV deficit or dehydration in older adults.
Older Adults-Assessment - correct answer ✔• Decreased thirst sensation increases risk of
hypernatremia and dehydration; do not rely on thirst to assess hypernatremia, ECV deficit, or
dehydration in older adults
, • Baroreceptors become sluggish with age, often causing brief postural hypotension; have older adults
arise slowly when you take orthostatic blood pressure measurements.
• Cardiovascular changes with aging often decrease the ability to adapt to a sudden increase in vascular
volume, increasing risk of pulmonary edema with rapid infusion of isotonic intravenous fluids.
Older Adults-Assessment - correct answer ✔• Older-adult kidneys are less able to concentrate urine,
making them less able to conserve fluid when needed; this increases the risk of hypernatremia, ECV
deficit, and dehydration
• Kidney changes of normal aging make it more difficult to excrete a large acid load, increasing the risk
of metabolic acidosis.
• Increased sensitivity to anticholinergic effects of medications causes dry mouth; use several different
assessments for ECV deficit and dehydration rather than relying solely on dry mouth
• The combined effects of normal aging, chronic diseases, and multiple medications often pose
challenges to maintaining fluid and electrolyte balance.
Assessment (Medical History) - correct answer ✔Recent Surgeries
-surgery causes an increased stress response for 24-48 hrs
-Increased secretion of aldosterone, glucocorticoids, and ADH
-Decreased osmolality
-Increased potassium secretion
Gastrointestinal Output
-Vomiting
-Diarrhea
