Chapter 54: Fluids, Electrolytes, and Parenteral Therapy Introductory Clinical Pharmacology 12th Edition by Susan M Ford

Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. A client who is prescribed digoxin is receiving electrolyte replacement therapy. The nurse would monitor the client for signs of digoxin toxicity if which electrolyte is administered? a. Sodium b. Potassium c. Magnesium d. Phosphorous Answer: B Rationale: The nurse should monitor a client taking digoxin for signs of digoxin toxicity if potassium is being given. The use of magnesium and digoxin can result in heart block. Sodium is necessary for normal heart action. The use of phosphorous with digoxin is not noted to create adverse reactions. Question format: Multiple Choice Chapter: 54 Learning Objective: 6 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 755, Intracellular Electrolytes 2. A nurse is preparing to administer albumin intravenously to a client. The nurse anticipates noting which reason in the medical record of the client? a. Loss of fluids due to severe dehydration b. Poor wound-healing abilities with a high risk of infection. c. Experienced a severe loss of only plasma d. Experienced hypovolemic shock due to trauma Answer: D Rationale: Plasma protein fractions are used in clients to treat hypovolemic shock that occurs as a result of burns, trauma, surgery, and infections or in conditions where shock is not currently present but likely to occur. It is also used in the case of hypoproteinemia, as might be seen in clients with nephrotic syndrome and hepatic cirrhosis, as well as other diseases or disorders. When a client loses a lot of blood volume due to severe hemorrhage or when a client is experiencing a condition in which plasma alone is lost, the client can be administered plasma intravenously or albumin, which can also quickly restore the volume in most situations. Protein substrates like amino acid preparations are administered to clients with poor wound-healing abilities. Clients with severe dehydration are often given basic IV fluids with electrolytes. Question format: Multiple Choice Chapter: 54 Learning Objective: 1 Cognitive Level: Understand Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 757, Plasma Protein Fractions 3. A nurse is preparing to administer IV fat emulsions to a client. The nurse will exercise caution when administering this solution after discovering the client also has which disorder noted in the medical record? a. Pulmonary disorder b. Egg allergy c. Acute pancreatitis d. Vitamin deficiency Answer: A Rationale: When caring for a client who is to receive IV fat emulsions, the nurse should know that IV fat emulsions are to be used cautiously if the client has a pulmonary disorder, severe liver impairment, anemia, and blood coagulation disorders. The solution is a pregnancy category C drug and is also used cautiously during pregnancy and lactation. IV fat emulsions are contraindicated if the client is allergic to eggs or has a condition that interferes with normal fat metabolism such as acute pancreatitis. Alcohol dextrose solutions and not IV fat emulsions are used cautiously in clients with a vitamin deficiency. Question format: Multiple Choice Chapter: 54 Learning Objective: 6 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 759, Hyper/Hypoglycemia 4. A nurse is preparing to administer potassium to a client. Which reaction should the nurse carefully monitor the client for if the use of salt substitutes is documented in the client's record? a. Severe hemolytic reactions b. Elevated serum potassium levels c. Acute dehydration d. Severe hyperkalemia Answer: D Rationale: The nurse should monitor the client's condition for signs and symptoms of severe hyperkalemia, which occurs due to the interaction of potassium with salt substitutes. Concurrent use of potassium with angiotensin-converting enzyme (ACE) inhibitors may result in an elevated serum potassium level. Acute dehydration or severe hemolytic reactions contraindicate the use of potassium in clients. Question format: Multiple Choice Chapter: 54 Learning Objective: 6 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 755, Intracellular Electrolytes 5. A nurse is preparing to administer bicarbonate to a client who is also prescribed fluoroquinolones. Which potential situation will the nurse carefully monitor the client for after administering these two drugs? a. Respiratory alkalosis b. Severe abdominal pain c. Increased risk of crystalluria d. Renal impairment Answer: C Rationale: The nurse should monitor the client's condition for an increased risk of crystalluria as a result of the interaction of fluoroquinolones and bicarbonate. Respiratory alkalosis, severe abdominal pain, and renal impairment contraindicate the use of bicarbonate. Question format: Multiple Choice Chapter: 54 Learning Objective: 6 Cognitive Level: Understand Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 760, Correcting Metabolic Acidosis 6. A nurse has administered ammonium chloride to a client as prescribed. Which assessment finding will the nurse prioritize? a. Depressed reflexes b. Muscle weakness c. Circulatory collapse d. Metabolic acidosis