NURS 2003 Week Three - Fluid +
Electrolytes and Acid/Base Regulation
A newly admitted patient is diagnosed with hyponatremia. When making room assignments,
the charge nurse should take which action?
A. assign patient to a room near the nurses station
B. place the patient in a room nearest to the water fountain
C. place patient on telemetry to monitor for peaked T waves
D. assign the patient to a semi-private room and place an order for a low-salt diet. - correct
answer-The patient should be placed near the nurses station if confused in order for the staff
to closely monitor the
patient. To help improve serum sodium levels, water intake is restricted. Therefore a
confused patient should not be placed near a water fountain. Peaked T waves are a sign of
hyperkalemia, not hyponatremia. A confused patient could be distracting and disruptive for
another patient in a semi-private room. This patient needs sodium replacement, not
restriction.
a patient is admitted for hypovolemia associated with multiple draining wounds. Which
assessment would be the most accurate way for the nurse to evaluate fluid balance?
A. skin turgor
B. Daily weight
C. Presence of edema
D. Hourly urine output - correct answer-Answer:
B
If the patients weight is increased, they are retaining fluid, if it decreases, they are still losing
too much fluid.
A patient receives 3% NaCl solution for correction of hyponatremia. Which assessment is
most important for the nurse to monitor for while the patient is receiving this infusion?
A. Lung sounds
B. Urinary output
C. Peripheral pulses
D. Peripheral edema - correct answer-Answer:
A
Hypertonic solutions cause water retention, so the patient should be monitored for symptoms
of fluid excess. Crackles in the lungs may indicate the onset of pulmonary edema and are a
serious manifestation of fluid excess. Bounding peripheral pulses, peripheral edema, or
changes in urine output are also important to monitor when administering hypertonic
solutions, but they do not indicate acute respiratory or cardiac decompensation.
, A patient who is lethargic and exhibits deep, rapid respirations has the following arterial
blood gas (ABG)
results:
pH 7.32
PaO2 88 mm Hg,
PaCO2 37 mm Hg
HCO3 16 mEq/L.
How should the nurse interpret
these results?
A. metabolic acidosis
B. metabolic alkalosis
C. respiratory acidosis
D. respiratory alkalosis - correct answer-Answer:
A
A patient who was involved in a motor vehicle crash has had a tracheostomy placed to allow
for continued mechanical ventilation. How should the nurse interpret the following arterial
blood gas results: pH 7.48,
PaO2 85 mm Hg,
PaCO2 32 mm Hg
HCO3 25 mEq/L?
a. metabolic acidosis
b. metabolic alkalosis
c. respiratory acidosis
d. respiratory alkalosis - correct answer-Answer:
D
Respiratory alkalosis
How do the lungs act as an acid base buffer? (compensation)
A. by increasing RR when CO2 levels are high in the blood, thereby reducing acid load
B. by increasing RR when CO2 levels in the blood are low, thereby reducing base load
C. by decreasing RR when CO2 levels in blood are high, thereby reducing acid load.
D. decreasing RR when CO2 levels in the blood are low, reducing acid load. - correct
answer-Answer:
A
METABOLIC COMPENSATION:
If a patient was accumulating carbonic acid in the blood, what would the kidneys do to
maintain homeostasis?
How would the HCO3 level reflect this? - correct answer-Answer:
Electrolytes and Acid/Base Regulation
A newly admitted patient is diagnosed with hyponatremia. When making room assignments,
the charge nurse should take which action?
A. assign patient to a room near the nurses station
B. place the patient in a room nearest to the water fountain
C. place patient on telemetry to monitor for peaked T waves
D. assign the patient to a semi-private room and place an order for a low-salt diet. - correct
answer-The patient should be placed near the nurses station if confused in order for the staff
to closely monitor the
patient. To help improve serum sodium levels, water intake is restricted. Therefore a
confused patient should not be placed near a water fountain. Peaked T waves are a sign of
hyperkalemia, not hyponatremia. A confused patient could be distracting and disruptive for
another patient in a semi-private room. This patient needs sodium replacement, not
restriction.
a patient is admitted for hypovolemia associated with multiple draining wounds. Which
assessment would be the most accurate way for the nurse to evaluate fluid balance?
A. skin turgor
B. Daily weight
C. Presence of edema
D. Hourly urine output - correct answer-Answer:
B
If the patients weight is increased, they are retaining fluid, if it decreases, they are still losing
too much fluid.
A patient receives 3% NaCl solution for correction of hyponatremia. Which assessment is
most important for the nurse to monitor for while the patient is receiving this infusion?
A. Lung sounds
B. Urinary output
C. Peripheral pulses
D. Peripheral edema - correct answer-Answer:
A
Hypertonic solutions cause water retention, so the patient should be monitored for symptoms
of fluid excess. Crackles in the lungs may indicate the onset of pulmonary edema and are a
serious manifestation of fluid excess. Bounding peripheral pulses, peripheral edema, or
changes in urine output are also important to monitor when administering hypertonic
solutions, but they do not indicate acute respiratory or cardiac decompensation.
, A patient who is lethargic and exhibits deep, rapid respirations has the following arterial
blood gas (ABG)
results:
pH 7.32
PaO2 88 mm Hg,
PaCO2 37 mm Hg
HCO3 16 mEq/L.
How should the nurse interpret
these results?
A. metabolic acidosis
B. metabolic alkalosis
C. respiratory acidosis
D. respiratory alkalosis - correct answer-Answer:
A
A patient who was involved in a motor vehicle crash has had a tracheostomy placed to allow
for continued mechanical ventilation. How should the nurse interpret the following arterial
blood gas results: pH 7.48,
PaO2 85 mm Hg,
PaCO2 32 mm Hg
HCO3 25 mEq/L?
a. metabolic acidosis
b. metabolic alkalosis
c. respiratory acidosis
d. respiratory alkalosis - correct answer-Answer:
D
Respiratory alkalosis
How do the lungs act as an acid base buffer? (compensation)
A. by increasing RR when CO2 levels are high in the blood, thereby reducing acid load
B. by increasing RR when CO2 levels in the blood are low, thereby reducing base load
C. by decreasing RR when CO2 levels in blood are high, thereby reducing acid load.
D. decreasing RR when CO2 levels in the blood are low, reducing acid load. - correct
answer-Answer:
A
METABOLIC COMPENSATION:
If a patient was accumulating carbonic acid in the blood, what would the kidneys do to
maintain homeostasis?
How would the HCO3 level reflect this? - correct answer-Answer:
