Fluid & Electrolyte Balance Questions And Answers Verified 100% Correct

Fluid & Electrolyte Balance Questions And Answers Verified 100% Correct Dehydration is determined by ___ ___ along with clinical ___. - ANSWER - laboratory findings, manifestations Laboratory findings with dehydration usually show elevated levels of ___, ___, ___, ___, ___, and various ___, because . - ANSWER - hemoglobin, hematocrit, serum osmolarity, glucose, protein, blood urea nitrogen, electrolytes more water is lost and other substances remain, increasing hemoconcentration Hemoconcentration is not present when dehydration is caused by hemorrhage, because ___ - ANSWER - loss of all blood and plasma products occurs together. Weight loss over ___ pound(s) per day is fluid loss. - ANSWER - 1/2 How do fluids move between tissues, cells, and systems in the body? - ANSWER - osmosis, diffusion, membrane transport, hydrostatic pressure, membrane permeability, colloidal osmotic pressure, and particle size Diffusion - ANSWER - movement of particles (solute) across a permeable membrane from an area of higher concentration to an area of lower concentration balancing the number of particles on either side Osmosis - ANSWER - Movement of water only through a selectively permeable (semipermeable) membrane, balancing the solute/solvent proportion on either side What is the primary assessment in evaluating the effectiveness of diuretic therapy? A Blood pressure B-Respiratory rate C-Urinary output D-Skin turgor - ANSWER - Since the most direct effect of a diuretic is diuresis, urinary output is the most reliable indicator of its effectiveness. Blood pressure, respiratory rate, and skin turgor all reflect volume status, but are not the primary evaluation of diuretic administration. The RN is assessing a 70-year-old client admitted to the unit with severe dehydration. Which finding requires immediate intervention by the nurse? A-Client behavior that changes from anxious and restless to lethargic and confused B-Deep furrows on the surface of the tongue C-Poor skin turgor with tenting remaining for 2 minutes after the skin is pinched D-Urine output of 950 mL for the past 24 hours - ANSWER - Client behavior that changes from anxious and restless to lethargic and confused The nurse instructs an older adult client to increase intake of dietary potassium when the client is prescribed which classification of drugs? -Alpha antagonists -Beta blockers -Corticosteroids -High-ceiling (loop) diuretics - ANSWER - High-ceiling (loop) diuretics. High-ceiling (loop) diuretics are potassium-depleting drugs. The client should increase intake of dietary potassium to compensate for this depletion. Alpha antagonists, beta blockers, and corticosteroids are not potassium-depleting drugs. The nurse is reviewing serum electrolytes and blood chemistry for a newly admitted client. Which result causes the greatest concern? -Glucose: 97 mg/dL -Magnesium: 2.1 mEq/L -Potassium: 5.9 mEq/L -Sodium: 143 mEq/L - ANSWER - Potassium: 5.9 mEq/L. A potassium value of 5.9 mEq/L is high, and the client should be assessed further. A glucose value of 97 mg/dL, a magnesium value of 2.1 mEq/L, and a sodium value of 143 mEq/L are normal values. The nurse is reviewing lab values for a client recently admitted to the medical-surgical unit. Which lab result is severely abnormal? -Potassium, 3.5 mEq/L -Sodium, 137 mEq/L -Chloride, 107 mEq/L -Magnesium, 6.2 mEq/L - ANSWER - Magnesium, 6.2 mEq/L. A magnesium level of 6.2 mEq/L is greatly elevated. Clients with severe hypermagnesemia are in grave danger of cardiac arrest. The normal magnesium level is 1.3-2.1 mEq/L. The sodium and potassium results are within normal limits. The chloride level is just slightly elevated, with the normal range being between 98-106 mEq/L. A client is admitted to the hospital with a heart rate of 166 beats/min, increased thirst, restlessness, and agitation. Which electrolyte imbalance does the nurse suspect? Hypernatremia -Hypomagnesemia -Hypercalcemia -Hyperphosphatemia - ANSWER - These symptoms are indicative of hypernatremia. Clinical manifestations of hypomagnesemia are seen in the neuromuscular, central nervous, and intestinal systems. Hypercalcemia manifests with an altered level of consciousness that can range from confusion and lethargy to coma, and severe hypercalcemia depresses electrical conduction, slowing heart rate. Hyperphosphatemia causes few direct problems with body function (although hypocalcemia is usually also present). A 70-year-old woman is admitted to the hospital with heart failure, shortness of breath (SOB), and 3+ pitting edema in her lower extremities. Her current medications are furosemide (Lasix), digoxin (Lanoxin), and an angiotensin-converting enzyme (ACE) inhibitor (Lotensin). She states that she stopped taking her Lasix because she did not think that it was helping her heart failure. Her health care provider orders furosemide (Lasix) 5 mg IV push. Which client assessment determines that the medication is working? -Decreased blood pressure (BP) -Increased heart rate -Increased urine output -Weight gain - ANSWER - Increased urine output. When giving Lasix, the nurse monitors the client for response to drug therapy, especially weight loss and increased urine output. Although a fall in the client's BP may occur with the decrease in body fluid, this is not the most important assessment to be monitored. Urinary output is most important. Lasix may cause a decrease in heart rate as it lowers the client's body fluid, but this effect would take some time to note. Weight loss, rather than weight gain, is often the effect of Lasix, but it does not occur immediately. On the second day of caring for a client with generalized edema, which change best reflects that the administered diuretic is effective? -Urinary output decrease from 600 mL/8 hr to 200 mL/8 hr -Respiratory rate decrease from 24 to 20 -Weight loss of 6 pounds -Blood pressure decrease from 138/88 to 126/78 mm Hg - ANSWER - Weight loss of 6 pounds. Weight loss and increased urinary output are primary indicators of the effectiveness of a diuretic. In clients with edema, each pound of weight gained after the first pound equates to 500 mL of retained water, so if water loss occurs with diuretic therapy, weight loss will result. The changes in vital signs may reflect volume loss, but are not the best indicators of the effectiveness of a diuretic. The nurse is instructing a client who is being discharged with a diagnosis of congestive heart failure (CHF). Which client statement indicates a correct understanding of CHF? -"I can gain 2 pounds of water a day without risk." -"I should call my provider if I gain more than 1 pound a week." -"Weighing myself daily can determine if my caloric intake is adequate." -"Weighing myself daily can reveal increased fluid retention." - ANSWER - Fluid retention may not be visible. Rapid weight gain is the best indicator of fluid retention and overload. Each pound of weight gained (after the first half-pound) equates to 500 mL of retained water. The client should be weighed at the same time every day (before breakfast) on the same scale. Daily weights are not an indication of effective dieting for purposes of