Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
29 Cards in this Set
- Front
- Back
|
Which electrolyte is regulated by aldosterone? (Select all that apply.) Chloride
Potassium Sodium Magnesium Calcium |
Aldosterone controls the renal absorption and excretion of sodium, potassium, and chloride. ,
|
|
|
Which electrolyte is regulated by Parathyroid hormone, calcitriol and calcitionin? (Select all that apply.)
Chloride Potassium Sodium Magnesium Calcium |
Calcium levels are regulated by parathyroid hormone, calcitriol, and calcitonin
|
|
|
Which electrolyte is regulated by Parathyroid hormone, and vitamin D? (Select all that apply.)
Chloride Potassium Sodium Magnesium Calcium |
while magnesium levels are regulated by parathyroid hormone and vitamin D
|
|
|
Place the populations in order from least total body water to most total body water (measured as a percentage of total body weight).
Infants, Adult males, Older Adults, Adult female, Newborn 1st 2nd 3rd 4th 5th |
1Older adults
2ndAdult females 3rdAdult males 4thInfants 5thNewborns |
|
|
Fluid volume deficit can result from which conditions?
(Select all that apply.) Fever Kidney failure Vomiting Diarrhea Water intoxication |
Fluid volume deficit, or dehydration, can occur when excessive amounts of fluids are lost through diarrhea or vomiting. Fever can cause excessive sweating and insensible losses of fluid, also leading to dehydration. Kidney failure causes water retention, leading to fluid volume excess, not deficit. Water intoxication results from excessive fluid intake and also leads to fluid volume excess.
|
|
|
What is the most common electrolyte disorder in the general population? Hyperkalemia
Hypernatremia Hypokalemia Hyponatremia |
Hyponatremia is the most common electrolyte disorder, with a prevalence of 7.7% in the general population. Hypernatremia is the second most common, with a prevalence of 3.4%
|
|
|
Which modifiable risk factor has the most direct effect on calcium balance?
Stress Exercise Diuretics Fluid intake |
Regular weight-bearing exercise helps maintain calcium balance. Stress, fluidintake, and diuretics can all affect fluid and electrolyte balance in a general way, but do not specifically target calcium.
|
|
|
When engaging the client in the plan of care for end stage renal disease, to what should the nurse pay particular attention?
Weighing client daily Monitoring input and output Meal planning when dietary modifications are required Medication regimens and their side effects |
The nurse should involve the client in meal planning if dietary modifications are required. The nurse can provide education about medication regimens, but the client is not usually involved in planning these regimens. Weighing the client and monitoring input and output are interventions carried out by the nurse, with little involvement by the client.
|
|
|
Which fluid or electrolyte imbalance is best treated with dialysis? Blood loss
Hyperkalemia Fluid volume deficit Hyponatremia |
Clients with hyperkalemia are treated with dialysis to remove excess potassium from the blood. Fluid volume deficit is treated with fluid. Blood loss is treated with blood transfusions or IV colloids. Hyponatremia is treated with sodium supplements.
|
|
|
Which is a characteristic of the intracellular fluid compartment of the body?
Further divides into intravascular, interstitial, and transcellular fluids Makes about one-third of total body fluid in adults Is a medium for metabolic processes Includes cerebrospinal and peritoneal fluids |
The intracellular fluid compartment makes up about two-thirds of total body fluid in adults and is found within cells. It is a medium for metabolic processes. Extracellular fluid makes up the other one-third of total body fluid and is divided intointravascular, interstitial, and transcellular fluids. Cerebrospinal and peritoneal fluids are examples of transcellular fluids
|
|
|
Landon McCabe brings his 4-month-old daughter, June, to the urgent care clinic. June has been vomiting every few hours for the past 12 hours and feeding poorly. After noting June's dry mouth and lack oftears, the healthcare provider diagnoses June with mild dehydration. After you teach Mr. McCabe about rehydrating June, he asks, "How did June get dehydrated so quickly?" What is the best response for you to give Mr. McCabe?
"Infants need to take in a lot of fluid, so if they lose a lot of fluid through vomiting, it is easy for them to get dehydrated." "Infants have a smaller percentage of their body water outside their cells than adults, so it is easy for them to getdehydrated." "Infants have a low body surface area, so they lose fluid more easily than adults and it is easy for them to get dehydrated." "Infants have a smaller body water percentage than adults, so if they lose a lot fluid through vomiting, it is easy for them to get dehydrated." |
Infants need to take in a lot of fluid, so if they lose a lot of fluid through vomiting, it is easy for them to get dehydrated."
Infants have a proportionally higher body water percentage, higher fluid requirements, higher body surface area, and lower intracellular fluid volume thanadults, all of which make them more prone to dehydration. |
|
|
You are assessing 8-year-old Kristian Davidson at school after he complained of feeling dizzy during recess on ahot, sunny day. You note manifestations of mild heatexhaustion, perform first aid, and notify Kristian's parents to follow up with their heathcare provider. What is the best recommendation for you to make to the principal of the school to help prevent future occurrences of heat-related illness?
Provide a time for children to rest after recess Teach children to drink water only before recess Move afternoon recess to a cooler morning hour Encourage children to drink water when they feel thirsty |
To prevent heat-related illness, it would be best to move recess from the hottest part of the day to a cooler part of the day.
Children should be encouraged to take frequent water breaks and drink before they begin to feel thirsty, not just when they feel thirsty or only before recess. Children should also be encouraged to take frequent rest breaks during recess, not just afterward. |
|
|
You are administering intravenous crystalloid solutions to26-year-old Marco Ramirez, who suffered severe heat exhaustion at an outdoor concert. Mr. Ramirez asks, "What is this stuff you're giving me?" What is the best response for you to give to Mr. Ramirez?
"I'm giving you a solution that is a lot like the fluid outside your cells. It will replace the fluid you lost." "I'm giving you a solution with a drug that will keep you from losing water." "I'm giving you a solution that has proteins in it. It will help replace the fluid you lost." "I'm giving you a solution that is a lot like your blood. It will replace the fluid you lost." |
"I'm giving you a solution that is a lot like the fluid outside your cells. It will replace the fluid you lost."
Crystalloid solutions are given intravenously to clients like Mr. Ramirez who have lost fluids from excessive sweating, inadequate intake, or insensible water loss. Crystalloid solutions mimic the body's extracellular fluid and replace lost fluids. Colloid solutions more closely resemble blood, as they contain proteins and other large molecules, and are given in cases of excessive blood loss. Crystalloid solutions do not contain a drug that causes a client to retain water. |
|
|
A client experiencing hyperkalemia is scheduled for dialysis. The nurse anticipates an order for what therapy to help drive potassium back into the cells prior todialysis?
Blood transfusion Antidiuretic hormone Insulin Potassium supplements |
Insulin
Glucose and insulin are administered to the client with hyperkalemia to help drive potassium back into the intracellular fluid, reducing the amount of potassium in the blood. Potassium supplements would only increase the client's potassium levels. Blood transfusions are only given for major blood loss, which is not indicated for the client. Antidiuretic hormone (ADH) is administered to clients with hypernatremia due to decreased ADH production, not hyperkalemia. |
|
|
The student nurse is assisting the nurse in administering intravenous normal saline to a dehydrated client.
The nurse explains to the student that active transport is essential in maintaining sodium and potassium ion concentrations in the body's fluid compartments. The student asks how active transport differs from other transport processes. What is the best response by thenurse? "Unlike diffusion, active transport moves solutes from a solution with a lower concentration of solutes to a more concentrated solution." "Unlike osmosis, active transport moves water from a solution with a higher concentration of solutes to a less concentrated solution.""Unlike osmosis, active transport moves water from a solution with a lower concentration of solutes to a more concentrated solution.""Unlike diffusion, active transport moves solutes from a solution with a higher concentration of solutes to a less concentrated solution." |
Unlike diffusion, active transport moves solutes against their concentration gradients from a solution with a lower concentration to a more concentrated solution. Active transport does not move water, only solutes. Osmosis is the movement of water from a solution with a lower concentration of solutes to a more concentrated solution.
|
|
|
An emergency room nurse is assessing a client who overhydrated during a marathon. Which assessment is essential for the nurse to perform during the physical examination? (Select all that apply.)
Blood pressure Lung sounds Level of consciousness Eye accommodation Teeth |
The client with water intoxication is experiencing a fluid volume excess and likely low electrolyte levels. Measuring blood pressure, auscultating lung sounds, and assessing level of consciousness are all priority assessments for the nurse to perform. Inspecting the oral mucosa, not teeth, is priority for this client. Palpating theeyeball, not testing for accommodation, is priority for this client.
|
|
|
The community health nurse is performing health screenings at a homeless shelter. When assessing for fluid and electrolyte imbalances, which question is most important for the nurse to ask?
"Are you currently being treated for joint problems?" "Have you recently had a cold?" "Describe your anxiety level on a typical day.""Describe what you eat and drink on a typical day." |
is important for the nurse to consider socioeconomic factors affecting food and fluid intake when assessing a client's risk for fluid and electrolyte imbalances, especially with a vulnerable population like the homeless. Asking a client to describe a typical day's food and fluid intake will help the nurse determine if a client's oral intake is adequate. Joint problems and minor respiratory infections are not primary risk factors for fluid and electrolyte imbalances. It would be more important for the nurse to ask about kidney or thyroid disease, diabetes, or hypertension and acute conditions that cause fluid loss such as gastroenteritis. Asking about anxiety is too general when assessing a client's fluid and electrolyte status, as some anxiety is to be expected in a homeless client.
|
|
|
The nurse is administering a blood transfusion to a client who is hemorrhaging. The nurse identifies that the client is experiencing a deficit in which body fluidcompartment? Intravascular fluid
Interstitial fluid Transcellular fluid Intracellular fluid |
Blood loss causes a deficit in the intravascular fluid compartment, which is a subcompartment of extracellular fluid (ECF). Transcellular and interstitial fluids, along with lymph, make up the other compartments of ECF. Intracellular fluid is the other major fluid compartment in the body.
|
|
|
The nurse is caring for a client with hyponatremia. What are independent interventions that the nurse can perform to help manage the client's electrolyte imbalance? Administer oral sodium supplements
Involve client in meal planning Administer intravenous sodium Monitor intake and output Weigh client daily |
Monitoring intake and output, weighing the client daily, and involving the client in meal planning are all independent interventions that the nurse can perform to help manage the client's hyponatremia. Administering oral and intravenous sodium supplements are collaborative interventions that can only be carried out with a healthcare provider's orders.
|
|
|
The nurse is caring for a client with a fluid volume deficit. Which nursing intervention addresses the client's potential for poor perfusion?
Checking client's temperature Assessing client's nail beds. Monitoring for signs of blood loss Administering whole blood |
Fluid and electrolyte balance is related to several nursing concepts, including perfusion, cellular regulation, and cognition. Fluid volume loss can lead to decreasedperfusion, so the nurse should assess pulses, nail beds, and color to assure that perfusion is adequate. Monitoring for signs of blood loss and administering whole blood are interventions targeted toward hemorrhage (cellular regulation) rather than poor perfusion. Checking the client's temperature helps to determine the client's thermoregulation status, not perfusion
|
|
|
The nurse is performing an assessment on a client who has had nothing by mouth since the previous evening. Which manifestation related to the client's fluid restriction would be of concern to the nurse? (Select all that apply.)
Edema Dry mucous membranes Increased blood pressure Tenting skin Increased hematocrit |
Oral fluid restriction can cause dehydration. The nurse should monitor for manifestations of dehydration such as dry mucous membranes, increased hematocrit, and tenting skin. Edema and increased blood pressure are manifestations of fluid volume excess, not deficit.
|
|
|
The nurse is providing education to a group of volunteers who are planting trees in a city park on a hot, sunny day. What teaching should the nurse provide about avoiding heat-related illness? (Select all that apply.)
Avoid participating in the tree planting if ill Older adults are at less risk Take frequent rest breaks Drink water when they feel thirsty Wear lightweight clothes |
Individuals should take frequent rest and water breaks, and wear lightweight clothes to avoid heat-related illness. Those who are ill are at greater risk for heat-related illness, so they should avoid participating. Individuals should drink water before they feel thirsty, not just when they feel thirsty. Older adults and small children are at greater risk for heat-related illness.
|
|
|
The nurse is reviewing laboratory values for a client with hyperthyroidism. Which component of the complete blood count will be most useful to the nurse in determining the client's fluid status?
Platelet count Hematocrit Red blood cell count White blood cell count |
Hematocrit (Hct) and hemoglobin (Hb) are useful in assessing a client's fluid status because they are influenced by plasma volume. Hct and Hb values are high with dehydration (as may occur with uncontrolled hyperthyroidism) and low with overhydration. Red and white blood cell and platelet counts are not useful in determining fluid status.
|
|
|
A nurse is unable to secure an intravenous access site due to severe dehydration. Which order does the nurse anticipate receiving from the healthcare provider?
Oral fluid replacement Diuretics Sodium supplements Hypodermoclysis |
When IV access is problematic, fluids can be administered subcutaneously, a method called hypodermoclysis. Diuretics are used to treat fluid volume excess, not dehydration. Oral fluid replacement is ordered for mild dehydration, not severe dehydration. Fluid replacement, not sodium supplements, would be anticipated.
|
|
|
The nurse is monitoring the fluid and electrolyte status of a client receiving intravenous colloids. The nurse understands that it is priority to monitor the client for manifestations of which imbalance? Hypernatremia
Fluid overload Fluid deficit Hyperkalemia |
The client receiving intravenous (IV) colloids or any IV fluid is at risk for fluid overload. It is therefore important to monitor the client for manifestations of fluid overload. Fluid deficit, hyperkalemia, and hypernatremia do not typically result when infusing colloids.
|
|
|
The nurse is reviewing the intake and output (I&O) records of a client. Which entry in the intake record would cause the nurse concern? (Select all that apply.)
Tube drainage Parenteral fluids Intravenous medications Tube feedings Vomitus |
Tube feedings, parenteral fluids, and intravenous medications should all be documented in the client's intake record. Tube drainage and vomitus should be documented in the client's output and would cause the nurse concern. Tube drainage and vomitus need to be recorded on the output record, not intake record.
|
|
|
The nurse is monitoring a client who has undergone a thyroidectomy. The nurse suspects the parathyroid glands may have been inadvertently removed if imbalances are seen in which serum electrolyte level? (Select all that apply.) Magnesium
Chloride Potassium Sodium Calcium |
Parathyroid hormone (PTH) regulates serum levels of calcium and magnesium. If imbalances in these electrolytes are seen, then PTH may be absent due to inadvertent removal of the parathyroid glands. Sodium, potassium and chloride are regulated by aldosterone, not PTH.
|
|
|
The nurse is caring for a hospitalized client who is experiencing anxiety-related hyperventilation. To account for the client's hyperventilation, when recording theclient's fluid intake and output, the nurse should adjust the amount of fluid lost through which route?
Feces Insensible loss Urine Sweat |
With increased respirations, the client will experience a greater-than-normal insensible loss of fluid through the lungs. Hyperventilation will not affect the amount of fluid lost through the urine, sweat, or feces.
|
|
|
The nurse is reviewing the medication record of a client admitted with dehydration. Which medication would cause the nurse concern? Nonsteroidal anti-inflammatory drug (NSAID)
Vasodilator Benzodiazepine Selective serotonin reuptake inhibitor (SSRI)
|
Clients with dehydration are likely to develop electrolyte imbalances as the body attempts to compensate for the lost fluid. Benzodiazepines are associated with electrolyte imbalances and would cause the nurse concern since they could worsen the client's electrolyte imbalances. Antipsychotic agents, not antidepressants likeSSRIs, can affect fluid balance. Vasoconstrictors, not vasodilators, can also affect fluid balance. NSAIDs are not associated with fluid or electrolyte imbalances
|
