Fluids and electrolyte balance

Front

A 72-year-old client on NG suctioning has sodium of 126 mEq/L. They are restless and complaining of a headache. What’s your priority action?

Back

Administer 3% NaCl IV as ordered

Answer explanation

Severe symptomatic hyponatremia requires hypertonic saline to correct sodium and reduce risk of seizures.

Front

A post-op client is on furosemide. They complain of muscle weakness and an irregular heartbeat. Labs: K⁺ 2.8 mEq/L. What intervention should the nurse anticipate?

Back

Give oral potassium supplement and monitor ECG

Answer explanation

Oral or slow IV K⁺ replacement is appropriate; bolus IV K⁺ is dangerous (risk of arrhythmias).

Front

A client with hypoparathyroidism develops tingling around the mouth and a positive Trousseau’s sign. What is the most urgent nursing action?

Back

Administer IV calcium gluconate

Answer explanation

Symptomatic hypocalcemia can cause laryngospasm and seizures—IV calcium is priority.

Front

What is the primary risk of administering fluids too rapidly?

Back

Fluid overload

Front

A client presents with sodium 155 mEq/L, dry mucous membranes, and confusion. Which fluid would you expect to administer?

Back

D5W or 0.45% NS

Answer explanation

Hypotonic solutions (D5W, 0.45% NS) correct hypernatremia by diluting serum sodium.

Front

A client with CKD has potassium 6.8 mEq/L and peaked T waves on ECG. What is the priority treatment?

Back

Give IV calcium gluconate

Answer explanation

IV calcium stabilizes cardiac membranes, preventing arrhythmias. Other measures (insulin/glucose, dialysis) follow.

Front

Which electrolyte imbalance is the priority concern for this client? Hyponatremia, Hyperkalemia, Hypokalemia, Hypocalcemia

Back

Hypokalemia

Front

Which intervention should the nurse anticipate for this client? Options: Administer IV potassium chloride at 20 mEq/hr, Provide oral potassium supplements with food, Restrict dietary potassium, Stop all potassium replacement until next lab draw

Back

Provide oral potassium supplements with food

Front

Which additional electrolyte imbalance should the nurse monitor closely in this client? Hyperphosphatemia, Hypomagnesemia, Hypernatremia, Hypocalcemia

Back

Hypomagnesemia

Front

Mr. Lopez’s potassium is 2.7 mEq/L. The nurse should anticipate replacement until potassium reaches at least _____ mEq/L to reduce the risk of dysrhythmias.

Back

3.5-5