Fluids and Electrolytes/Acid-Base

A nurse assesses clients at a family practice clinic for risk factors that could lead to dehydration. Which client is at greatest risk for dehydration?

• A 36 year old who is prescribed long-term steroid therapy.

• A 55 year old who recently received intravenous fluids

• A 76 year old who is cognitively impaired.

• An 83 year old with congestive heart failure.

A nurse is caring for an older client who exhibits dehydration-induced confusion. Which intervention by the nurse is best?

• Assess client further for fall risk

• Increase the IV flow rate to 250 mL/hr.

• Measure intake and output every 4 hours.

• Place the client in a high-Fowler position

A nurse is assessing clients on a medical-surgical unit. Which adult client does the nurse identify as being at greatest risk for insensible water loss?

• Client taking furosemide

• Anxious client who has tachypnea

• Client who is on fluid restrictions

• Client who is constipated with abdominal pain

After teaching a client who is prescribed a restricted sodium diet, a nurse assesses the client’s understanding. Which food choice for lunch indicates that the client correctly understood the teaching?

• Slices of smoked ham with potato salad

• Bowl of tomato soup with a grilled cheese sandwich

• Salami and cheese on whole-wheat crackers

• Grilled chicken breast with glazed carrots

A nurse assesses a client with diabetes mellitus who is admitted with an acid–base imbalance. The client’s arterial blood gas values are pH 7.36, PaO₂ 98 mm Hg, PaCO₂ 33 mm Hg, and HCO₃⁻ 18 mEq/L (18 mmol/L). Which sign or symptom does the nurse identify as an example of the client’s compensatory mechanisms?

• Increased rate and depth of respirations

• Increased urinary output

• Increased thirst and hunger

• Increased release of acids from the kidneys

A nurse assesses a client who is prescribed furosemide for hypertension. For which acid–base imbalance does the nurse assess to prevent complications of this therapy?

• Respiratory acidosis

• Respiratory alkalosis

• Metabolic acidosis

• Metabolic alkalosis

A nurse assesses a client who is admitted with an acid–base imbalance. The client’s arterial blood gas values were pH 7.32, PaO₂ 85 mm Hg, PaCO₂ 34 mm Hg, and HCO₃⁻ 16 mEq/L (16 mmol/L). The most recent blood gasses show a drop in the pH. What action does the nurse take next?

• Assess client’s rate, rhythm, and depth of respiration.

• Measure the client’s pulse and blood pressure

• Document the findings and continue to monitor.

• Notify the primary health care provider.

A nurse is caring for a client who has the following arterial blood values: pH 7.12, PaO₂ 56 mm Hg, PaCO₂ 65 mm Hg, and HCO₃⁻ 22 mEq/L (22 mmol/L). Which clinical situation does the nurse correlate with these values?

• Diabetic ketoacidosis in a person with emphysema

• Bronchial obstruction related to aspiration of a hot dog

• Anxiety-induced hyperventilation in an adolescent

• Diarrhea for 36 hours in an older, frail woman

After teaching a client who was malnourished and is being discharged, a nurse assesses the client’s understanding. Which statement indicates that the client correctly understood teaching to decrease risk for the development of metabolic acidosis?

• “I will drink at least three glasses of milk each day.”

• “I will eat three well-balanced meals and a snack daily.”

• “I will not take pain medication and antihistamines together.”

• “I will avoid salting my food when cooking or during meals.”

A nurse evaluates the following arterial blood gas values in a client: pH 7.48, PaO₂ 98 mm Hg, PaCO₂ 28 mm Hg, and HCO₃⁻ 22 mEq/L (22 mmol/L). Which client condition does the nurse correlate with these results?

• Diarrhea and vomiting for 36 hours

• Anxiety-induced hyperventilation

• Chronic obstructive pulmonary disease (COPD)

• Diabetic ketoacidosis and emphysema