Fluid & Electrolytes

The nurse is caring for a client with a sodium level of 148 mEq/L with dehydration. Which sign or symptom does the nurse monitor for in the client?

• Tachycardia

• Weight gain

• Hypertension

• Dyspnea

Answer explanation

Dehydration is fluid loss - and classic signs/symptoms of dehydration are tachycardia and HYPOtension (especially on standing). Decrease urine output and poor skin turgor would also be seen with dehydration.

Fluid overload would result in hypertension, weight gain, and dyspnea. Edema would also be observed.

The nurse is preparing education on fluid homeostasis. Which physiologic mechanisms that work together to maintain fluid homeostasis does the nurse include in the teaching? Select all that apply

• Intake and output

• Renin-angiotensin-aldosterone system

• Electrolytes

• Edema

• Thirst sensation

Answer explanation

Intake and output, RAAS, serum electrolytes and the thirst sensation all work together to keep the body in fluid balance.

Edema is a sign that the body is out of fluid balance.

The nurse is assessing a client with an electrolyte imbalance. The nurse documents a positive Trousseau's sign. Which electrolyte imbalance does the client have?

• Hyperkalemia

• Hyponatremia

• Hypocalcemia

• Hypermagnesemia

Answer explanation

Trousseau's and Chovstek's signs are positive indications of muscle excitability. Low calcium levels (hypocalcemia) cause muscles to be "twitchy".

A client with excess body fluid is given an IV diuretic. The client's urine output does not increase. Which serum component does the nurse suspect to be low?

• Calcium

• Albumin

• Angiotensin

• Glucose

Answer explanation

Albumin is a large protein and is responsible for oncotic pressure - the pulling pressure to remove fluid from cells and bring it into circulation. When albumin is low/missing, hydrostatic pressure (pushing pressure from the blood stream to the cells) overtakes oncotic pressure.

The diuretic will act on the kidneys to remove fluid from circulation - but there will be little fluid in circulation if albumin is low.