ATI Fluid, Electrolyte, and Acid-Base Targeted Exam PDF

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6/25/2021

ATI Fluid, Electrolyte, and Acid-Base Targeted Exam Flashcards | Quizlet

ATI Fluid, Electrolyte, and Acid-Base Targeted Exam Terms in this set (30) A nurse is assessing a client

Cardiac rhythm

who has a serum calcium level of 8.1 mg/dL. Which of the

When using the airway, breathing, circulation

following findings is the priority

approach to client care, the nurse should first assess

for the nurse to assess?

the client's cardiac rhythm because this total serum calcium level is below the expected reference

-Deep tendon reflexes

range. Hypocalcemia can cause ECG changes,

-Cardiac rhythm

bradycardia, or tachycardia.

-Peripheral sensation -Bowel sounds

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1/18

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A nurse is caring for a client

pH 7.51, PaO2 94 mm Hg, PaCO2 36 mm Hg, HCO3-

who requires nasogastric

31 mEq/L

suctioning. Which of the following sets of laboratory

An elevated pH and HCO3- with a PaCO2 either

results indicates that the client

elevated or within the expected reference range

has metabolic alkalosis?

indicates metabolic alkalosis.

-pH 7.51, PaO2 94 mmHg, PaCO2 36 mmHg, HCO3- 31 mEq/L -pH 7.48, PaO2 89 mmHg, PaCO2 30 mmHg, HCO3- 26 mEq/L -pH 7.31, PaO2 77 mmHg, PaCO2 52 mmHg, HCO3- 23 mEq/L -pH 7.26, PaO2 84 mmHg, PaCO2 38 mmHg, HCO3- 20 mEq/L

A nurse is caring for a client

Bounding peripheral pulses

who has dehydration and is receiving IV fluids. When

The nurse should recognize that increased vascular

assessing for complications,

volume results in full, bounding peripheral pulses.

the nurse should recognize which of the following manifestations as a sign of fluid overload? -Increased urine specific gravity -Hypoactive bowel sounds -Bounding peripheral pulses -Decreased respiratory rate

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2/18

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A nurse is caring for a client

ATI Fluid, Electrolyte, and Acid-Base Targeted Exam Flashcards | Quizlet

Initiate high-flow oxygen therapy.

who is experiencing respiratory distress as a result of

When using the airway, breathing, circulation

pulmonary edema. Which of

approach to client care, the nurse should first

the following actions should

administer high-flow oxygen therapy by face mask

the nurse take first?

at 5 to 6 L/min to keep the client's oxygen saturation above 90%.

-Assist with intubation -Initiate high-flow oxygen therapy -Administer a rapid-acting diuretic -Provide cardiac monitoring

A nurse is admitting a client

0.9% sodium chloride with 10 mEq/L of potassium

who takes 40 mg furosemide

chloride at 100 mL/hr

daily for heart failure and has experienced 3 days of

This IV solution will provide adequate fluid and

vomiting. The nurse suspects

potassium replacement to offset the losses from

hypokalemia. Which of the

vomiting. The typical amount of potassium chloride

following medications should

to administer IV is 5 to 10 mEq/hr and not to exceed

the nurse prepare to

20 mEq/hr. The dilution should be 1 mEq to 10 mL of

administer?

0.9% sodium chloride.

-Sodium polystyrene sulfonate 30 g/day -0.9% sodium chloride with 10 mEq/L of potassium chloride at 100 mL/hr -Bumetanide 8 mg/day -100 mL of dextrose 10% in water with 10 units of insulin

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A nurse is admitting a client

ATI Fluid, Electrolyte, and Acid-Base Targeted Exam Flashcards | Quizlet

Respiratory acidosis

who has status asthmaticus. The client's ABG results are pH 7.32,

Status asthmaticus causes inadequate gas

PaO2 74 mmHg, PaCO2 56

exchange, resulting in a low pH and PaO2, an

mmHg, and HCO3- 26 mEq/L.

elevated PaCO2, and an HCO3- within the expected

The nurse should interpret

reference range. These laboratory values indicate

these laboratory values as

respiratory acidosis.

which of the following imbalances? -Respiratory acidosis -Respiratory alkalosis -Metabolic acidosis -Metabolic alkalosis

A nurse is assessing a client

Mental status

who has dehydration. Which of the following assessments is

The greatest risk to this client is injury from a fall due

the priority?

to a decline in the client's mental status. Therefore, assessing the client's mental status is the nurse's

-Skin turgor

priority.

-Urine output -Weight -Mental status

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A nurse is caring for a client

ATI Fluid, Electrolyte, and Acid-Base Targeted Exam Flashcards | Quizlet

Potassium 6.1 mEq/L

who requires continuous cardiac monitoring. The nurse

Hyperkalemia, defined as a potassium level above

identifies a prolonged PR

5.0 mEq/L, can cause a prolonged PR interval, a

interval and a widened QRS

wide QRS complex, flat or absent P waves, and tall,

complex. Which of the

peaked T waves.

following laboratory values supports this finding? -Sodium 152 mEq/L -Chloride 102 mEq/L -Magnesium 1.8 mEq/L -Potassium 6.1 mEq/L

While reviewing a client's

Implement seizure precautions.

laboratory results, a nurse notes a serum calcium level of

The client is at risk for seizures due to low excitation

8.0 mg/dL. Which of the

threshold as a result of a decreased calcium level.

following actions should the

The nurse should initiate seizure precautions to

nurse take?

prevent injury.

-Implement seizure precautions -Administer phosphate -Initiate diuretic therapy -Prepare the client for hemodialysis

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A nurse is providing dietary

ATI Fluid, Electrolyte, and Acid-Base Targeted Exam Flashcards | Quizlet

1 large hard-boiled egg

teaching to a client who has kidney disease. Which of the

One large hard-boiled egg contains 5 mg of

following food choices should

magnesium. Therefore, the nurse should recommend

the nurse include in the

this food as containing the lowest amount of

teaching as containing the

magnesium.

lowest amount of magnesium? -1 large hard boiled egg -1 cup bran cereal - 1/2 cup almonds - 1 cup cooked spinach

A nurse is assessing a client

Hyperactive deep-tendon reflexes

who has hypomagnesemia. Which of the following findings

Hyperactive deep-tendon reflexes is an expected

should the nurse expect?

finding for a client who has hypomagnesemia. Other expected findings include muscle cramps,

-Hyperactive deep-tendon

numbness, and tingling.

reflexes -Increased bowel sounds -Drowsiness -Decreased blood pressure

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6/18

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A nurse is reviewing the

ATI Fluid, Electrolyte, and Acid-Base Targeted Exam Flashcards | Quizlet

Serum potassium 3.0 mEq/L

medical record of a client who has diabetes mellitus and is

This serum potassium level is below the expected

receiving regular insulin by

reference range. Hypokalemia is a serious

continuous IV infusion to treat

complication that can occur when a client who has

diabetic ketoacidosis. Which of

diabetic ketoacidosis is receiving insulin to treat the

the following findings should

condition. The nurse should report this finding to the

the nurse report to the

provider.

provider? -Urine output of 30 mL/hr -Blood glucose of 19=80 mg/dL -Serum potassium 3.0 mEq/L -BUN 18 mg/dL

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7/18

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A nurse is reviewing the ABG

pH 7.26, PaO2 84 mm Hg, PaCO2 38 mm Hg,

results for four clients. Which of

HCO3- 20 mEq/L

the following findings should the nurse identify as metabolic

A pH below 7.35 is an indication of acidosis. HCO3-

acidosis?

below 22 mEq/L is an indication of metabolic acidosis.

- pH 7.51, PaO2 94 mm Hg, PaCO2 38 mm Hg, HCO3- 29 mEq/L - pH 7.48, PaO2 89 mm Hg, PaCO2 30 mm Hg, HCO3- 24 mEq/L - pH 7.36, PaO2 77 mm Hg, PaCO2 52 mm Hg, HCO3- 26 mEq/L - pH 7.26, PaO2 84 mm Hg, PaCO2 38 mm Hg, HCO3- 20 mEq/L

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8/18

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A nurse is providing teaching

"When I sit down to watch television, I'll be sure to

for a client who has venous

put my feet up."

insufficiency of the lower extremities. Which of the

Venous insufficiency makes it difficult for blood flow

following statements by the

to return to the heart. Elevating her feet will increase

client indicates an

the return. The client should elevate her feet for at

understanding of the teaching?

least 20 min several times per day.

-"If my stockings feel tight, I'll just roll them down for a while." -"I'll put on my elastic stockings at the first sign of swelling." -"When I sit down to watch television, I'll be sure to put my feet up." -"It's okay to cross my legs as long as it's for less than an hour."

A nurse is providing dietary

1 cup plain yogurt

teaching to a client who has heart failure and is receiving

One cup of plain yogurt contains 380 g of

furosemide. Which of the

potassium. Therefore, the nurse should recommend

following food should the

this food as containing the greatest amount of

nurse recommend as

potassium.

containing the greatest amount of potassium? -1/2 cup chopped celery -1 cup plain yogurt -1 slice whole grain bread -1/2 cup cooked tofu

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9/18

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A nurse is caring for a client

ATI Fluid, Electrolyte, and Acid-Base Targeted Exam Flashcards | Quizlet

0.45% sodium chloride

who has a sodium level of 155 mEq/L. Which of the following

A sodium level of 155 mEq/L is an indication of

IV fluids should the nurse

hypernatremia. The nurse should anticipate a

anticipate the provider to

prescription for a hypotonic solution. The 0.45%

prescribe?

sodium chloride is a hypotonic solution used to provide free water and treat cellular dehydration,

-Dextrose 5% in 0.9% sodium

which promotes waste elimination by the kidneys.

chloride -Dextrose 5% in lactated Ringer's -3% sodium chloride -0.45% sodium chloride

A nurse is assessing a client

Slow peripheral pulses

who has a phosphorus level of 2.4 mg/dL. Which of the

This phosphorus level is below the expected

following findings should the

reference range. The nurse should expect the client

nurse expect?

to have slow peripheral pulses. The nurse might also find that the client's pulses are difficult to find and

-Hepatic failure

easy to block.

-Abdominal pain -Slow peripheral pulses -Increase in cardiac output

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10/18

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A nurse is teaching nutritional

ATI Fluid, Electrolyte, and Acid-Base Targeted Exam Flashcards | Quizlet

"I will add broccoli and kale to my diet."

strategies to a client who has a low serum calcium level and an

The nurse should recommend that the client

allergy to milk. Which of the

consume broccoli and kale, which are good sources

following statements by the

of calcium, as alternatives to dairy products.

client indicates an understanding of the teaching? -"I will eat more cheese because I can't drink milk." -"I need to avoid foods with vitamin D because I am allergic to milk." -"I will stop taking my calcium supplements if they irritate my stomach." -"I will add broccoli and kale to my diet."

A nurse is reviewing the

Hematocrit 34%

laboratory report of a client who has fluid volume excess.

The nurse should identify that a client who has fluid

Which of the following

volume excess can have a hematocrit level that is

laboratory values should the

below the expected reference range of 37 to 47%

nurse expect?

for females or 42 to 52% for males. Fluid volume excess can cause hemodilution and a decreased

-Hemoglobin 20 g/dL

hematocrit level.

-Hematocrit 34% -BUN 25 mg/dL Urine specific gravity 1.050

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11/18

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A nurse is caring for a client

ATI Fluid, Electrolyte, and Acid-Base Targeted Exam Flashcards | Quizlet

Auscultate the client's lungs.

who is receiving furosemide daily. During the morning

An adverse effect of many diuretics, including

assessment, the client tells the

furosemide, is hypokalemia. When using the airway,

nurse that he is "feeling weak in

breathing, circulation approach to client care, the

the legs." Which of the

nurse should first auscultate the client's lungs to

following actions should the

assess for respiratory changes due to weakness of

nurse take first?

the respiratory muscles.

-Monitor the client's bowel sounds. -Review the client's daily laboratory results. -Auscultate the client's lungs. -Palpate the client's peripheral pulses

A nurse is assessing a client

Decreased muscle strength

who has hyperkalemia. Which of the following findings should

The nurse should expect the client to experience

the nurse expect?

muscle weakness, fatigue, paresthesia, and nausea.

-Decreased muscle strength -Decreased gastric motility -Increased heart rate -Increased blood pressure

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12/18

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A nurse is evaluating a client

ATI Fluid, Electrolyte, and Acid-Base Targeted Exam Flashcards | Quizlet

Serum sodium 138 mEq/L

who is receiving IV fluids to treat isotonic dehydration.

Isotonic dehydration includes loss of water and

Which of the following

electrolytes due to a decrease in oral intake of

laboratory findings indicates

water and salt. A serum sodium level of 138 mEq/L is

that the fluid therapy has been

within the expected reference range and indicates

effective?

that the fluid therapy has been effective.

-BUN 26 mg/dL -Serum sodium 138 mEq/L -Hct 56% -Urine specific gravity 1.035

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13/18

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A nurse is caring for a client

ATI Fluid, Electrolyte, and Acid-Base Targeted Exam Flashcards | Quizlet

PaCO2

who reports difficulty breathing and tingling in both hands. His

The nurse should anticipate that a client who has

respiratory rate is 36/min and

respiratory alkalosis will have a decreased PaCO2

he appears very restless. Which

level due to hyperventilation.

of the following values should the nurse anticipate to be outside the expected reference range if the client is experiencing respiratory alkalosis? -PaO2 -PaCO2 -Sodium -Bicarbonate

A nurse is assessing a client

Provide calming interventions.

who is using PCA following a thoracotomy. The client is short

The client's respiratory rate is above the expected

of breath, appears restless, and

range. Calming the client should decrease the

has a respiratory rate of 28/min.

respiratory rate, which will cause the client's carbon

The client's ABG results are pH

dioxide levels to increase to expected levels of 35

7.52, PaO2 89 mm Hg, PaCO2

to 45 mm Hg and lower the pH to expected levels

28 mm Hg, and HCO3- 24

of 7.35 to 7.45. The nurse should instruct the client to

mEq/L. Which of the following

breathe slowly.

actions should the nurse take? -Instruct the client to cough forcefully -Assist the client with ambulation -Provide calming interventions -Discontinue the PCA