NR 324 - Week 1 - Fluid Electrolytes Review Questions with 100% accurate solutions - Chamberlain University

What are the s/s of fluid overload?

- poor skin turgor

- flat neck veins?

- hypotension

- tachycardia

- weak threads pulse

- crackles in the lungs

- weight gain

- bounding pulses

What diagnostic test will the nurse anticipate for a patient with suspected fluid overload?

- chest x-ray

- lab draw (CBC, CMP, BNP)

- possible ABG

THINK:

- edema, possible HF, sedentary lifestyle

What is the interpretation for the following:

- pH 7.47

- CO2 36

HCO3 28

Metabolic alkalosis

What are the parameters for a IV fluid order?

What fluid is hypotonic? (0.45% NS, 0.9% NS, or 3% NS)

0.45% NS

You have the following order:

- infuse 1200 ml 0.9% NaCl over 5hrs IV

What is the hourly rate?

240ml/hr

What is the interpretation of the following:

- pH 7.28

- CO2 42

- HCO3 18

Metabolic acidosis

What do you anticipate to do when a client has hypovolemia?

- start IV (isotonic solution)

- give fluid bolus to rehydrate (maybe 250ml bolus)

- NS or LR (abt a L)

- monitor UO

REMEMBER: pt most likely a fall risk

What is the interpretation of the following:

- pH 7.32

- CO2 47

- HCO3 24

Respiratory acidosis

Which foods contain high potassium?

- Green leafy veggies (spinach)

- bananas

- prawns

- oranges

- potatoes

What type of acid-base imbalance would you expect when the client has NG tube suction intermittently?

What are your PRIORITY actions for a client with the following lab results?

- K 3.2 mEq/L

- Na 128 mEq/L

- notify the provider, they are both low

- patient needs K and fluid restriction (don't want to dilute already low Na)

THINK:

- normal K+ = 3.5-5.3, normal Na = 135.145

- low K+ (more sensitive) & slightly low Na

- are they malnourished and not eating well? On a diuretic?

- educate pt on importance of daily K+

Which client has a high risk of hypokalemia?

- client with NG suction

- client with diarrhea & vomiting

THINK:

- pt possibly on diuretic

What should the nurse asses for a pt with suspected fluid overload?

- auscultate lung sounds & assess respiratory status (incentive spirometer recommended to avoid pneumonia)

- check peripheral pulses (bc furthest away)

- assess for edema

- vital signs

Which fluid is HYPERtonic? (0.9% NaCl, 0.45% NaCl, 3% NaCl)

3% NaCl

Name an isotonic intravenous fluid.

Lactated Ringer's or 0.9% NS

What type of acid-base imbalance would you expect when the client has opioid overdose?

Respiratory acidosis

THINK:

- CNS depression = less breaths, not exhaling CO2 and can lead to acidosis

- need to open up alveoli with use of incentive spirometer

- panic attack = respiratory alkalosis = hyperventilating/too many breaths/not enough O2 & too little CO2 — hands begin cramping due to lack of O2 — PAPER BAG

What are some of the neuromuscular effects of hypvolemia ?

Confusion

Weakness

Seizures

Syncope

Dizziness

What's are some of the complications of IV therapy?

Fluid overload, phlebitis , infiltration (fluid going out of vein and into surrounding area)

THINK:

Infection (break of skin integrity), vesication (depending on solution — vancomycin irritation), extravasation (can be emergent)