Fluid and Electrolyte Imbalances Practice Flashcards

A complete set of Q&A flashcards covering fluid balance, IV solution types, electrolyte imbalances, ECG changes, and relevant nursing interventions.

Which finding should the nurse expect in a client with fluid volume deficit?

Tachycardia

Which assessment finding is most consistent with fluid volume excess?

Crackles in the lungs

If a client has lost $2\,L$ of fluid, approximately how much weight loss should the nurse expect?

$$4.4\,lb$$

Which urine output is considered expected for an adult?

$$30\text{–}60\,mL/hr$$

Which urine output is expected for a pediatric client?

$$1\text{–}2\,mL/kg/hr$$

Which assessment is most important for monitoring changes in fluid status over time?

Daily weight

Which action is appropriate when obtaining a daily weight on a client with a fluid imbalance?

Weigh at the same time each day

Which client is at greatest risk for fluid and electrolyte imbalance?

Infant with vomiting and diarrhea

Which assessment finding is least reliable for detecting dehydration in an older adult?

Skin turgor

What is the nurse's priority action if a client with fluid volume excess develops dyspnea and crackles?

Assess respiratory status

Which IV fluid is isotonic?

$0.9\%$ NS

Which statement best describes an isotonic solution?

Expands the intravascular space without major fluid shift

Which IV solution is hypotonic?

$0.45\%$ NS

Where does a hypotonic IV solution cause water to move?

From the bloodstream into the cells

Which complication is associated with excessive hypotonic fluid administration?

Cell swelling

Which IV fluid is hypertonic?

$3\%$ NaCl

Where does a hypertonic solution cause water to move?

Out of cells into the vascular space

Which client may receive an isotonic fluid for severe fluid volume deficit?

Client with dehydration

Which finding during IV fluid administration may indicate fluid volume overload?

Crackles

Which hormone causes sodium and water retention and potassium excretion?

Aldosterone

Which statement about antidiuretic hormone (ADH) is correct?

It causes the kidneys to retain water

Which complication is the nurse most concerned about for a client with a serum sodium level of $150\,mEq/L$?

Cerebral bleeding

Which manifestation is expected with hypernatremia?

Thirst

Which intervention is appropriate for a nurse caring for a client with hypernatremia?

Increase PO water as prescribed

Which nursing intervention is appropriate for both hypernatremia and hyponatremia because of neurologic complications?

Seizure precautions

Which complication should the nurse suspect in a client with a serum sodium of $120\,mEq/L$ and confusion?

Cerebral edema

Which condition can cause hyponatremia through water retention and dilution?

SIADH

Which intervention would the nurse expect for a client with hyponatremia caused by excessive water retention?

Fluid restriction

Which IV fluid would the nurse expect for a client with hyponatremia caused by sodium loss?

Isotonic fluid

Which statement about $3\%$ NaCl is correct?

It is hypertonic and must be given cautiously

Which electrolyte should the nurse associate most strongly with cardiac electrical activity?

Potassium

Which serum potassium value is within the normal range described in the lecture?

$$4.2\,mEq/L$$

Which ECG change is associated with hyperkalemia?

Peaked T waves

Which ECG finding is associated with hypokalemia?

U waves

What monitoring measure should a client with a potassium level of $6.5\,mEq/L$ be placed on?

Telemetry

Which condition is commonly associated with hyperkalemia?

Renal failure

Which acid-base imbalance is generally associated with hyperkalemia?

Acidosis

Which acid-base imbalance is generally associated with hypokalemia?

Alkalosis

Which medication may be used to shift potassium from the blood into the cells?

Insulin

Which nursing action is correct when administering IV potassium?

Dilute and infuse slowly

Which statement about potassium administration requires immediate correction?

"I can crush the potassium tablet before giving it."

Which manifestation is most consistent with hypokalemia?

Muscle weakness and decreased intestinal motility

Which electrolyte imbalance is associated with Chvostek and Trousseau signs?

Hypocalcemia

What is the nurse's priority when a client with hypocalcemia develops stridor?

Maintain the airway

Which ECG change is associated with hypocalcemia?

Prolonged ST segment

Which ECG change is associated with hypercalcemia?

Shortened ST segment

Which manifestation is most consistent with hypercalcemia?

Constipation and decreased reflexes

A client with hypermagnesemia is at greatest risk for which complication?

Respiratory depression

Which finding is expected with hypomagnesemia?

Muscle cramps and tremors

Which condition should the nurse suspect if a severely malnourished client begins enteral nutrition and develops low phosphate?

Refeeding syndrome