Order Alterations in Fluid Balance Assignment

Order Alterations in Fluid Balance Assignment
Order Alterations in Fluid Balance Assignment
A nurse is assessing a patient for fluid volume excess.
What questions should the nurse ask the patient to
obtain information concerning this problem? Select
all that apply.-
1,_____“ __ “Do your rings feel tighter lately?”
2._____~ _ “How often do you need to urinate?”
3, _________ “How much water do you drink
a day?”
4,_______——s- “Have you noticed an increase in
thirst?”
5. ~~ “Did you gain weight in the last
few days?”
A nurse is caring for a patient with a serum calcium
level of 7.5 mEq/L. What nursing intervention is
important when caring for this patient?
1. Give the patient the prescribed calcium supplement.
2. Teach the patient to avoid foods high in calcium.
3. Assess the patient for hypoactive reflexes.
4, Prepare the patient for hemodialysis.
A patient is receiving an intravenous infusion of
0.9 percent sodium chloride (NaCl) at 75 mL/hour.
At 10 a.m. the patient received an antibiotic diluted
in 100 mL of NaC], this solution was infused over
1 hour. At 2 p.m. the patient received an antiemetic
diluted in 50 mL of sterile water; this solution was
infused over 30 minutes. Both medications were
hung as IVPB infusions through a secondary line
that interrupted the primary infusion of NaCl. How
much intravenous solution did the patient receive
between 8 a.m. and 8 p.m.? Record your answer
using a whole number.
Answer: mL
A nurse is caring for a patient admitted to the hospital with a diagnosis of congestive heart failure and is
retaining fluid. For what clinical indicator should the
nurse assess the patient that supports the presence of
this condition?
1. Weight loss
2. Hypotension
3. Bounding pulse
4, Hemoconcentration
A primary health-care provider orders 0.9 percent
sodium chloride with 10 mEq of potassium chloride
to be infused at 40 mL/hour. The nurse has intravenous tubing with a drop factor of 60 gtt/mL. How
many drops per minute should the nurse administer
to deliver the ordered amount of solution? Record
your answer using a whole number.
Answer: drops/minute
14.
16.
17.
A nurse is caring for a patient who reports having
severe diarrhea and vomiting for the last few days.
The patient’s laboratory results indicate that the
patient has a serum sodium level of 146 mEq/L. For
which clinical indicator unique to this serum sodium
level should the nurse assess the patient?
1. Confusion
2. Headache
3. Agitation
4. Thirst
. A nurse is monitoring several patients for clinical
manifestations of either hyperkalemia or hypokalemia. What clinical manifestations can occur
with both imbalances? Select all that apply.
Irregular pulse
Muscle weakness
Facial nerve twitching
Increased bowel sounds
Flattened T wave on an electrocardiogram tracing
Slices Koad ae
A nurse is obtaining a health history from a patient
who is has a serum potassium level of 3.2 mEq. What
patient statement indicates a potential precipitating
cause of this clinical manifestation?
1. “I’ve had diarrhea for several days.”
2. “We eat a lot of green leafy vegetables in our
house.”
3. “I take electrolyte supplements because ’m on
a diuretic.”
4. “My blood glucose has been very high lately
because I have diabetes.”
A nurse is assessing a patient with a diagnosis of
hypocalcemia. Which patient clinical manifestation
supports this diagnosis?
1. Hypoactive reflexes
2. Relaxed muscles
3. Deep bone pain
4. Muscle cramps
. A nurse is caring for a patient who is experiencing
impaired venous return secondary to immobility.
The primary health-care provider prescribes
furosemide (Lasix) 40 mg PO daily. Place the
following statements in order of application of
the nursing process.
1. Excess fluid volume is related to impaired venous
return secondary to immobility.
2. The patient’s potassium level remains within the
expected range.
3. The patient has 2 edema of the lower extremities.
4, Administer furosemide (Lasix) 40 mg PO daily.
5. The patient will lose 1.5 lb daily.
Answer:
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