Fluid, Electrolyte, and Acid-Base Imbalances by Lewis Medical-Surgical Nursing, 10th Edition (Chapter 16)

MULTIPLE CHOICE 1.2.3.4.5.6.7.8.9.10.11.12.The nurse is caring for a patient with a massive burn injury and possible hypovolemia. Which assessment data will be of most concern to the nurse? b. Blood pressure is 90/40 mm Hg. A patient who has a small cell carcinoma of the lung develops syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should notify the health care provider about which assessment finding? b. Serum sodium level of 120 mg/dL A patient with multiple draining wounds is admitted for hypovolemia. Which assessment would be the most accurate way for the nurse to evaluate fluid balance? b. Daily weight The home health nurse cares for an alert and oriented older adult patient with a history of dehydration. Which instructions should the nurse give this patient related to fluid intake? b. “Increase fluids if your mouth feels dry.” A patient who is taking a potassium-wasting diuretic for treatment of hypertension complains of generalized weakness. Which action is appropriate for the nurse to take? d. Suggest that the health care provider order a basic metabolic panel. Spironolactone (Aldactone), an aldosterone antagonist, is prescribed for a patient. Which statement by the patient indicates that the teaching about this medication has been effective? d. “I will drink apple juice instead of orange juice for breakfast.” A patient with new-onset confusion and hyponatremia is being admitted. When making room assignments, the charge nurse should take which action? b. Assign the patient to a room near the nurse’s station. IV potassium chloride (KCl) 60 mEq is prescribed for treatment of a patient with severe hypokalemia. Which action should the nurse take? b. Infuse the KCl at a rate of 10 mEq/hour. A postoperative patient who had surgery for a perforated gastric ulcer has been receiving nasogastric suction for 3 days. The patient now has a serum sodium level of 127 mEq/L (127 mmol/L). Which prescribed therapy should the nurse question? a. Infuse 5% dextrose in water at 125 mL/hr. A patient who was involved in a motor vehicle crash has had a tracheostomy placed to allow for continued mechanical ventilation. How should the nurse interpret the following arterial blood gas results: pH 7.48, PaO2 85 mm Hg, PaCO2 32 mm Hg, and HCO3 25 mEq/L? d. Respiratory alkalosis The nurse notes that a patient who was admitted with diabetic ketoacidosis has rapid, deep respirations. Which action should the nurse take? d. Administer the prescribed normal saline bolus and insulin. An older adult patient who is malnourished presents to the emergency department with a serum protein level of 5.2 g/dL. The nurse would expect which clinical manifestation? b. Edema