Nokea
A client has developed electrolyte imbalances. The nurse understands that which of the following would most likely contribute to the client's current situation? Select all that apply.
- A. Vomiting
- B. Constipation
- C. Surgery
- D. Drug administration
- E. Diagnostic tests
Correct Answer: A,C,D,E
Rationale: The following can result in electrolyte imbalances in a client: vomiting, diarrhea, surgery, drug administration, and diagnostic tests.
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A physician orders normal saline for a client to replace lost fluids due to poor oral intake. The order is for 1000 mL normal saline to be infused over a period of 6 hours. If the drop factor is 20 drops/mL, the nurse would set the IV flow rate at
- A. 55 drops/min
- B. 56 drops/min
- C. 57 drops/min
- D. 58 drops/min
Correct Answer: B
Rationale: 1000 mL / 6 hours = 166.7 mL/hr; 166.7 mL/hr ? 1 hr/60 min = 2.8 mL/min; 2.8 mL/min ? 20 = 55.5 or 56 drops/min.
The primary health care provider prescribes potassium to be replaced IV. When reviewing the client's medication history, the nurse determines that the underlying reason for this order is most likely the administration of which of the following drugs? Select all that apply.
- A. Furosemide (Lasix)
- B. Enalaprilat (Vasotec)
- C. Bumetanide (Bumex)
- D. Ceftriaxone (Rocephin)
- E. Spironolactone (Aldactone)
Correct Answer: A,C
Rationale: The administration of loop diuretics, like furosemide (Lasix) and bumetanide (Bumex), causes the excretion of water and potassium and can result in the need for IV fluid replacement of potassium.
A nurse is assigned to care for a client who has received albumin intravenously. The nurse understands that which of the following reasons has prompted the administration of plasma protein fractions to the client?
- A. The client must have lost a lot of blood volume due to severe hemorrhage.
- B. The client must have poor wound-healing abilities with a high risk of infection.
- C. The client must be experiencing a condition in which plasma alone is lost.
- D. The client must be experiencing hypovolemic shock due to trauma.
Correct Answer: D
Rationale: Plasma protein fractions are used in clients to treat hypovolemic shock that occurs as a result of burns, trauma, surgery, and infections or in conditions where shock is not currently present but likely to occur. It is also used in the case of hypoproteinemia, as might be seen in clients with nephrotic syndrome and hepatic cirrhosis, as well as other diseases or disorders.
A nurse is caring for a client prescribed dextran IV. The nurse would observe the client for which of the following as a possible adverse reaction?
- A. Cyanosis
- B. Wheezing
- C. Hyperlipidemia
- D. Hypercoagulability
Correct Answer: B
Rationale: Dextran administration may result in allergic reactions, which are evidenced by urticaria, hypotension, nausea, vomiting, headache, dyspnea, fever, tightness of the chest, and wheezing.
A physician orders levofloxacin (Levaquin) for a client to treat infection. The order is for levofloxacin (Levaquin) 1000 mg/50 mL to be infused over a period of 1 hour. The IV infusion set delivers 15 drops/mL. The nurse would set the infusion rate at
- A. 12 drops/min
- B. 13 drops/min
- C. 14 drops/min
- D. 15 drops/min
Correct Answer: B
Rationale: 50 mL / 1 hour = 50 mL/hr; 50 mL/hr ? 1 hr/60 min = 0.83 mL/min; 0.83 mL/min ? 15 = 12.5 or 13 drops/min.