Nokea
A client is prescribed normal saline as an IV infusion. Based on the nurse's understanding of the drug, the nurse would administer the infusion cautiously to a client with which of the following? Select all that apply.
- A. Hypoproteinemia
- B. Urinary tract infection
- C. Edema
- D. Hepatic impairment
- E. Renal impairment
Correct Answer: A,C,E
Rationale: The nurse must monitor clients with the following conditions particularly closely during the administration of normal saline because sodium should be used cautiously in these clients: surgical clients and clients with circulatory insufficiency, hypoproteinemia, edema, urinary tract obstruction, congestive heart failure, or renal impairment.
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A physician orders levofloxacin (Levaquin) for a client to treat infection. The order is for levofloxacin (Levaquin) 500 mg/100 mL to be infused over a period of 1 hour. The IV infusion set has a drop factor of 10 drops/mL. The nurse would set the infusion flow rate at
- A. 16 drops/min
- B. 17 drops/min
- C. 18 drops/min
- D. 19 drops/min
Correct Answer: B
Rationale: 100 mL / 1 hour = 100 mL/hr; 100 mL/hr ? 1 hr/60 min = 1.67 mL/min; 1.67 mL/min ? 10 = 16.7 or 17 drops/min.
A nurse is teaching a client about his prescribed potassium replacement therapy. The client is to continue taking the drug orally at home. After teaching the client about this therapy, the nurse determines that additional teaching is needed when the client states which of the following?
- A. I'll take the drug immediately after a meal.
- B. I need to drink a full glass of water when I take the drug.
- C. If I have trouble swallowing the drug, I can crush it.
- D. If the pharmacy gives me a liquid form, I can mix it in cold water or juice.
Correct Answer: C
Rationale: When given orally, potassium may cause GI distress. Therefore, it is given immediately after meals or with food and a full glass of water. Oral potassium must not be crushed or chewed.
After teaching a group of nursing students about electrolyte imbalances, the instructor determines that the teaching was successful when the group identifies which of the following as indicative of hypercalcemia? Select all that apply.
- A. Constipation
- B. Oliguria
- C. Polydipsia
- D. Bone pain
- E. Anorexia
Correct Answer: A,C,D,E
Rationale: Signs and symptoms of hypercalcemia include anorexia, nausea, vomiting, lethargy, bone tenderness or pain, polyuria, polydipsia, constipation, dehydration, muscle weakness and atrophy, stupor, coma, and cardiac arrest.
A client is prescribed bicarbonate. The client's medication history reveals that the client is also taking fluoroquinolones. The nurse would be alert for the development of which of the following due to an interaction of these two drugs?
- A. Respiratory alkalosis
- B. Severe abdominal pain
- C. Increased risk of crystalluria
- D. Renal impairment
Correct Answer: C
Rationale: The nurse should monitor the client's condition for an increased risk of crystalluria as a result of the interaction of fluoroquinolones and bicarbonate.
A nurse suspects a client receiving an infusion of normal saline may have hypernatremia based on assessment of which of the following? Select all that apply.
- A. Fever
- B. Dry skin
- C. Thirst
- D. Polyuria
- E. Weight gain
Correct Answer: A,B,C,E
Rationale: Signs and symptoms of hypernatremia include fever, hot, dry skin; sticky mucous membranes; rough, dry tongue; edema; weight gain; intense thirst; excitement; restlessness; agitation; and oliguria or anuria.