ATI Fluid Electrolyte and Acid-Base Regulation

ATI Fluid Electrolyte and Acid-Base Regulation Related

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A nurse in the neurologic ICU has orders to infuse a hypertonic solution into a patient with increased intracranial
pressure. This solution will increase the number of dissolved particles in the patients blood, creating pressure for
fluids in the tissues to shift into the capillaries and increase the blood volume. This process is best described as which
of the following?

  • A. Hydrostatic pressure
  • B. Osmosis and osmolality
  • C. Diffusion
  • D. Active transport
Correct Answer: B

Rationale: The correct answer is B: Osmosis and osmolality. When a hypertonic solution is infused, it increases the number of dissolved particles in the blood, creating an osmotic pressure gradient. This causes fluids in the tissues to shift into the capillaries, increasing blood volume. Osmosis is the movement of solvent (water) across a semi-permeable membrane to equalize solute concentrations. Osmolality refers to the concentration of solutes in a solution.

Hydrostatic pressure (choice A) is the force exerted by a fluid against a wall when it is under pressure, not related to the movement of solutes.

Diffusion (choice C) is the movement of solute molecules from an area of high concentration to low concentration, not involving a semi-permeable membrane.

Active transport (choice D) requires energy to move molecules across a membrane against their concentration gradient, not the mechanism described in the scenario.

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After teaching a client to increase dietary potassium intake, a nurse assesses the client's understanding. Which dietary meal selection indicates the client correctly understands the teaching?

  • A. Toasted English muffin with butter and blueberry jam, and tea with sugar
  • B. Two scrambled eggs, a slice of white toast, and a half cup of strawberries
  • C. Sausage, one slice of whole wheat toast, half cup of raisins, and a glass of milk
  • D. Bowl of oatmeal with brown sugar, a half cup of sliced peaches, and coffee
Correct Answer: C

Rationale: The correct answer is C because it includes foods high in potassium. Raisins, whole wheat toast, and milk are good sources of potassium. Sausage might contain some potassium as well.

A: This option lacks potassium-rich foods.
B: While strawberries have some potassium, the overall meal lacks a sufficient amount.
D: While oatmeal and peaches have potassium, coffee can actually inhibit potassium absorption.

A nurse assesses a client who is experiencing an acid-base imbalance. The clients arterial blood gas values are pH 7.34, PaO2 88 mm Hg, PaCO2 38 mm Hg, and HCO3 19 mEq/L. Which assessment should the nurse perform first?

  • A. . Cardiac rate and rhythm
  • B. Skin and mucous membranes
  • C. Musculoskeletal strength
  • D. Level of orientation
Correct Answer: A

Rationale: The correct answer is A: Cardiac rate and rhythm. In an acid-base imbalance, the pH is below the normal range indicating acidosis. The nurse should assess the cardiac rate and rhythm first because acidosis can have negative effects on the cardiovascular system. Acidosis can lead to arrhythmias and decreased cardiac output. Monitoring the cardiac rate and rhythm is crucial to detect any cardiac complications early. Choices B, C, and D are not the priority in this situation as they are not directly impacted by acid-base imbalances.

After providing discharge teaching, a nurse assesses the clients understanding regarding increased risk for metabolic alkalosis. Which statement indicates the client needs additional teaching?

  • A. . I dont drink milk because it gives me gas and diarrhea
  • B. I have been taking digoxin every day for the last 15 years
  • C. . I take sodium bicarbonate after every meal to prevent heartburn
  • D. In hot weather, I sweat so much that I drink six glasses of water each day.
Correct Answer: C

Rationale: The correct answer is C because taking sodium bicarbonate after every meal can actually increase the risk of metabolic alkalosis due to its alkaline nature. Sodium bicarbonate can lead to an excessive build-up of bicarbonate in the bloodstream, causing alkalosis.

Choice A is not directly related to metabolic alkalosis. Choice B, taking digoxin, is unrelated to metabolic alkalosis as well. Choice D, drinking six glasses of water due to sweating, does not contribute to metabolic alkalosis as it helps maintain hydration and electrolyte balance.

A patient's most recent laboratory results show a slight decrease in potassium. The physician has opted to forego drug therapy but has suggested increasing the patient's dietary intake of potassium. Which of the following would be a good source of potassium?

  • A. Apples
  • B. Asparagus
  • C. Carrots
  • D. Bananas
Correct Answer: D

Rationale: The correct answer is D: Bananas. Bananas are a good source of potassium, with around 400-500 mg per banana. Potassium is essential for maintaining proper muscle function, nerve signaling, and fluid balance in the body. Increasing dietary intake of potassium can help address a slight decrease in potassium levels without the need for drug therapy. Apples, asparagus, and carrots are not as high in potassium as bananas, making them less effective choices for addressing a potassium deficiency.

A nurse is assessing a client who has an electrolyte imbalance related to renal failure. For which potential complications of this electrolyte imbalance should the nurse assess? (Select all that do mot apply.)

  • A. Electrocardiogram changes
  • B. Slow, shallow respirations
  • C. Paralytic ileus
  • D. Skeletal muscle weakness
Correct Answer: B

Rationale: Correct Answer: B - Slow, shallow respirations

Rationale:
1. Electrolyte imbalance in renal failure often leads to respiratory alkalosis, causing rapid and deep respirations, not slow and shallow.
2. Electrocardiogram changes (A) are common with electrolyte imbalances, particularly potassium and calcium.
3. Paralytic ileus (C) is a complication of electrolyte imbalances, affecting gastrointestinal motility.
4. Skeletal muscle weakness (D) is a common manifestation of electrolyte imbalances, especially potassium and magnesium deficiencies.

Summary:
Choice B is incorrect because slow, shallow respirations are not typically associated with electrolyte imbalances related to renal failure. Choices A, C, and D are commonly seen complications of electrolyte imbalances and should be assessed by the nurse.

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