Nokea
A nurse is assigned to care for a client who is receiving IV fat emulsions. The nurse reviews the client's history and identifies the need to administer the fat emulsion cautiously based on which of the following?
- A. The client has a pulmonary disorder.
- B. The client is allergic to eggs.
- C. The client has acute pancreatitis
- D. The client has a vitamin deficiency.
Correct Answer: A
Rationale: When caring for a client who is to receive IV fat emulsions, the nurse should know that IV fat emulsions are to be used cautiously if the client has a pulmonary disorder, severe liver impairment, anemia, and blood coagulation disorders.
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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 caring for a client who is receiving ammonium chloride. The nurse would be alert for the development of which of the following as a possible adverse reaction?
- A. Depressed reflexes
- B. Muscle weakness
- C. Circulatory collapse
- D. Metabolic acidosis
Correct Answer: D
Rationale: The nurse should monitor the client's condition for metabolic acidosis as an adverse reaction to ammonium chloride.
A client who is prescribed digoxin (Lanoxin) is receiving electrolyte replacement therapy. The nurse would monitor the client for signs of digoxin toxicity if which of the following electrolytes is administered?
- A. Sodium
- B. Potassium
- C. Magnesium
- D. Phosphorous
Correct Answer: B
Rationale: The nurse should monitor a client taking digoxin (Lanoxin) for signs of digoxin toxicity if potassium is being given.
A nurse is administering IV fluid and electrolyte therapy to a client. The nurse reviews the client's laboratory test results. Which result would the nurse immediately report to the primary health care provider?
- A. Calcium 4.7 mEq/L
- B. Magnesium 2.0 mEq/L
- C. Potassium 2.1 mEq/L
- D. Sodium 140 mEq/L
Correct Answer: C
Rationale: The nurse would report a potassium level of 2.1 mEq/L because this indicates hypokalemia. A calcium level of 4.7 mEq/L, magnesium level of 2.0 mEq/L, and sodium level of 140 mEq/L are within normal ranges.
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.