Nokea
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.
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.A nurse assesses a clients peripheral IV site, and notices edema and tenderness above the site. Which action should the nurse take next?
- A. Apply cold compresses to the IV site.
- B. Elevate the extremity on a pillow.
- C. Flush the catheter with normal saline.
- D. . Stop the infusion of intravenous fluids.
Correct Answer: D
Rationale: The correct action is to stop the infusion of intravenous fluids. Edema and tenderness above the IV site suggest infiltration, where fluid leaks into surrounding tissues. Stopping the infusion prevents further damage and helps prevent complications. Applying cold compresses (A) may not address the underlying issue. Elevating the extremity (B) is helpful for other conditions like swelling due to dependent edema, not infiltration. Flushing the catheter (C) can exacerbate the issue by pushing more fluid into the tissue.
A nurse is assessing a client who has acute pancreatitis and is at risk for an acid-base imbalance. For which manifestation of this acid-base imbalance should the nurse assess?
- A. Agitation
- B. Kussmaul respirations
- C. Seizures
- D. Positive Chvosteks sign
Correct Answer: B
Rationale: The correct answer is B: Kussmaul respirations. In acute pancreatitis, metabolic acidosis can occur due to the release of pancreatic enzymes. Kussmaul respirations are deep, rapid breaths that help to blow off excess carbon dioxide in response to acidosis, aiming to correct the pH imbalance. Agitation (A) is a nonspecific symptom and not specific to acid-base imbalances. Seizures (C) are more commonly associated with electrolyte imbalances such as hyponatremia or hypocalcemia. Positive Chvostek's sign (D) is a clinical sign of hypocalcemia, not directly related to acid-base imbalances in acute pancreatitis.
A nurse develops a plan of care for a client who has a history of hypocalcemia. What interventions should the nurse include in this clients care plan? (Select all that apply.)
- A. Use a draw sheet to reposition the client in bed.
- B. . Strain all urine output and assess for urinary stones.
- C. Provide nonslip footwear for the client to use when out of bed.
Correct Answer: B
Rationale: The correct answer is B. Straining all urine output and assessing for urinary stones is important for a client with hypocalcemia as they are at risk for developing kidney stones due to increased calcium excretion. By straining urine, the nurse can monitor for the presence of stones.
A, using a draw sheet to reposition the client, is not directly related to hypocalcemia. C, providing nonslip footwear, is important for fall prevention but not specific to hypocalcemia. D, since it is not provided, cannot be evaluated.
A nurse assesses a client who was started on intraperitoneal therapy 5 days ago. The client reports abdominal pain and feeling warm. For which complication of this therapy should the nurse assess this client?
- A. Allergic reaction
- B. Bowel obstruction
- C. Catheter lumen occlusion
- D. Infection
Correct Answer: D
Rationale: The correct answer is D, infection. The client's symptoms of abdominal pain and feeling warm are indicative of a potential infection, which is a common complication of intraperitoneal therapy. Step-by-step rationale: 1. Abdominal pain can be a sign of peritonitis, an infection of the peritoneal cavity. 2. Feeling warm may indicate a fever, a common symptom of infection. 3. Prompt assessment and treatment of infection are crucial to prevent complications. Summary of other choices: A, allergic reaction - unlikely given the symptoms described; B, bowel obstruction - does not align with the symptoms provided; C, catheter lumen occlusion - not typically associated with abdominal pain and feeling warm.
A gerontologic nurse is teaching students about the high incidence and prevalence of dehydration in older adults.
What factors contribute to this phenomenon? Select all that do not apply.
- A. Decreased kidney mass
- B. Decreased renal blood flow
- C. Decreased excretion of potassium
- D. Increased conservation of sodium
Correct Answer: D
Rationale: The correct answer is D: Increased conservation of sodium. Older adults tend to have an increased conservation of sodium, leading to fluid retention and decreased fluid intake, which can contribute to dehydration.
A: Decreased kidney mass is incorrect because it is a factor that can contribute to decreased kidney function but not directly linked to dehydration.
B: Decreased renal blood flow can impact kidney function but is not a direct cause of dehydration in older adults.
C: Decreased excretion of potassium is not a factor that directly contributes to dehydration in older adults.