ATI Fluid Electrolyte and Acid-Base Regulation

ATI Fluid Electrolyte and Acid-Base Regulation Related

Review ATI Fluid Electrolyte and Acid-Base Regulation related questions and content

The nurse caring for a patient post colon resection is assessing the patient on the second postoperative day. The
nasogastric tube (NG) remains patent and continues at low intermittent wall suction. The IV is patent and infusing at
125 mL/hr. The patient reports pain at the incision site rated at a 3 on a 0-to-10 rating scale. During your initial shift
assessment, the patient complains of cramps in her legs and a tingling sensation in her feet. Your assessment indicates
decreased deep tendon reflexes (DTRs) and you suspect the patient has hypokalemia. What other sign or symptom
would you expect this patient to exhibit

  • A. Diarrhea
  • B. Dilute urine
  • C. Increased muscle tone
  • D. Joint pain
Correct Answer: B

Rationale: The correct answer is B: Dilute urine. Hypokalemia can lead to kidney dysfunction, causing the kidneys to excrete more water along with electrolytes, resulting in dilute urine. This is a manifestation of the body's attempt to compensate for low potassium levels by excreting excess water. The other choices are incorrect because: A) Diarrhea is more commonly associated with hyperkalemia, not hypokalemia. C) Increased muscle tone is not a typical sign of hypokalemia; rather, hypokalemia can lead to muscle weakness or paralysis due to impaired muscle function. D) Joint pain is not a typical symptom of hypokalemia; joint pain is more commonly associated with other conditions such as arthritis or inflammation.

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You are caring for a patient with a secondary diagnosis of hypermagnesemia. What assessment finding would be
most consistent with this diagnosis?

  • A. Hypertension
  • B. Kussmaul respirations
  • C. Increased DTRs
  • D. Shallow respirations
Correct Answer: D

Rationale: The correct answer is D: Shallow respirations. Hypermagnesemia can lead to respiratory depression due to its inhibitory effect on the central nervous system. Shallow respirations are a common respiratory manifestation of hypermagnesemia. Hypertension (choice A) is not typically associated with hypermagnesemia. Kussmaul respirations (choice B) are deep, rapid breathing patterns seen in metabolic acidosis, not hypermagnesemia. Increased deep tendon reflexes (DTRs) (choice C) are more indicative of hypomagnesemia, as magnesium deficiency can lead to hyperexcitability of nerves and muscles, resulting in increased DTRs.

You are an emergency-room nurse caring for a trauma patient. Your patient has the following arterial blood gas results: pH 7.26, PaCO2 28, HCO3 11 mEq/L. How would you interpret these results?

  • A. Respiratory acidosis with no compensation
  • B. Metabolic alkalosis with a compensatory alkalosis
  • C. Metabolic acidosis with no compensation
  • D. Metabolic acidosis with a compensatory respiratory alkalosis
Correct Answer: D

Rationale: To interpret the given ABG results:
1. pH <7.35 indicates acidosis.
2. PaCO2 <35 indicates respiratory alkalosis.
3. HCO3 <22 indicates metabolic acidosis.
Therefore, the ABG results show metabolic acidosis (low pH, low HCO3) with compensatory respiratory alkalosis (low PaCO2). This means the body is trying to compensate for the metabolic acidosis by decreasing PaCO2 through hyperventilation. Option D is correct. Options A, B, and C are incorrect as they do not align with the ABG results and the principles of acid-base balance.

You are caring for a patient who is being treated on the oncology unit with a diagnosis of lung cancer with bone
metastases. During your assessment, you note the patient complains of a new onset of weakness with abdominal pain.
Further assessment suggests that the patient likely has a fluid volume deficit. You should recognize that this patient
may be experiencing what electrolyte imbalance?

  • A. Hypernatremia
  • B. Hypomagnesemia
  • C. Hypophosphatemia
  • D. Hypercalcemia
Correct Answer: D

Rationale: The correct answer is D: Hypercalcemia. Bone metastases in lung cancer can lead to increased release of calcium into the blood, causing hypercalcemia. The patient's symptoms of weakness and abdominal pain are consistent with hypercalcemia. Hypernatremia (choice A) is unlikely as the symptoms do not align with high sodium levels. Hypomagnesemia (choice B) and hypophosphatemia (choice C) are less likely as they are not typically associated with bone metastases in lung cancer. In summary, the patient's presentation of weakness and abdominal pain in the setting of lung cancer with bone metastases points to hypercalcemia as the most likely electrolyte imbalance.

A client with a serum potassium of 7.5 mEq/L and cardiovascular changes needs immediate intervention. Which prescription should the nurse implement first?

  • A. Prepare to administer sodium polystyrene sulfate (Kayexalate) 15 g by mouth.
  • B. Provide a heart-healthy, low-potassium diet.
  • C. Prepare to administer dextrose 20% and 10 units of regular insulin IV push.
  • D. Prepare the client for hemodialysis treatment.
Correct Answer: C

Rationale: The correct answer is C. The client's high serum potassium level of 7.5 mEq/L can lead to serious cardiovascular complications like arrhythmias. The immediate priority is to lower potassium levels rapidly to prevent cardiac arrest. Administering dextrose 20% and regular insulin IV push helps shift potassium from extracellular to intracellular space, lowering serum levels quickly. Option A (Kayexalate) is not as rapid as insulin therapy. Option B (low-potassium diet) is not immediate. Option D (hemodialysis) is effective but not as quick as insulin therapy for urgent potassium reduction.

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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