Fluid and Electrolytes > Fundamentals
Exam Review
Regulation of Electrolytes
Total Questions : 5
Showing 5 questions, Sign in for moreA nurse is caring for a client who has a low serum sodium level. Which of the following actions should the nurse take?
Explanation
Choice A reason:
Restricting the client's fluid intake is not appropriate for a client who has a low serum sodium level. This could worsen the client's condition by increasing the relative concentration of sodium in the blood. Fluid restriction is indicated for clients who have a high serum sodium level.
Choice B reason:
Administering a hypertonic saline solution IV is the correct action for a nurse to take for a client who has a low serum sodium level. This will help increase the serum sodium level by drawing water out of the cells and into the blood. Hypertonic saline solutions are used to treat severe cases of hyponatremia.
Choice C reason:
Encouraging the client to eat foods high in potassium is not relevant for a client who has a low serum sodium level. Potassium is another electrolyte that affects the fluid balance in the body, but it does not directly affect the serum sodium level. Foods high in potassium are recommended for clients who have a low serum potassium level.
Choice D reason:
Monitoring the client for signs of hypernatremia is not necessary for a client who has a low serum sodium level. Hypernatremia is a condition of high serum sodium level, which is opposite to the client's condition. Signs of hypernatremia include thirst, dry mucous membranes, confusion, and seizures.
A nurse is reviewing the laboratory results of a client who has a high serum potassium level. Which of the following factors can cause hyperkalemia? (Select all that apply.)
Explanation
Choice A reason:
Renal failure. This is a common cause of hyperkalemia because the kidneys are responsible for excreting excess potassium from the body. When the kidneys are damaged or impaired, they cannot filter out enough potassium, leading to its accumulation in the blood.
Choice B reason:
Diuretic therapy. This is not a cause of hyperkalemia, but rather a potential treatment for it. Diuretics are medications that increase urine output and help remove excess fluid and electrolytes from the body. Some diuretics, such as thiazides and loop diuretics, can also lower potassium levels by increasing its loss in urine. However, other diuretics, such as potassium-sparing diuretics, can cause hyperkalemia by reducing potassium excretion.
Choice C reason:
Acidosis. This is a condition where the blood pH is lower than normal, indicating an excess of acid in the body. Acidosis can cause hyperkalemia by shifting potassium from the cells to the blood in exchange for hydrogen ions. This is a mechanism to buffer the acid and maintain the electrical balance across the cell membrane.
Choice D reason:
Insulin deficiency. This is a condition where the body does not produce enough insulin, a hormone that regulates blood glucose levels. Insulin deficiency can cause hyperkalemia by impairing the uptake of glucose and potassium into the cells. Insulin normally stimulates the activity of sodium-potassium pumps that transport sodium out of the cells and potassium into the cells.
Choice E reason:
Tissue injury. This is a condition where there is damage or destruction of body tissues due to trauma, infection, inflammation, or ischemia (lack of blood supply) Tissue injury can cause hyperkalemia by releasing potassium from the injured cells into the blood. This can occur in conditions such as burns, crush injuries, rhabdomyolysis (muscle breakdown), hemolysis (red blood cell breakdown), or tumor lysis syndrome (cancer cell breakdown)
A nurse is teaching a client who has osteoporosis about calcium supplements. Which of the following statements by the client indicates an understanding of the teaching?
Explanation
Choice A reason:
Taking calcium supplements with milk is not recommended because milk contains phosphorus, which can interfere with calcium absorption.
Choice B reason:
Eating spinach while taking calcium supplements is not a problem, as spinach is a good source of calcium and other nutrients. However, spinach also contains oxalates, which can bind to calcium and reduce its absorption. Therefore, spinach should not be the only source of calcium in the diet.
Choice C reason:
Taking calcium supplements with vitamin D is the best option, as vitamin D helps the body absorb and use calcium more effectively. Vitamin D can be obtained from sunlight exposure, fortified foods, or supplements.
Choice D reason:
Limiting caffeine intake while taking calcium supplements is a good idea, but not the most important one. Caffeine can increase calcium excretion in the urine, but this effect can be offset by consuming adequate amounts of calcium from food or supplements.
A nurse is assessing a client who has hypomagnesemia. Which of the following findings should the nurse expect?
Explanation
Choice A reason:
Hypotension is not an expected finding for a client who has hypomagnesemia. Hypotension is more likely to occur with hypovolemia, which is a decrease in the amount of fluid in the blood vessels. Hypomagnesemia is a decrease in the amount of magnesium in the blood, which affects neuromuscular function and can cause muscle spasms, tremors, and seizures.
Choice B reason:
Bradycardia is not an expected finding for a client who has hypomagnesemia. Bradycardia is a slow heart rate, usually below 60 beats per minute. Hypomagnesemia can cause cardiac arrhythmias, such as tachycardia (fast heart rate), premature ventricular contractions (PVCs), and torsades de pointes (a type of ventricular tachycardia)
Choice C reason:
Muscle weakness is not an expected finding for a client who has hypomagnesemia. Muscle weakness is more likely to occur with hypermagnesemia, which is an excess of magnesium in the blood. Hypermagnesemia can cause decreased neuromuscular excitability and reduced muscle contraction.
Choice D reason:
Tetany is an expected finding for a client who has hypomagnesemia. Tetany is a condition characterized by involuntary muscle contractions, often affecting the hands and feet. It is caused by low levels of calcium or magnesium in the blood, which interfere with normal nerve impulses.
A nurse is preparing to administer IV fluids to a client who has dehydration. The nurse should select a solution that contains which of the following electrolytes to regulate ECF balance and vascular volume?
Explanation
Choice A reason:
Potassium is the major cation in the intracellular fluid (ICF), not the extracellular fluid (ECF) It is important for nerve and muscle function, but it does not regulate ECF balance and vascular volume.
Choice B reason:
Calcium is a cation that is mostly found in bones and teeth, but also plays a role in muscle contraction, blood clotting, and enzyme activity. It does not regulate ECF balance and vascular volume.
Choice C reason:
Chloride is the correct answer. It is the major anion in the ECF and it helps to maintain osmotic pressure, acid-base balance, and fluid volume. It often accompanies sodium in fluid replacement therapy.
Choice D reason:
Phosphate is an anion that is mostly found in bones and teeth, but also participates in energy metabolism, acid-base balance, and nucleic acid synthesis. It does not regulate ECF balance and vascular volume.
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