Assessment
Which client has a high risk for hypokalemia?
Client with NG suction
Client with vomiting
Client with diarrhea
What are your priority actions for a client with the following lab results?
K 3.2 mEq/L
Na 128 mEq/L
Notify the provider, they are both low
Patient needs K and fluid restriction
What type of acid-base imbalance would you expect when the client has opioid overdose?
Resp acidosis
Name an isotonic intravenous fluid.
Lactated Ringer's
0.9% Normal Saline
A fluid with the same tonicity as normal blood is called isotonic.
What should the nurse assess for in a patient with abnormal serum potassium levels?
Cardiac Dysrhythmias
What diagnostic tests will the nurse anticipate for a patient with suspected fluid overload?
Chest x-ray
Lab draw (CBC, CMP, BNP)
Possible ABGs
What type of acid-base imbalance would you expect when the client has NG tube suction intermittently?
Met Alkalosis
Which fluid is hypotonic?
0.9% NaCL
0.45% NaCL
3% NaCL
0.45% NaCL
A hypotonic solution is more dilute than the blood.
What are the clinical manifestations of dehydration?
Poor skin turgor
Flat neck veins
Hypotension
Tachycardia
Weak, thready pulses
What do you anticipate to do when client has hypovolemia?
Start IV
Give fluid bolus to rehydrate
NS or LR
Monitor urine output
What is the interpretation of the following:
pH 7.32
CO2 47
HCO3 24
Resp acidosis
Which fluid is hypertonic?
0.9% NaCL
0.45% NaCL
3% NaCL
3% NaCL
A hypertonic solution is more concentrated than normal blood.
What are S/S fluid overload?
Crackles in the lungs
JVD
Edema
Bounding pulses
Weight gain
What are some of the complications of IV therapy?
Fluid overload
Phlebitis
Infiltration
Extravasation
What is the interpretation of the following:
pH 7.28
CO2 42
HCO3 18
Metabolic acidosis
You have the following order:
Infuse 1200 ml 0.9% NaCL over 5 hours IV.
What is your hourly rate?
240ml/hr
What are some of the neuromuscular effects of hypovolemia?
Dizziness
Syncope
Confusion
Weakness
Seizures
What is urine specific gravity?
Urine specific gravity is a measure of the concentration of urine. It indicates how well your kidneys are balancing fluids and removing waste products from your blood.
Urine specific gravity: normal=1.002-1.030
High = heavily concentrated
Low = urine is too diluted
What is the interpretation for the following:
pH 7.47
CO2 36
HCO3 28
Metabolic alkalosis
What are the parameters for an IV fluid order?
Type of fluid
Amount of fluid
Route
Speed of administration