Electrolyte Imbalances
This electrolyte imbalance is characterized by muscle weakness, ECG changes, and can occur with overuse of potassium-sparing diuretics.
Answer: What is hyperkalemia?
Rationale: Hyperkalemia often results from impaired renal excretion or excess intake, such as potassium-sparing diuretics.
This condition is caused by excessive fluid loss and presents with hypotension, dry mucous membranes, and tachycardia.
Answer: What is hypovolemia?
Rationale: Signs of fluid volume deficit include low BP, dry mucosa, and compensatory increased heart rate.
When teaching a patient on fluid restriction, it's important to encourage this to monitor intake.
Answer: What is keeping a fluid intake log?
Rationale: Recording intake promotes awareness and compliance with fluid limits.
The nurse should monitor this vital sign closely when administering IV fluids rapidly.
Answer: What is blood pressure?
Rationale: Rapid fluid administration can cause hypertension or fluid overload.
A patient receiving midazolam for sedation begins to desaturate and become difficult to arouse. What is the nurse’s priority action?
Answer: What is assess airway and administer oxygen?
Rationale: Sedation affects respiratory drive; airway and oxygenation are top priorities.
This electrolyte imbalance may lead to tetany and positive Chvostek's and Trousseau's signs.
Answer: What is hypocalcemia?
Rationale: Low calcium increases neuromuscular excitability, leading to classic signs like tetany and facial twitching.
The best indicator of fluid volume status over time.
Answer: What is daily weight?
Rationale: A 1-kg weight gain or loss reflects 1 L of fluid; it's more accurate than I&O.
This hormone helps conserve sodium and water, especially during stress.
Answer: What is aldosterone?
Rationale: Aldosterone triggers sodium and water retention to maintain blood volume.
When caring for a patient with edema, elevate this.
Answer: What is the affected extremity?
Rationale: Elevation promotes venous return and reduces swelling.
A patient with prolonged vomiting is at risk for this acid-base imbalance.
Answer: What is metabolic alkalosis?
Rationale: Loss of gastric acid causes bicarbonate accumulation, leading to alkalosis.
This electrolyte is primarily excreted by the kidneys and is critical for cardiac and neuromuscular function.
Answer: What is potassium?
Rationale: Potassium is essential for action potentials; renal impairment can lead to dangerous imbalances.
In hypervolemia, fluid may accumulate in this 'third' space, leading to visible swelling.
Answer: What is the interstitial space (edema)?
Rationale: Excess fluid often shifts to interstitial areas, causing edema.
A patient taking loop diuretics should be taught to monitor for symptoms of this electrolyte imbalance.
Answer: What is hypokalemia?
Rationale: Loop diuretics can cause potassium loss, increasing risk of muscle cramps and arrhythmias.
For a patient receiving 3% saline, the nurse must monitor for signs of this life-threatening condition.
Answer: What is fluid volume overload or pulmonary edema?
Rationale: Hypertonic saline increases circulating volume, risking overload.
This lab value is expected to rise in renal failure and metabolic acidosis: 138, 145, 5.9, or 0.4?
Answer: What is 5.9 (potassium)?
Rationale: Renal failure reduces potassium excretion, especially in acidosis.
A patient with renal failure and hyperphosphatemia is likely to also have low levels of this electrolyte.
Answer: What is calcium?
Rationale: Phosphate and calcium have an inverse relationship, especially in renal dysfunction.
This term describes fluid that moves into areas where it is not easily exchanged with ECF (e.g., ascites).
Answer: What is third spacing?
Rationale: Third spacing is fluid trapped in compartments where it cannot be used for circulation.
Older adults are more prone to dehydration due to this age-related physiological change.
Answer: What is decreased thirst sensation?
Rationale: Thirst declines with age, reducing voluntary fluid intake.
Name two systems you must assess during fluid overload.
Answer: What are the cardiovascular and respiratory systems?
Rationale: These systems show early signs of fluid excess like crackles and hypertension.
A patient with SIADH is likely to have this sodium imbalance.
Answer: What is hyponatremia?
Rationale: SIADH causes dilutional hyponatremia due to water retention.
This magnesium-related condition can cause decreased deep tendon reflexes and respiratory depression.
Answer: What is hypermagnesemia?
Rationale: Excess magnesium depresses the CNS and neuromuscular junction, reducing reflexes and respirations.
This condition can result from aggressive diuretic therapy, vomiting, or inadequate fluid intake.
Answer: What is dehydration?
Rationale: Dehydration occurs when fluid loss exceeds intake or absorption.
A patient on phosphate-binding medications should avoid taking them with this mineral-rich beverage.
Answer: What is milk?
Rationale: Milk is high in calcium, which can interfere with phosphate binders.
For a patient at risk for impaired skin integrity from fluid imbalance, this type of care is essential.
Answer: What is frequent repositioning and moisturizing?
Rationale: Skin care helps prevent breakdown when edema or dehydration is present.
A patient receiving IV potassium must be monitored closely for these three things.
Answer: What are cardiac rhythm, kidney function, and infusion rate?
Rationale: IV potassium affects the heart and must be given cautiously with renal monitoring.
This is the most important nursing assessment before administering IV potassium to a hospitalized patient.
Answer: What is assessing kidney function (e.g., urine output or BUN/creatinine levels)?