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During the postoperative care of a 76-year-old patient, the nurse monitors the patient’s intake and output carefully, knowing that the patient is at risk for fluid and electrolyte imbalances primarily because?
a. older adults have an impaired thirst mechanism and need reminding to drink fluids.
b. water accounts for a greater percentage of body weight in the older adult than in younger adults.
c. older adults are more likely than younger adults to lose extracellular fluid during surgical procedures.
d. small losses of fluid are significant because body fluids account for 45% to 50% of body weight in older adults.
During administration of a hypertonic IV solution, the mechanism involved in equalizing the fluid concentration between ECF and the cells is?
a. osmosis.
b. diffusion.
c. active transport.
d. facilitated diffusion.
An older woman is admitted to the medical unit with GI bleeding. Assessment findings that indicate fluid volume deficit include (select all that apply)
a. weight loss.
b. dry oral mucosa.
c. full bounding pulse.
d. engorged neck veins.
e. decreased central venous pressure.
The nursing care for a patient with hyponatremia and fluid volume excess includes?
a. fluid restriction.
b. administration of hypotonic IV fluids.
c. administration of a cation-exchange resin.
d. placement of an indwelling urinary catheter.
The nurse should be alert for which manifestations in a patient receiving a loop diuretic?
a. Restlessness and agitation
b. Paresthesias and irritability
c. Weak, irregular pulse and poor muscle tone
d. Increased blood pressure and muscle spasms
Which patient is at greatest risk for developing hypermagnesemia?
a. 83-year-old man with lung cancer and hypertension
b. 65-year-old woman with hypertension taking β-adrenergic blockers
c. 42-year-old woman with systemic lupus erythematosus and renal failure
d. 50-year-old man with benign prostatic hyperplasia and a urinary tract infection
It is important for the nurse to assess for which manifestation(s) in a patient who has just undergone a total thyroidectomy (select all that apply)?
a. Confusion
b. Weight gain
c. Depressed reflexes
d. Circumoral numbness
e. Positive Chvostek’s sign
The nurse expects the long-term treatment of a patient with hyperphosphatemia from renal failure will include?
a. fluid restriction.
b. calcium supplements.
c. magnesium supplements.
d. increased intake of dairy products.
The lungs act as an acid-base buffer by?
a. increasing respiratory rate and depth when CO2 levels in the blood are high, reducing acid load.
b. increasing respiratory rate and depth when CO2 levels in the blood are low, reducing base load.
c. decreasing respiratory rate and depth when CO2 levels in the blood are high, reducing acid load.
d. decreasing respiratory rate and depth when CO2 levels in the blood are low, increasing acid load.
A patient has the following arterial blood gas results: pH 7.52, PaCO2 30 mm Hg, HCO3− 24 mEq/L. The nurse determines that these results indicate?
a. metabolic acidosis.
b. metabolic alkalosis.
c. respiratory acidosis.
d. respiratory alkalosis.
The typical fluid replacement for the patient with a fluid volume deficit is?
a. dextran.
b. 0.45% saline.
c. lactated Ringer’s solution.
d. 5% dextrose in 0.45% saline.
The nurse is unable to flush a central venous access device and suspects occlusion. The best nursing intervention would be to?
a. apply warm moist compresses to the insertion site.
b. try to force 10 mL of normal saline into the device.
c. place the patient on the left side with the head down.
d. have the patient change positions, raise arm, and cough.