Fluid & Electrolytes
Approximately two thirds of the body's total water volume exists in the _____ fluid.
a. Intracellular
b. Interstitial
c. Intravascular
d. Transcellular
A. Intracellular
Which laboratory value should the nurse examine when evaluating uncompensated respiratory alkalosis?
a. PaO2
b. Anion gap
c. PaCO2
d. HCO3
c. PaCO2
Which system is responsible for compensating for respiratory acidosis/alkalosis?
Metabolic system
A nurse is explaining to a student nurse that perioperative nursing care occurs _______, ________, and ________ surgery.
Before, during, and after surgery.
3% NaCl is what type of solution?
Hypertonic solution
This process involves the passive movement of water from an area of LOW particle concentration to an area of HIGH particle concentration.
Osmosis
What 2 labs are important for RENAL function?
BUN & Creatinine.
Which system is responsible for compensating for metabolic acidosis/alkalosis?
Respiratory system
The nurse is caring for a patient who is scheduled to undergo a surgical procedure. The nurse is completing an assessment and reviews the patients laboratory tests and allergies. In which perioperative nursing phase would this work be completed?
a. Perioperative
b. Preoperative
c. Intraoperative
d. Postoperative
B. Preoperative
What is the MOST abundant electrolyte in our body?
Potassium
The nurse would expect a patient with respiratory acidosis to have an excessive amount of
a. Carbon dioxide.
b. Bicarbonate.
c. Oxygen.
d. Phosphate.
a. Carbon dioxide
**Will this patient be hyperventilating or hypoventilating?**
The nurse would expect a patient with increased levels of serum calcium to also have _____ levels.
a. Increased potassium
b. Decreased phosphate
c. Decreased sodium
d. Increased magnesium
b. Decreased phosphate
*Remember, Calcium & Phosphate have an inverse relationship. When one is elevates, the other decreases and vice versa.
Interpret these ABG values:
pH = 7.29, PaCO2 = 47, HCO3 = 24
Respiratory acidosis
The nurse is caring for a patient in the postanesthesia care unit. The patient has developed profuse bleeding from the surgical site, and the surgeon has determined the need to return to the operative area. This procedure would be classified as...
Emergency procedure
The physician asks the nurse to monitor the fluid volume status of a congestive heart failure patient and a patient at risk for clinical dehydration. What is the most effective nursing intervention for monitoring both of these patients?
a. Weigh the patients every morning before breakfast.
b. Ask the patients to record their intake and output.
c. Measure the patients blood pressure every 4 hours.
d. Assess the patients for edema in extremities.
a. Weigh the patients every morning before breakfast.
0.9% Normal Saline, Lactated Ringer, D5W are examples of what type of solution?
Isotonic solution
What are the normal ABG lab values for:
1) pH
2) PaCO2
3) HCO3
1) pH: 7.35 - 7.45
2) PaCO2: 35 - 45 mm Hg
3) HCO3: 22 - 26 mEq/L
Interpret these ABG values:
pH = 7.48, PaCO2 = 41, HCO3 = 29
Metabolic alkalosis
Removal of a gallbladder for stones is an example of what type of procedure?
Urgent procedure
A 2-year-old child was brought into the emergency department after ingesting several morphine tablets from a bottle in his mothers purse. The nurse knows that the child is at greatest risk for which acid-base imbalance?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis
a. Respiratory acidosis
The nurse is caring for a diabetic patient in renal failure. Which laboratory findings would the nurse expect?
a. pH 7.3, PaCO2 36 mm Hg, HCO3 19 mEq/L
b. pH 7.5, PaCO2 35 mm Hg, HCO3 35 mEq/L
c. pH 7.3, PaCO2 47 mm Hg, HCO3 23 mEq/L
d. pH 7.35, PaCO2 40 mm Hg, HCO3 25 mEq/L
a. pH 7.3, PaCO2 36 mm Hg, HCO3 19 mEq/L
List all of the normal electrolyte values.
1) Sodium
2) Potassium
3) Chloride
4) Osmolality
5) Calcium
6) BUN
7) Creatinine
8) eGFR
9) Magnesium
1) Sodium: 135 - 145 mEq/L
2) Potassium: 3.5 - 5.3 mEq/L
3) Chloride: 97 - 111 mEq/L
4) Osmolality: 280 - 301 mOS/kg
5) Calcium: 8.7 - 10.2 mg/dL
6) BUN: 7 - 23 mg/dL
7) Creatinine 0.5 - 1.3 mg/dL
8) eGFR: 97 - 137 mL/min
9) Magnesium: 1.5 - 2.5 mEq/L
Interpret these ABG values:
pH = 7.35, PaCO2 = 30, HCO3 = 19
Metabolic acidosis
The nurse is completing a medication history for the surgical patient in preadmission testing. Which of the following medications should the nurse instruct the patient to hold in preparation for surgery?
a. Warfarin
b. Acetaminophen
c. Vitamin C
d. Miconazole
A. Warfarin
NCLEX Question:
George Kent is a 54 year old widower with a history of chronic obstructive pulmonary disease and was rushed to the emergency department with increasing shortness of breath, pyrexia, and a productive cough with yellow-green sputum. He has difficulty in communicating because of his inability to complete a sentence. One of his sons, Jacob, says he has been unwell for three days. Upon examination, crackles and wheezes can be heard in the lower lobes; he has a tachycardia and a bounding pulse. Measurement of arterial blood gas shows pH 7.3, PaCO2 68 mm Hg, HCO3 28 mmol/L, and PaO2 60 mm Hg. How would you interpret this?
A. Respiratory Acidosis, Uncompensated
B. Respiratory Acidosis, Partially Compensated
C. Metabolic Alkalosis, Uncompensated
D. Metabolic Acidosis, Partially, Compensated
B. Respiratory Acidosis, Partially Compensated
The patient has respiratory acidosis (raised carbon dioxide) resulting from an acute exacerbation of chronic obstructive pulmonary disease, with partial compensation.