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Fluid and Electrolytes - Kaplan
Terms in this set (61)
A client tells the LPN, "I use milk of magnesia twice a day to have a bowel movement." For the past week, the client has had problems with diarrhea. The LPN expects to see which value in teh client's lab report?
Magnesium 1 mEq/L
The LPN notes that a client has a serum sodium of 128 mEq/L. Which does the LPN expect to observe?
A client receives a gastrointestinal viral diagnosis. The LPN expects to find which abnormal value in the client's laboratory report?
Phosphorus 2.1 mg/dL
RATIONALE: The normal phosophorus range is 2.5 to 4.5 mg/dL.
The LPN reviews laboratory results and notes that the client's serum magnesium is 4.1 mEq/L. Which will the LPN expect to observe?
A client is a vegan vegetarian and is exhibiting symptoms of palpitations, tingling of the hands and feet, nausea, and weakness. The LPN knows this client is at risk for which nutritional deficit most likely causing the symptoms?
The LPN reinforces the diet education for the client who has hyperphosphatemia. The LPN sould instruct the client to avoid which food?
2% fat milk
A client's lab values are potassium 4.5 mEq/L, sodium 215 mEq/L, calcium, 8.8 mg/dL, magnesium 1.9 mEq/L, phosphorous 3.3 mg/dL, and chloride 102 mEq/L. Which observations does the LPN expect?
Anorexia, nausea, and vomiting
The LPN cares for the client diagnosed with hypokalemia. The LPN recognzes which may be the cause of hypokalemia?
Thiazide diuretics. Severe diarrhea. Ileostomy. Drainage from nasogastric tube.
Which client is at highest risk to develop increased serum magnesium levels?
A client diagnosed with chronic kidney failure who takes antacids daily.
The LPN is caring for a client diagnosed with pernicious anemia. The LPN knows treatment for this disease includes what materials?
Intramuscular or intranasal Vitamin B12 for life.
The LPN is giving carbonyl iron to a client also taking tetracycline. How should the carbonyl iron be administered?
Give the carbonyl iron 2 hours after the tetracycline.
The client diagnosed with hypertension who is taking enalapril asks, "Can I use a salt substitute?" Which response should the LPN make?
"Salt substitutes contain potassium; enalapril causes your body to retain potassium; the combination will cause potassium to be elevated."
A client receives a diagnoses if diabetic ketoacidosis. The LPN expects to find which value in the client's admitting lab results?
Magnesium 3.2 mEq/L
The LPN reinforces diet instructions for a client who takes digoxin 0.25 mg and furosemide 40 mg daily. What food choices should be included in the reinforced instructions?
Bananas and oranges
The LPN reviews laboratory results and notes a client's serum potassium is 2.8 mEq/L. Which observation should the LPN report immediately to the nurse?
Irregular apical heart rate
The LPN reviews laboratory results for a client who receives 0.25 mg digoxin daily. What is the most important laboratory value for the LPN to review?
The LPN cares for clients on the medical/surgica unit. The LPN identifies which client is at greatest risk to develop hypokalemia?
The client with a 3-day history of vomiting
The LPN cares for the client receiving a hypertonic tube feeding. The LPN notes that the client has hypertension, tachycardia, and rales. The LPN expects to see which value in the client's lab results to be?
Sodium 152 mEq/L
The LPN cares for a client diagnosed with hyperkalemia. The LPN administers sodium polystyrene sulfonate to the client. What is the best explanation of the medication?
Moves potassium into the bowel for excretion
The LPN reinforces teaching for a client who requires an increased magnesium intake,. What food should the LPN recommend?
Apples and pears
Which client is at risk to develop increased serum potassium levels?
Client diagnosed with acute kidney disease
The LPN assists with the care of a client diagnosed with dehydration. What will the LPN expect to observe?
Urine specific gravity 1.038
The LPN cares for a client diagnosed with diabetes insipidus. What will the LPN expect to observe?
Increased serum sodium
The LPN cares for an 80-year-old client with a 3-day history of vomiting. What is the priority observation for the LPN to make?
Sitting and lying blood pressure
The LPN cares for a client diagnosed with fluid volume overload. Which laboratory value will the LPN expect to see?
RATIONALE: Normal hematocrit 38-54%; hematocrit decreased due to increased fluid volume; hematocrit, hemoglobin, serum sodium, and albumin decrease
The LPN cares for an 82-year-old client diagnosed with heart failure. What is the most reliable indicator of fluid status?
The LPN assists with the care of a client who had a subtotal thyroidectomy 24 hours ago. Which observation should the LPN report immediately to the RN?
Tingling of the fingers
The LPN cares for a client diagnosed with a closed head injury. The client is at risk for the syndrome of inappropriate antidiuretic hormone secretion (SAIDH). What are symptoms of SIADH?
Serum sodium 128 mEq/L. Weight gain. Muscle weakness.
A client remains in a coma three weeks after an injury. The LPN expects to see which client laboratory result?
Total calcium 11.3 mg/dL
The LPN cares for the client who has had a nasogastric (NG) tube connected to intermittent low wall suction for three days. The LPN notes a value of chloride 90 mEq/L in the client's lab report. Which symptom should the LPN expect the client to display?
Agitation. Anorexia. Dysrhythmias. Muscle cramps.
The LPN review the lab values of a client who had a thyroidectomy and notes the calcium is 7.5 mg/dL. The LPN recognizes which activity as the probably reason for this value?
Removal of the parathyroid gland.
A client receives a diagnosis of diabetic ketoacidosis. The LPN expects to find which value in the client's admitting lab results?
Magnesium 3.2 mEq/L
Which signs and symptoms would the LPN expect to observe in the client diagnosed with fluid volume overload?
The LPN reviews the laboratory values for the client and notes the client's serum sodium level is 129 mEq/L. Which should the LPN expect to observe?
The LPN weighs the client with acute heart failure and obseves the client has gained 4.5 pounds during the last 24 hours. Approximately how much fluid has the clent retained?
A client has taken corticosteroids for six weeks for rheumatoid arthritis. The client doubled the dose after two weeks for more effective pain management. The LPN expects to find which value on the client's laboratory report?
Chloride 115 mEq/L
The LPN cares for the client receiving spironolactone. The LPN recalls that spironolactone is in which drug classification?
The LPN cares for a client diagnosed with anorexia nervosa. The client weighs 80 pounds. The client's parents tell the LPN the client has been dieting for months and takes laxatives daily. At the time of admission, the client's pulse is 50 bpm and temperature is 97 F. Which is the priority client goal at this time?
Normalize electrolyte balance
The LPN cares for an elderly client diagnosed with pneumonia. The healthcare provider orders "encourage fluids to 1500 mL per day". How does the LPN interpret this order?
The order is given because the client needs to replace fluids lost through fever and dyspnea.
The LPN reinforces teaching for a client who takes spironolactone. Which client response indicates teaching is successful?
"I understand that I should immediately report any nausea, vomiting, or diarrhea."
The LPN reinforces teaching of the client receiving furosemide. Which statement by the client indicates that the teaching is effective about adverse effects of the medication?
"I understand that I need to notify my health care provider immediately if I have severe abdominal pain."
The LPN reinforces teaching for a client receiving furosemide twice daily. Which statement should be included in the reinforced teaching?
"Sit on the edge of the bed before getting up."
A client is receving mannitol intravenously. The LPN knows which nursing action takes priority in relation to the mannitol?
Urinary output every 1 hour
A client is diagnosed with dehydration and electrolyte imbalance due to vomiting. Which nursing intervention is most important for the LPN to implement for this client?
Intake and output
A client has been vomiting and having diarrhea for several days and is now exhibiting symptoms of muscle weakness and confusion. The LPN knows this will require the client to receive increased amounts of which?
The LPN cares for a 79-year-old client who has not eaten for 3 days. The family reports that client has consumed very little water. What will the LN expect to observe?
Decreased mental alertness
The LPN cares for a client diagnosed with dehydration. Which indicates to the LPN an improvement in the client's hydration status?
Total urinary output 1,900 ml in 24 hours
An elderly client presents to the emergency department with a bright red rash on teh feet and legs, vomiting, and diarrhea. Further investigation reveals teh client has been soaking the feet in a boric acid solution daily as a disinfectant. Which treatmentmodalities would the LPN expect to carry out for this client first?
Clear water wash of feet and legs
The LPN cares for a client diagnosed with severe traumatic brain injury with increased intracranial pressure. What is the rationale for the 2000 mL fluid restriction?
To decrease cerebral edema
the LPN cares for a client receiving spironolactone. It is important for the LPN to report which client statement to the RN?
"I use a salt substitute because of my heart failure."
A client takes furosemide because of fluid retention related to mitral valve prolapse. The LPN will encourage which foods in the diet related to the furosemide?
Apricots, bananas, and potatoes
An order for a client reads: IV 1000 mL Lactated Ringers every 8 hours. What will the LPN do next?
Calculate the correct drip rate.
The LPN student observes as the nurse cares for a clietn with a newly placed central venous catheter inserted. The catheter is inserted for the administration of total parenteral nutrition (TPN). The LPN student knows which initial action should be performed prior to administering the first TPN treatment?
Obtain a chest x-ray to ensure proper placement of the catheter.
A 3-year-old child comes to the emergency department with a temperature of 104 F, respirations 6 and shallow, and diaphoresis. The parent tells the LPN that the child at a whole bottle of enteric coated aspirin. Laboratory blood tests are complete. The LPN would expect to find which results?
The LPN cares for a preschool-aged child receiving cyclophosphamide for the treatment of neuroblastoma. Which nursing intervention is most important to incorporate from the plan of care?
Increase intake of oral fluids
The LPN assists the health care provider with a parcentesis on a client. What action is the priority for the LPN before the paracentesis begins?
Check that the consent form is signed.
The LPN cares for a client whose serum potassium level is 2.5 mEq/L. The LPN should observe for which symptom?
A client is to have an aspiration of fluid from the abdomen. What would be the LPN's responsibilities related to this procedure?
Make sure consent is signed. Have client void. Assist in maintaining sterile environment. Place sterile dressing over puncture site. Label specimen and take to laboratory. Observe for any adverse effects.
A client is receiving preoperative medications. The LPN administers the atropine and the client asks why that is necessary. The LPN would respond with which information?
It helps decrease secretions.
A client receiving an intravenous (IV) notifies the LPN that the IV insertion site seems to be puffy. The LPN should take which action next?
Loosen the tape over the IV insertion site.
A client is ordered to receive 1000 mL of fluid in 6 hours. At what drip rate would the LPN set the IV if the drip faactor is 15 drops/minute?
THIS SET IS OFTEN IN FOLDERS WITH...
RENAL A B KAPLAN
GI Kaplan A
Genitourinary/Renal - Kaplan
GI - Kaplan
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