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Nursing Quiz

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Nursing
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Rasmussen University
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Fluid, electrolyte, and acid base
1
CRITICAL THINKING EXERCISES
1. A client is admitted to the emergency department after an automobile accident and complains
of severe pain. Although there is no evidence of bleeding, there is extreme anxiety.
Respirations are very rapid and the pulse is 110. Would the acid-base balance most likely to
develop be acidosis or alkalosis, and would the cause be respiratory or metabolic? Explain.
Answer: The acid balance will be alkalosis because it is respiratory since the client’s body
requires oxygen to function normally. For this particular reason, the client was breathing too
fast causing carbon dioxide levels to drop which led to the PH of the blood to rise and be
alkaline.
2. A client has several days of severe vomiting and diarrhea. ABGs reveal a pH of 7.3, PCO
2
of 35, and HCO
3
of 20. What acid-base imbalance is present? What assessments could you
make to detect compensation efforts by the body?
Answer: The acid balance is alkalosis because the client’s body lost electrolytes due to
excess vomiting.
Assessments to be considered are checking the client’s general behavior and state. Also,
check the client’s eyes if they are normal, sunken or dry. In addition, check the mouth and
tongue of the client to know if they are wet or dry. Assessing the client’s pulse and skin
turgor.
3. An older adult client has been living alone in an apartment. During your home health visit,
the client demonstrates the following: weight loss of 5 pounds in 3 days; weak pulse; blood
pressure 90/50 (baseline 115/80); oliguria with dark, tea-colored urine; weakness; and dry
lips and mucous membranes. What additional data would you need to determine whether
the condition is caused by decreased intake, excessive losses, or both?
Answer: Asking the client if he/she was constipating, problems sleeping at night, sweating
excessively, feeling stressed, fatigued, experiencing headaches, and taking some kind of
drugs and experiencing shortness of breath.

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Fluid, electrolyte, and acid base
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4. A client with a known history of congestive heart failure becomes very short of breath,
anxious and diaphoretic. BP - 130/70, P - 114, RR - 36, T - 99º F. What fluid and electrolyte
disturbance would be most likely, and what are the complications to anticipate? What other
assessment data are needed? What aspects of nursing care, if any, could be delegated to
assistive personnel?
Answer: Extracellular fluid and sodium retention. The expected complications will be kidney
failure, liver damage, and heart valve and rhythm problems.
Assessment data required will be checking if the client has dyspnea, level of fatigue, fluid
retention, chest pain, jugular venous distention, hepatojugular reflux and pulmonary rales.
Collaboration, since nurses play a vital role in assessing and treating patients in general and
critical care. Also, response of nurses to the patient inquiries in case they need assistance or
inquiries.
CRITICAL THINKING CHALLENGE 1
The client is a 45-year-old, obese woman with type 1 diabetes who is brought to the emergency
department in a coma. Her daughter tells you that the client has had pain and burning on
urination for the past 3 days and that she stopped drinking fluids so that she would not have to go
to the bathroom as often. The daughter also tells you that the client has not taken her insulin for
at least 2 days. The client’s laboratory results are as follows: Blood glucose level is 540 mg/dL,
white blood cell count (WBC) is 22,000/mm3, hematocrit is 52%, serum potassium is 7 mmol/L,
serum sodium is 140 mmol/L, blood osmolarity is 380 mOsm/L, and her urine is positive for
ketones.
1. What type of dehydration does she have?
Answer: Hypertonic dehydration

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Fluid, electrolyte, and acid base CRITICAL THINKING EXERCISES 1. A client is admitted to the emergency department after an automobile accident and complains of severe pain. Although there is no evidence of bleeding, there is extreme anxiety. Respirations are very rapid and the pulse is 110. Would the acid-base balance most likely to develop be acidosis or alkalosis, and would the cause be respiratory or metabolic? Explain. Answer: The acid balance will be alkalosis because it is respiratory since the client’s body requires oxygen to function normally. For this particular reason, the client was breathing too fast causing carbon dioxide levels to drop which led to the PH of the blood to rise and be alkaline. 2. A client has several days of severe vomiting and diarrhea. ABGs reveal a pH of 7.3, PCO2 of 35, and HCO3 of 20. What acid-base imbalance is present? What assessments could you make to detect compensation efforts by the body? Answer: The acid balance is alkalosis because the client’s body lost electrolytes due to excess vomiting. Assessments to be considered are checking the client’s general behavior and state. Also, check the client’s eyes if they are normal, sunken or dry. In addition, check the mouth and tongue of the client to know if they are wet or dry. Assessing the client’s pulse and skin turgor. 3. An older adult client has been living alone in an apartment. During your home health visit, the client demonstrates the following: weight loss of 5 pounds ...
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