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medical surgical testbank with questions and 100% sure answers
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Terms in this set (179)
fluid and electrolyres
Exam 1 acid base
thermoregulation
Chapter 17: Fluid, Electrolyte, and Acid-Base ---
Imbalances
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,1. The nurse obtains all of the following assessment The blood pressure is 90/40 mm Hg.
data about a patient with deficient fluid volume
caused by a massive burn injury. Which of the Rationale: The blood pressure indicates that the patient may be developing hypovolemic shock as
following assessment data will be of greatest a result of fluid loss. This will require immediate intervention to prevent the complications
concern? associated with systemic hypoperfusion. The poor oral intake, decreased urine output, and skin
tenting all indicate the need for increasing the patients fluid intake but not as urgently as the
a. hypotension.
The blood pressure is 90/40 mm Hg.
b.
Urine output is 30 ml over the last hour.
c.
Oral fluid intake is 100 ml for the last 8 hours.
d.
There is prolonged skin tenting over the sternum.
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2. A recently admitted patient has a small cell decreased serum sodium level.
carcinoma of the lung, which is causing the
syndrome of inappropriate antidiuretic hormone Rationale: SIADH causes water retention and a decrease in serum sodium level. Weight loss,
(SIADH). The nurse will monitor carefully for increased urine output, and elevated serum hematocrit may be associated with excessive loss of
water, but not with SIADH and water retention.
a.
increased total urinary output.
b.
elevation of serum hematocrit.
c.
decreased serum sodium level.
d.
rapid and unexpected weight loss.
3. When the nurse is evaluating the fluid balance daily weight.
for a patient admitted for hypovolemia associated
with multiple draining wounds, the most accurate Rationale: Daily weight is the most easily obtained and accurate means of assessing volume
assessment to include is status. Skin turgor varies considerably with age. Considerable excess fluid volume may be present
before fluid moves into the interstitial space and causes edema. Hourly urine outputs do not take
a. account of fluid intake or of fluid loss through insensible loss, sweating, or loss from the
gastrointestinal tract or wounds.
skin turgor.
b.
daily weight.
c.
presence of edema.
d.
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4. When caring for an alert and oriented elderly if the oral mucosa feels dry.
patient with a history of dehydration, the home
health nurse will teach the patient to increase fluid Rationale: An alert, elderly patient will be able to self-assess for signs of oral dryness such as
intake thick oral secretions or dry-appearing mucosa. The thirst mechanism decreases with age and is
not an accurate indicator of volume depletion. Many older patients prefer to restrict fluids slightly
a. in the evening to improve sleep quality. The patient will not be likely to notice and act
appropriately when changes in LOC occur.
in the late evening hours.
b.
if the oral mucosa feels dry.
c.
when the patient feels thirsty.
d.
as soon as changes in level of consciousness
(LOC) occur.
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