NCLEX ELECTROLYTES AND FLUID ALL EXAM REVISION
QUESTIONS AND CORRECT ANSWERS (ALREADY GRADED
A+) (2024 UPDATE) 100% GUARANTEED
Hyperkalemia Interventions - ANSWER- Blood transfusion should be fresh blood, if possible,
stored blood may elevate potassium level, breakdown of old blood causes potassium release
Avoid potassium foods
Avoid use of salt substitutes
Hypocalcemia normal values 8.6 to 10mg/dl - ANSWER- causes: inhibition of calcium
absorption from the gastrointestinal tract
Inadequate oral intake, lactose intolerance
Malabsorption syndromes such as celiac sprue or Crohn's disease
Inadequate intake of vitamin D
End stage renal disease
Increased calcium excretion
Renal failure
Diarrhea, steatorrhea, wound drainage, gastrointestional
Hypocalcemia - ANSWER- decrease in ionized fraction of calcium
Hyperproteinemia, alkalosis, calcium binders chelators
,Acute pancreatitis, hyperphosphatemia, immobility
Removal or destruction of parathyroid glands
Hypocalcemia cardiac - ANSWER- decreased heart rate
Hypotension, diminished peripheral pulses
Prolonged ST interval, prolonged QT interval
Hypocalcemia respiratory - ANSWER- not directly affected but, respiratory failure and arrest
may result from decreased respiratory movement because of muscle tetany or seizures
Hypocalcemia neuromuscular - ANSWER- irritable skeletal muscles Twitches, cramps, tetany,
seizures
Painful muscles spasms in the calf or foot during periods of inactivity
Paresthesia followed by numbness that may affect the lips, nose, and ears in addition to the limbs
Positive Trousseau's and Chvostek's signs
Hyperactive deep tendon reflexes
Anxiety, irritability
Hypocalcemia gastrointestinal - ANSWER- increased gastric motility; hyperactive bowel
sounds
Abdominal cramping, diarrhea
Hypocalcemia Interventions - ANSWER- monitor cardiovascular, respiratory, neuromuscular,
and gastrointestinal status; place the client on a cardiac monitor
,Administer calcium supplements orally or calcium intravenously
Warm injection to body temperature before administration and administer slowly; monitor for ECG
changes, observe for infiltration, and monitor for hypercalcemia
Administer medications that increase absorption of calcium
Hypocalcemia Interventions - ANSWER- aluminum hydroxide reduces serum phosphorus
levels, causing the countereffect of increasing calcium levels.
Vitamin D aids in the absorption of calcium from the intestinal tract
Provide quiet environment to reduce environmental stimuli
Initiate seizure precautions
Move the client carefully, and monitor for signs of a fracture
Keep 10% calcium gluconate available for treatment of acute calcium deficit
Instruct client to consume foods high in calcium
Cheese, collard greens, milk and soy milk, Rhubarb, sardines, spinach, tofu, yogurt
Hypercalcemia - ANSWER- increased calcium absorption
Excessive oral intake
Excessive oral intake of vitamin D
Decreased calcium excretion
Renal failure
Use of thiazide diuretics
, Increased bone resorption of calcium
Hyperparathyroidism
Hyperthyroidism, Malignancy (bone destruction from metastatic tumors)
Immobility, use of glucocorticoids
Hemoconcentration
Dehydration, use of lithium, adrenal insufficiency
Hypercalcemia cardiovascular - ANSWER- increased heart rate in early phase, bradycardia
that can lead to cardiac arrest in the late phase
Increased blood pressure
Bounding, full peripheral pulses
ECG Shortened ST segment, widened T wave
Hypercalcemia respiratory - ANSWER- ineffective respiratory movement as a result of
profound skeletal muscle weakness
Hypercalcemia neuromuscular - ANSWER- profound muscle weakness
Diminished or absent deep tendon reflexes
Disorientation, lethargy, coma
Hypercalcemia renal - ANSWER- increased urinary output leading to dehydration
Formation of renal calculi
