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ANS: C - Meat, dairy products, and dried fruit have high concentrations of potassium. Eggs, breads, cereals, sugar, and some fruits (berries, peaches) are low in potassium. The menu selection of sausage, toast, raisins, and milk has the greatest number of items with higher potassium content.
ANS: C - Not all fruit is potassium rich. Fruits that are relatively low in potassium and can be included in the diet include apples, apricots, berries, cherries, grapefruit, peaches, and pineapples. Fruits high in potassium include bananas, kiwi, cantaloupe, oranges, and dried fruit. Cooking fruit does not alter its potassium content.
Students also viewedc. Decreased extracellular fluids with normal tonicity
Rationale: Patients with gastroenteritis may have tachycardia, hypotension, oliguria, and dark-colored urine. In addition, increased hematocrit, elevated blood urea nitrogen, and increased specific gravity indicate extracellular volume depletion with isotonicity. Patients with low levels of sodium, or hyponatremia, usually present with confusion, nausea, vomiting, seizures, and lab reports indicating lower serum osmolality. Patients with low levels of potassium, or hypokalemia, present with bilateral muscle weakness, abdominal distention, decreased bowel sounds, and constipation. If the patient had coexisting increased serum osmolality and serum sodium levels above 145 mEq/L, then the patient would have symptoms of both hypernatremia and extracellular volume depletion.
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An older adult client is receiving furosemide (Lasix) for treatment of peripheral edema. Which nursing assessment data identify that the client is at risk for falling?
(Orthostatic blood pressure changes) Blood pressure decreases when changing positions. The client may not have sufficient blood flow to the brain, causing sensations of light-headedness and dizziness. This problem increases the risk for falling, especially in older adults.
A client has a low serum potassium level and is ordered a dose of parenteral potassium chloride (KCl). How does a nurse safely administer KCl to the client?
(Infuses 10 mEq over a 1-hour period) A dose of KCl 200 mEq in 1 liter of normal saline infused at 100 mL/hr is too concentrated and can cause injury.
Which situation can cause a client to experience "insensible water loss"?
(Diarrhea, dry hot weather, fever, increased respiratory rate, mechanical ventilation) Nausea with no accompanying vomiting would not cause insensible water loss.
Which client is at increased risk for fluid and electrolyte imbalance? Select all that apply.
(45-year-old man on diuretics ,47-year-old man traveling to South America in summer, 76-year-old bedridden woman)
A nurse instructs an older adult client to increase intake of dietary potassium when the client is prescribed which classification of drugs?
(High-ceiling (loop) diuretics) Loop diuretics are potassium-depleting drugs. The client should increase intake of dietary potassium to compensate for this depletion.
A nurse is instructing a client who is being discharged with a diagnosis of congestive heart failure (CHF). Which client statement indicates a correct understanding of CHF?
("Weighing myself daily can reveal increased fluid retention.") Fluid retention may not be visible. Rapid weight gain is the best indicator of fluid retention and overload. Each pound of weight gained (after the first half-pound) equates to 500 mL of retained water. The client should be weighed at the same time every day (before breakfast) on the same scale.
Which client is at greatest risk for hypernatremia?
(54-year old who is sweating profusely) Excessive sweating is a common cause of hypernatremia.
A client is admitted with hypokalemia and skeletal muscle weakness. Which assessment does the nurse perform first?
(Respirations) Respiratory changes are likely because of weakness of the muscles needed for breathing. Skeletal muscle weakness results in shallow respirations. Thus, respiratory status should be assessed first in any client who might have hypokalemia.
A client develops fluid overload while in the intensive care unit. Which nursing intervention does the nurse perform first?
Elevating the head of the bed will ease breathing for the client.
A nurse is assessing a client with hyponatremia. Which finding requires immediate action?
(Muscular weakness) Muscle weakness in clients with hyponatremia requires immediate action. If muscle weakness is present, immediately check respiratory effectiveness because ventilation is dependent on adequate strength of the respiratory muscles.
A nurse is caring for a client who is receiving intravenous (IV) magnesium sulfate (MgSO4). Which assessment parameter is critical?
(Hourly deep tendon reflexes) The client who is receiving IV MgSO4 should be assessed for signs of toxicity every hour by assessment of DTRs.
The client is a 69-year-old woman with uncontrolled diabetes, polyuria, and a blood pressure of 86/46. Which staff member is assigned to care for her?
(RN who has floated from the intensive care unit) The clinical manifestations suggest that the client is experiencing hypovolemia and possible hypovolemic shock. The RN who floated from the intensive care unit will have extensive experience caring for clients with hypovolemia.
A physician writes orders for a client who is admitted with a serum potassium (K) level of 6.9 mEq/L. What does the nurse implement first?
(Placing the client on a cardiac monitor.) Because hyperkalemia can lead to life-threatening bradycardia, the initial action should be to place the client on a cardiac monitor.
After receiving change-of-shift report, which client does the RN assess first?
(46-year-old receiving IV diuretics whose blood pressure is 95/52) The client's history of receiving IV diuretics and having low blood pressure indicates that the client may be experiencing hypoperfusion caused by hypovolemia, and that immediate assessment and interventions are needed.
A 90-year-old client with hypermagnesemia is seen in the emergency department (ED). The ED nurse prepares the client for admission to which inpatient unit?
(Telemetry/Cardiac Step-Down) Because hypermagnesemia causes changes in the electrocardiogram that may result in cardiac arrest, the client should be admitted to the Telemetry/Cardiac Step-Down unit.
A nurse is planning care for a client with hypocalcemia. Which nursing action is appropriate to delegate to unlicensed assistive personnel (UAP)?
(Transferring the client from the bed to a stretcher using a lift sheet) Transferring clients is a nursing skill that is included in UAP education and scope of practice.
A client is admitted to the nursing unit with a diagnosis of hypokalemia. Which assessment does the nurse complete first?
(Obtaining a pulse oximetry reading) Because hypokalemia may cause respiratory insufficiency and respiratory arrest, the client's respiratory status should be assessed first.
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