Fluid and Electrolyte Balance Flashcards
6 cards from real CRNI practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Fluid and Electrolyte Balance flashcards as text
A patient receiving IV normal saline at 150 mL/hr develops crackles, jugular vein distension, and dyspnea. What is the priority nursing intervention?
Answer: Slow or stop the infusion and notify the provider
These signs indicate fluid volume overload, requiring immediate reduction or cessation of the IV infusion and provider notification for diuretic orders.
Which electrolyte imbalance is MOST dangerous when administering potassium chloride IV?
Answer: Hyperkalemia from infusion rate exceeding renal excretion
Hyperkalemia from excessive IV potassium infusion can cause fatal cardiac arrhythmias, making infusion rate monitoring critical.
What is the primary purpose of using an isotonic crystalloid solution for IV fluid replacement?
Answer: To expand the intravascular volume without shifting fluid between compartments
Isotonic crystalloids have the same osmolality as plasma, expanding intravascular volume without causing osmotic fluid shifts between compartments.
A patient's serum sodium is 118 mEq/L. What is the maximum safe correction rate to prevent neurological complications?
Answer: 8-12 mEq/L per 24 hours
Sodium correction should not exceed 8-12 mEq/L in 24 hours to prevent osmotic demyelination syndrome, a devastating neurological complication.
Which assessment finding indicates the patient is experiencing third-spacing of fluid?
Answer: Peripheral edema with low urine output and hypotension
Third-spacing causes fluid to shift from the intravascular space into interstitial tissues, resulting in edema, intravascular depletion (hypotension), and decreased urine output.
What is the nursing implication of infusing hypertonic saline (3% NaCl)?
Answer: It requires central venous access and continuous cardiac monitoring
Hypertonic saline is a high-risk infusion requiring central venous access to prevent phlebitis and continuous cardiac monitoring due to risk of rapid electrolyte shifts.