Fluid and Electrolyte Balance Flashcards
7 cards from real NACE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Fluid and Electrolyte Balance flashcards as text
A patient's serum sodium is 128 mEq/L. Which symptom would the nurse most likely assess?
Answer: Muscle cramps and irritability
Hyponatremia (sodium <135 mEq/L) causes neurological symptoms including confusion, headache, muscle cramps, and irritability due to osmotic fluid shifts into brain cells.
Which IV solution is classified as isotonic?
Answer: 0.9% sodium chloride
0.9% sodium chloride (normal saline) is isotonic with an osmolality of approximately 308 mOsm/L, close to plasma osmolality, so it does not cause fluid shifts into or out of cells.
A patient with chronic renal failure has a serum potassium of 6.2 mEq/L. Which ECG change would the nurse anticipate first?
Answer: Peaked T waves
Hyperkalemia initially produces tall, narrow (peaked) T waves on ECG due to altered cardiac repolarization; this may progress to widened QRS complexes and ventricular fibrillation.
A postoperative patient receiving 3 L of IV fluids daily develops a new respiratory finding. Which assessment finding indicates fluid overload?
Answer: Bilateral crackles at the lung bases
Bilateral crackles at the lung bases indicate pulmonary edema from fluid overload, as excess fluid accumulates in the alveoli and interstitial lung tissue.
Which clinical finding is most consistent with severe dehydration in an adult patient?
Answer: Poor skin turgor and concentrated urine
Poor skin turgor (tenting) and dark, concentrated urine (high specific gravity) are classic signs of severe dehydration reflecting significant fluid deficit.
A patient's serum potassium is 2.9 mEq/L. Which intervention is the priority nursing action?
Answer: Place the patient on continuous cardiac monitoring
Hypokalemia can cause life-threatening dysrhythmias; continuous cardiac monitoring is the priority to detect and respond to arrhythmias early before or during potassium replacement.
Which patient is at greatest risk for developing hypernatremia?
Answer: A 70-year-old with advanced dementia who cannot request fluids independently
Patients with dementia who cannot communicate thirst or independently access water are at high risk for hypernatremia due to inadequate free water intake relative to sodium.