F&E Questions – Flashcards
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1. A client's nursing diagnosis is Deficient Fluid Volume related to excessive fluid loss. Which action related to the fluid management should be delegated to a nursing assistant? a. Administer IV fluids as prescribed by the physician. b. Provide straws and offer fluids between meals. c. Develop plan for added fluid intake over 24 hours d. Teach family members to assist client with fluid intake
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1. ANSWER B - The nursing assistant can reinforce additional fluid intake once it is part of the care plan. Administering IV fluids, developing plans, and teaching families require additional education and skills that are within the scope of practice for the RN.
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2. The client also has the nursing diagnosis Decreased Cardiac Output related to decrease plasma volume. Which finding on assessment supports this nursing diagnosis? a. Flattened neck veins when client is in supine position b. Full and bounding pedal and post-tibial pulses c. Pitting edema located in feet, ankles, and calves d. Shallow respirations with crackles on auscultation
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2. ANSWER A - Normally, neck veins are distended when the client is in the supine position. The veins flatten as the client moves to a sitting position. The other three responses are characteristic of Excess Fluid Volume.
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3. The nursing care plan for the client with dehydration includes interventions for oral health. Which interventions are within the scope of practice for the LPN/LVN being supervised by the nurse? (Choose all that apply.) a. Remind client to avoid commercial mouthwashes. b. Encourage mouth rinsing with warm saline. c. Assess lips, tongue, and mucous membranes d. Provide mouth care every 2 hours while client is awake e. Seek dietary consult to increase fluids on meal trays.
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3. ANSWER A, B, C, D - The LPN/LVN's scope of practice and educational preparation includes oral care and routine observation. State practice acts vary as to whether LPN/LVNs are permitted to perform assessment. The client should be reminded to avoid most commercial mouthwashes that contain alcohol, a drying agent. Initiating a dietary consult is within the purview of the RN or physician.
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4. The physician has written the following orders for the client with Excess Fluid volume. The client's morning assessment includes bounding peripheral pulses, weight gain of 2 pounds, pitting ankle edema, and moist crackles bilaterally. Which order takes priority at this time? a. Weigh client every morning. b. Maintain accurate intake and output. c. Restrict fluid to 1500 mL per day d. Administer furosemide (Lasix) 40 mg IV push
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4. ANSWER D - Bilateral moist crackles indicate fluid-filled alveoli, which interferes with gas exchange. Furosemide is a potent loop diuretic that will help mobilize the fluid in the lungs. The other orders are important but not urgent.
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5. You have been pulled to the telemetry unit for the day. The monitor informs you that the client has developed prominent U waves. Which laboratory value should you check immediately? a. Sodium b. Potassium c. Magnesium d. Calcium
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5. ANSWER B - Suspect hypokalemia and check the client's potassium level. Common ECG changes with hypokalemia include ST depression, inverted T waves, and prominent U waves. Client with hypokalemia may also develop heart block.
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6. The client's potassium level is 6.7 mEq/L. Which intervention should you delegate to the student nurse under your supervision? a. Administer Kayexalate 15 g orally b. Administer spironolactone 25 mg orally c. Assess WCG strip for tall T waves d. Administer potassium 10 mEq orally
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6. ANSWER A - The client's potassium level is high (normal range 3.5-5.0). Kayexalate removes potassium from the body through the gastrointestinal system. Spironolactone is a potassium-sparing diuretic that may cause the client's potassium level to go even higher. The nursing student may not have the skill to assess ECG strips and this should be done by the RN
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7. A client is admitted to the unit with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH). For which electrolyte abnormality will you be sure to monitor? a. Hypokalemia b. Hyperkalemia c. Hyponatremia d. Hypernatremia
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7. ANSWER C - SIADH causes a relative sodium deficit due to excessive retention of water. (diluted)
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8. The charge nurse assigned in the care for a client with acute renal failure and hypernatremia to you, a newly graduated RN. Which actions can you delegate to the nursing assistant? a. Provide oral care every 3-4 hours b. Monitor for indications of dehydration c. Administer 0.45% saline by IV line d. Assess daily weights for trends
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8. ANSWER A - Providing oral care is within the scope of practice for the nursing assistant. Monitoring and assessing clients, as well as administering IV fluids, require the additional education and skill of the RN.
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9. The experienced LPN/LVN reports that a client's blood pressure and heart rate have decreased and that when the face is assessed, one side twitches. What action should you take at this time? a. Reassess the client's blood pressure and heart rate b. Review the client's morning calcium level c. Request a neurologic consult today d. Check the client's pupillary reaction to light
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9. ANSWER B - A positive Chvostek's sign (facial twitching of one side of the mouth, nose, and cheek in response to tapping the face just below and in front of the ear) is a neurologic manifestation of hypocalcemia. The LPN/LVN is experienced and possesses the skills to take accurate vital signs.
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10.You are preparing to discharge a client whose calcium level was low but is now just slightly within the normal range (9-10.5 mg/dL). Which statement by the client indicates the need for additional teaching? a. "I will call my doctor if I experience muscle twitching or seizures." b. "I will make sure to take my vitamin D with my calcium each day." c. "I will take my calcium pill every morning before breakfast." d. "I will avoid dairy products, broccoli, and spinach when I eat."
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10. ANSWER D - Clients with low calcium levels should be encouraged to consume dairy products, seafood, nuts, broccoli, and spinach. Which are all good sources of dietary calcium.
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11. A nursing assistant asks why the client with a chronically low phosphorus level needs so much assistance with activities of daily living. What is your best response? a. "The client's low phosphorus is probably due to malnutrition." b. "The client is just worn out form not getting enough rest." c. "The client's skeletal muscles are weak because of the low phosphorus." d. "The client will do more for herself when her phosphorus is normal"
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11. ANSWER C - A musculoskeletal manifestation of low phosphorous is generalized muscle weakness that may lead to acute muscle breakdown (rhabdomyolysis). Even though the other statements are true, they do not answer the nursing assistant's question.
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12. You are reviewing a client's morning laboratory results. Which of these results is of most concern? a. Serum potassium 5.2 mEq/L b. Serum sodium 134 mEq/L c. Serum calcium 10.6 mg/dL d. Serum magnesium 0.8 mEq/L
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12. ANSWER D - While all of these laboratory values are outside of the normal range, the magnesium is most outside of normal. With a magnesium level this low, the client is at risk for ECG changes and life-threatening ventricular dysrhythmias.
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13. Which action should you delegate to the nursing assistant for the client with diabetic ketoacidosis? (Choose all that apply.) a. Check fingerstick glucose every hour. b. Record intake and output every hour. c. Check vital signs every 15 minutes. d. Assess for indicators of fluid imbalance.
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13. ANSWER B, C - The nursing assistant's training and education include how to take vital signs and record intake and output. The need to take vital signs this frequently indicates that the client maybe unstable. The nurse should give the nursing assistant reporting parameters when delegating this action, should also check the vital signs for indications in instability. Performing fingerstick glucose checks and assessing clients require additional education and skill that are appropriate to licensed nurses. Some facilities may train experienced nursing assistants to perform fingerstick glucose checks and change their role descriptions to designate their new skills, but this is beyond the normal scope of practice for a nursing assistant
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14. The nurse is caring for a client with heart failure who has a magnesium level of 1.4 mg/dL. The nurse should: a) monitor the client for irregular heart rhythms b) teach the client to avoid foods high in magnesium c) encourage the intake of antacids with phosphate d) provide a diet of ground beef, eggs, and chicken breast
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14. Answer: A The normal magnesium level ranges from 1.8 to 3.0 mg/dL. The nurse avoids administering phosphate in the presence of hypomagnesemia because it aggravates the condition. The client should be monitored for dysrhythmias because magnesium plays an important role in myocardial nerve cell impulse conduction; thus, hypomagnesemia increases the client's risk of ventricular dysrhythmias. The nurse instructs the client to consume foods rich in magnesium; ground beef, eggs, and chicken breast are low in magnesium.
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15. A nurse finds that the client's serum sodium level is 129 mEq/L. Which does the nurse implement to restore the client's fluid and electrolyte balance gradually? a) administer a loop diuretic b) provide a 2-gram sodium diet c) provide a 4-gram sodium diet d) place client on fluid restriction
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15. Answer: D A serum sodium level of less than 135 mEq/L means that the client is hyponatremic; when it is due to hypervolemia, hyponatremia is the result of hemodilution. Thus, a fluid restriction is indicated to restore fluid and electrolyte balance gradually by increasing the relative serum sodium level as the client excretes water. Option A is unlikely to restore fluid and electrolyte balance because loop diuretics excrete sodium and water; in addition, the fluid shifts are likely to occur within hours instead of gradually. A 2-gram sodium diet is a sodium-restricted diet and a 4-gram sodium diet is a no-added-salt diet; both diets are unlikely to increase the serum sodium.
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16. What is the nurse's primary concern regarding fluid & electrolytes when caring for an elderly patient who is intermittently confused? a) risk of dehydration b) risk of kidney damage c) risk of stroke d) risk of bleeding
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16. Answer: A As an adult ages, the thirst mechanism declines. Adding this in a pt with an altered level of consciousness, there is an increased risk of dehydration & high serum osmolality. The risks for kidney damage are not specifically related to aging or fluid & electrolyte issues. The risk of stroke is not specifically related to aging or fluid & electrolyte issues. The risk of bleeding is not specifically related to aging or fluid & electrolyte issues.
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17. A pt, experiencing multisystem fluid volume deficit, has the symptoms of tachycardia, pale, cool skin, & decreased urine output. The nurse realizes these findings are most likely a direct result of which of the following? a) the body's natural compensatory mechanisms b) pharmacological effects of a diuretic c) effects of rapidly infused intravenous fluids d) cardiac failure
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17. Answer: A The internal vasoconstrictive compensatory reactions within the body are responsible for the symptoms exhibited. The body naturally attempts to conserve fluid internally specifically for the brain & heart. A diuretic would cause further fluid loss, & is contraindicated. Rapidly infused intravenous fluids would not cause a decrease in urine output. The manifestations reported are not indicative of cardiac failure in this pt.
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18. A pregnant pt is admitted with excessive thirst, increased urination, & has a medical diagnosis of diabetes insipidus. The nurse chooses which of the following nursing diagnoses as most appropriate? a) Risk for Imbalanced Fluid Volume b) Excess Fluid Volume c) Imbalanced Nutrition d) Ineffective Tissue Perfusion
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18. Answer: A The pt with excessive thirst, increased urination & a medical diagnosis of diabetes insipidus is at risk for Imbalanced Fluid Volume due to the pt &'s excess volume loss that can increase the serum levels of sodium. Excess Fluid Volume is not an issue for pts with diabetes insipidus, especially during the early stages of treatment. Imbalanced Nutrition does not apply. Ineffective Tissue Perfusion does not apply
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19. A pt recovering from surgery has an indwelling urinary catheter. The nurse would contact the pt's primary healthcare provider with which of the following 24-hour urine output volumes? a) 600 mL b) 750 mL c) 1000 mL d) 1200 mL
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19. Answer: A A urine output of less than 30 mL per hour must be reported to the primary healthcare provider. This indicates inadequate renal perfusion, placing the pt at increased risk for acute renal failure & inadequate tissue perfusion. A minimum of 720 mL over a 24-hour period is desired (30 mL multiplied by 24 hours equals 720 mL per 24 hours).
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20. A pt is receiving intravenous fluids postoperatively following cardiac surgery. Nursing assessments should focus on which postoperative complication? a) fluid volume excess b) fluid volume deficit c) seizure activity d) liver failure
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20. Answer: A Antidiuretic hormone & aldosterone levels are commonly increased following the stress response before, during, & immediately after surgery. This increase leads to sodium & water retention. Adding more fluids intravenously can cause a fluid volume excess & stress upon the heart & circulatory system. Adding more fluids intravenously can cause a fluid volume excess, not fluid volume deficit, & stress upon the heart & circulatory system. Seizure activity would more commonly be associated with electrolyte imbalances. Liver failure is not anticipated related to postoperative intravenous fluid administration.
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21. A pt is diagnosed with severe hyponatremia. The nurse realizes this pt will mostly likely need which of the following precautions implemented? a) infection b) neutropenic c) high-risk fall d) seizure
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21. Answer: D Severe hyponatremia can lead to seizures. Seizure precautions such as a quiet environment, raised side rails, & having an oral airway at the bedside would be included. Infection precautions not specifically indicated for a pt with hyponatremia. Neutropenic precautions not specifically indicated for a pt with hyponatremia. High-risk fall precautions not specifically indicated for a pt with hyponatremia.
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22. A pt is diagnosed with hypokalemia. After reviewing the pt's current medications, which of the following might have contributed to the pt's health problem? a) thiazide diuretic b) corticosteroid c) narcotic d) muscle relaxer
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22 Answer: B Excess potassium loss through the kidneys is often caused by such meds as corticosteroids, potassium-wasting diuretics (i.e. Lasix), amphotericin B, & large doses of some antibiotics. Excessive sodium is lost with the use of thiazide diuretics. Narcotics do not typically affect electrolyte balance. Muscle relaxants do not typically affect electrolyte balance.
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23. A pt prescribed spironolactone is demonstrating ECG changes & complaining of muscle weakness. The nurse realizes this pt is exhibiting signs of which of the following? a) hyperkalemia b) hypokalemia c) hypercalcemia d) hypocalcemia
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23. Answer: A Hyperkalemia is serum potassium level greater than 5.0 mEq/L. Decreased potassium excretion is seen in potassium-sparing diuretics such as spironolactone. Common manifestations of hyperkalemia are muscle weakness & ECG changes. Hypokalemia is seen in non-potassium diuretics such as furosemide. Hypercalcemia has been associated with thiazide diuretics. Hypocalcemia is seen in pts who have received many units of citrated blood & is not associated with diuretic use.
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24. The nurse is planning care for a pt with fluid volume overload & hyponatremia. Which of the following should be included in this pt's plan of care?. a) Administer intravenous fluids. b) Provide Kayexalate. c) Administer intravenous normal saline with furosemide. d) Restrict fluids
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24. Answer: D The nursing care for a pt with hyponatremia is dependent on the cause. Restriction of fluids to 1,000 mL/day is usually implemented to assist sodium increase & to prevent the sodium level from dropping further due to dilution. The administration of intravenous fluids would be indicated in fluid volume deficit & hypernatremia. Kayexalate is used in pts with hyperkalemia. The administration of normal saline with furosemide is used to increase calcium secretion.
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25. When caring for a pt diagnosed with hypocalcemia, which of the following should the nurse additionally assess in the pt? a) other electrolyte disturbances b) hypertension c) visual disturbances d) drug toxicity
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25. Answer: A The pt diagnosed with hypocalcemia may also have high phosphorus or decreased magnesium levels. The pt with hypocalcemia may exhibit hypotension, & not hypertension. Visual disturbances do not occur with hypocalcemia. Hypercalcemia is more commonly caused by drug toxicities.
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26. A pt with a history of stomach ulcers is diagnosed with hypophosphatemia. Which of the following interventions should the nurse include in this pt's plan of care? a) Request a dietitian consult for selecting foods high in phosphorous. b) Provide aluminum hydroxide antacids as prescribed. c) Instruct pt to avoid poultry, peanuts, & seeds. d) Instruct to avoid the intake of sodium phosphate.
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26. Answer: A Treatment of hypophosphatemia includes treating the underlying cause & promoting a high phosphate diet, especially milk, if it is tolerated. Other foods high in phosphate are dried beans & peas, eggs, fish, organ meats, Brazil nuts & peanuts, poultry, seeds & whole grains. Phosphate-binding antacids, such as aluminum hydroxide, should be avoided. Poultry, peanuts, & seeds are part of a high phosphate diet. Mild hypophosphatemia may be corrected by oral supplements, such as sodium phosphate.
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27. An elderly pt does not complain of thirst. What should the nurse do to assess that this pt is not dehydrated? a) Ask the physician for an order to begin intravenous fluid replacement. b) Ask the physician to order a chest x-ray. c) Assess the urine for osmolality. d) Ask the physician for an order for a brain scan.
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27. Answer: C The thirst mechanism declines with aging, which makes older adults more vulnerable to dehydration & hyperosmolality. The nurse should check the pt's urine for osmolality as a 1st step in determining hydration status before other detailed & invasive testing is done. (The osmolality urine test measures the concentration of particles in urine. Osmolality (particles/kg water) and osmolarity (particles/liter of solution) are sometimes confused, but for dilute fluids such as urine they are essentially the same. A random specimen: 50 to 1200 milliosmoles per kilogram (mOsm/kg) ) It is inappropriate to seek an IV at this stage. There is no indication the pt is experiencing pulmonary complications thus a cheat x-ray is not indicated. There is no data to support the need for a brain scan.
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28. An elderly pt who is being medicated for pain had an episode of incontinence. The nurse realizes that this pt is at risk for developing a) dehydration. b) over-hydration. c) fecal incontinence. d) a stroke
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28. Correct Answer: A Functional changes of aging also affect fluid balance. Older adults who have self-care deficits, or who are confused, depressed, tube-fed, on bed rest, or taking medications (such as sedatives, tranquilizers, diuretics, & laxatives), are at greatest risk for fluid volume imbalance. There is inadequate evidence to support the risk of over-hydration. There is inadequate evidence to support the risk of fecal incontinence. There is inadequate evidence to support the risk of a stroke.
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29. The nurse assesses a pt's weight loss as being 22 lbs. How many liters of fluid did this pt lose?
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29. Correct Answer: 10 liters Each liter of body fluid weighs 1 kg or 2.2 lbs. This pt has lost 10 liters of fluid.
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30. A postoperative pt with a fluid volume deficit is prescribed progressive ambulation yet is weak from an inadequate fluid status. What can the nurse do to help this pt? a) Assist the pt to maintain a standing position for several minutes. b) This pt should be on bed rest. c) Assist the pt to move into different positions in stages. d) Contact physical therapy to provide a walker.
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30. Answer: C The pt needs to be taught how to avoid orthostatic hypotension which would include assisting & teaching the pt how to move from one position to another in stages The pt should avoid prolonged standing. Bed rest can promote skin breakdown. A physician referral is needed for physical therapy intervention & is not indicated in this situation.
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31. A postoperative pt is diagnosed with fluid volume overload. Which of the following should the nurse assess in this pt? a) poor skin turgor b) decreased urine output c) distended neck veins d) concentrated hemoglobin & hematocrit levels
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31) Answer: C Circulatory overload causes manifestations such as a full, bounding pulse; distended neck & peripheral veins; increased central venous pressure; cough; dyspnea; orthopnea; rales in the lungs; pulmonary edema; polyuria; ascites; peripheral edema, or if severe, anasarca, in which dilution of plasma by excess fluid causes a decreased hematocrit & blood urea nitrogen (BUN); & possible cerebral edema Poor skin turgor is associated with fluid volume deficit. Decreased urine output is associated with fluid volume deficit.. Increased hemoglobin & hematocrit values are associated with fluid volume deficit.
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32. An elderly pt is at home after being diagnosed with fluid volume overload. Which of the following should the home care nurse instruct this pt to do? a) Wear support hose. b) Keep legs in a dependent position. c) Avoid wearing shoes while in the home. d) Try to sleep without extra pillows.
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32) Answer: A Rationale 1: The home care nurse should instruct this pt about ways to decrease dependent edema, which include wearing support hose, elevating feet when in a sitting position, & resting in a recliner or bed with extra pillows. Rationale 2: The pt should elevate the legs. Rationale 3: As long as the shoes are well fitting, there is not reason to avoid wearing them. Rationale 4: It is appropriate for the pt to use extra pillows to keep the head up while sleeping.
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33. A pt with fluid retention related to renal problems is admitted to the hospital. The nurse realizes that this pt could possibly have which of the following electrolyte imbalances? a) hypokalemia b) hyperkalemia c) carbon dioxide d) magnesium
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33) Answer: B The kidneys are the principal organs involved in the elimination of potassium. Renal failure is often associated with elevations potassium levels. The kidney is the primary regulator of sodium in the body. Fluid retention is associated with hyponatremia. Carbon dioxide abnormalities are not normally seen in this type of pt. Magnesium abnormalities are not normally seen in this type of pt. (In renal failure, serum sodium: usually normal, but may be low (diluted); serum potassium: raised; serum calcium: may be normal, low or high; & serum phosphate: usually high)
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34. A pt is admitted with hypernatremia caused by being stranded on a boat in the Atlantic Ocean for five days without a fresh water source. Which of the following is this pt at risk for developing? a) pulmonary edema b) atrial dysrhythmias c) cerebral bleeding d) stress fractures
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34. Answer: C The brain experiences the most serious effects of cellular dehydration. As brain cells contract, the brain shrinks, which puts mechanical traction on cerebral vessels. These vessels may tear, bleed, & lead to cerebral vascular bleeding. Pulmonary edema is not associated with dehydration. Atrial dysrhythmias are not a factor for this pt. There have been no activities to support the development or occurrence of stress fractures.
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35. The nurse is admitting a pt who was diagnosed with acute renal failure. Which of the following electrolytes will be most affected with this disorder? a) calcium b) magnesium c) phosphorous d) potassium
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35. Answer: D Because the kidneys are the principal organs involved in the elimination of potassium, renal failure This pt will be less likely to develop a calcium imbalance, a magnesium imbalance, or a phosphorous imbalance.
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36. A pt who is taking digoxin (Lanoxin) is admitted with possible hypokalemia. Which of the following does the nurse realize might occur with this pt? a) Digoxin toxicity may occur. b) A higher dose of digoxin (Lanoxin) may be needed. c) A diuretic may be needed. d) Fluid volume deficit may occur.
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36. Answer: A Hypokalemia increases the risk of digitalis toxicity in pts who receive this drug for heart failure. More digoxin is not needed. A diuretic may cause further fluid loss. There is inadequate information to assess for concerns related to fluid volume deficits.
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37. An elderly pt with a history of sodium retention & on a low salt diet arrives to the clinic with the complaints of "heart skipping beats" & leg tremors, and is found to have a high potassium level. Which of the following should the nurse ask this pt regarding these symptoms? a) "Have you stopped taking your digoxin medication?" b) "When was the last time you had a bowel movement?" c) "Were you doing any unusual physical activity?" d) "Are you using a salt substitute?"
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37. Answer: D The patient is having symptoms of elevated potassium. The pt has a history of sodium retention & might think that a salt substitute can be used. Advise pts who are taking a potassium supplement or potassium-sparing diuretic to avoid salt substitutes, which usually contain potassium Although this pt may be prescribed digoxin this is not the primary focus of this question. The pt's bowel habits are not of concern at this time. The cardiac & musculoskeletal discomforts being reported are not consistent with physical exertion.
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38. A 35-year-old female pt comes into the clinic postoperative parathyroidectomy. Which of the following should the nurse instruct this pt? a) Drink one glass of red wine per day. b) Avoid the sun. c) Milk & milk-based products will ensure an adequate calcium intake. d) Red meat is the protein source of choice
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38. Answer: C This pt is at risk for developing hypocalcemia. This risk can be avoided if instructed to ingest milk & milk-based products This pt should avoid alcohol. This pt can benefit from sun exposure.. Protein monitoring is not indicated.
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39. An elderly pt with peripheral neuropathy has been taking magnesium supplements. The nurse realizes that which of the following symptoms can indicate hypermagnesaemia? a) hypotension, warmth, & sweating b) nausea & vomiting c) hyperreflexia d) excessive urination
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39. Answer: A Elevations in magnesium levels are accompanied by hypotension, warmth, & sweating. Lower levels of magnesium are associated with nausea & vomiting. Lower levels of magnesium are associated & hyperreflexia. Urinary changes are not noted.
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40. A pt is diagnosed with hyperphosphatemia. The nurse realizes that this pt might also have an imbalance of which of the following electrolytes? a) calcium b) sodium c) potassium d) chloride
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40. Answer: A Excessive serum phosphate levels cause few specific symptoms. The effects of high serum phosphate levels on nerves & muscles are more likely the result of hypocalcemia that develops secondary to an elevated serum phosphorus level. The phosphate in the serum combines with ionized calcium, & the ionized serum calcium level falls.
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41. The pt is receiving intravenous potassium (KCL). Which nursing actions are required? Select all that apply. a) Administer the dose IV push over 3 minutes. b) Monitor the injection site for redness. c) Add the ordered dose to the IV hanging. d) Use an infusion controller for the IV. e) Monitor fluid intake & output.
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41. Answer: B, D, E Do not administer KCL by IV. Potassium can be irritating to vein and cause redness. Always use an infusion controller to prevent possibility of a bolus amount. Monitor I & O and ensure adequate output for prevention of potassium retention.
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42. Which pts are at risk for the development of hypercalcemia? Select all that apply. a) the pt with a malignancy b) the pt taking lithium c) the pt who uses sunscreen to excess d) the pt with hyperparathyroidism e) the pt who overuses antacids
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42 Answer: A, B, D, E Pts with malignancy are at risk for development of hypercalcemia due to destruction of bone or the production of hormone-like substances by the malignancy. Lithium & overuse of antacids can result in hypercalcemia. Hypercalcemia can result from hyperparathyroidism which causes release of calcium from the bones, increased calcium absorption in the intestines & retention of calcium by the kidneys. The pt who uses sunscreen to excess is more likely to have a vitamin D deficiency which would result in hypocalcemia..
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43. The pt who has a serum magnesium level of 1.4 mg/dL is being treated with dietary modification. Which foods should the nurse suggest for this pt? Select all that apply. a) bananas b) seafood c) white rice d) lean red meat e) chocolate
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43. Answer: A, B, E Serum magnesium level of 1.4 mg/dL suggests mild hypomagnesaemia, so this pt should be counseled to eat foods high in magnesium. Foods high in magnesium include green leafy vegetables, seafood, milk, bananas, citrus fruits, & chocolate. White rice & lean red meat are not included.
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The pt has been placed on a 1200 mL daily fluid restriction. The pt's IV is infusing at a keep open rate of 10 mL/hr. The pt has no additional IV medications. How much fluid should the pt be allowed on day shift from 0700 until 1500 daily? (Assume po fluids distributed days 50%, evenings 35% & nights 15%)
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Answer: 480 Rationale: Fluid allowed is calculated by figuring the total daily IV intake (in this case 10 mL/hr × 24 hours = 240 mL/day), subtracting that total from the daily allowance (in this case 1200mL - 240 mL = 960mL). The amount calculated is then distributed as 50% for the traditional day shift, 25%-35% for the traditional evening shift, & the remainder for the traditional night shift. In this case, 50% of 960 is 480 mL
