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Chapter 16: Fluid, Electrolyte, and Acid- Base Imbalances Lewis: Medical-Surgical Nursing, 10th Edition Exam Questions and Answers $9.99   Add to cart

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Chapter 16: Fluid, Electrolyte, and Acid- Base Imbalances Lewis: Medical-Surgical Nursing, 10th Edition Exam Questions and Answers

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Chapter 16: Fluid, Electrolyte, and Acid- Base Imbalances Lewis: Medical-Surgical Nursing, 10th Edition Exam Questions and Answers A patient who has a small cell carcinoma of the lung develops syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should notify the health care provi...

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  • October 23, 2024
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  • Lewis Medical-Surgical Nursing
  • Lewis Medical-Surgical Nursing
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Chapter 16: Fluid, Electrolyte, and Acid-
Base Imbalances Lewis: Medical-Surgical
Nursing, 10th Edition Exam Questions
and Answers

A patient who has a small cell carcinoma of the lung develops syndrome of inappropriate antidiuretic

hormone (SIADH). The nurse should notify the health care provider about which assessment finding?


a. Serum hematocrit of 42%


b. Serum sodium level of 120 mg/dL


c. Reported weight gain of 2.2 lb (1 kg)


d. Urinary output of 280 mL during past 8 hours - Ans:✔✔-ANS: B


Hyponatremia is the most important finding to report. SIADH causes water retention and a decrease in

serum sodium level. Hyponatremia can cause confusion and other central nervous system effects. A

critically low value likely needs to be treated. At least 30 mL/hr of urine output indicates adequate




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FIRST PUBLISH OCTOBER 2024




kidney function. The hematocrit level is normal. Weight gain is expected with SIADH because of water

retention.


A patient who is taking a potassium-wasting diuretic for treatment of hypertension complains of

generalized weakness. Which action is appropriate for the nurse to take?


a. Assess for facial muscle spasms.


b. Ask the patient about loose stools.


c. Recommend the patient avoid drinking orange juice with meals.


d. Suggest that the health care provider order a basic metabolic panel. - Ans:✔✔-ANS: D


Generalized weakness is a manifestation of hypokalemia. After the health care provider orders the

metabolic panel, the nurse should check the potassium level. Facial muscle spasms might occur with

hypocalcemia. Orange juice is high in potassium and would be advisable to drink if the patient is

hypokalemic. Loose stools are associated with hyperkalemia.


Spironolactone (Aldactone), an aldosterone antagonist, is prescribed for a patient. Which statement by

the patient indicates that the teaching about this medication has been effective?


a. "I will try to drink at least 8 glasses of water every day."


b. "I will use a salt substitute to decrease my sodium intake."


c. "I will increase my intake of potassium-containing foods."
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d. "I will drink apple juice instead of orange juice for breakfast." - Ans:✔✔-ANS: D


Because spironolactone is a potassium-sparing diuretic, patients should be taught to choose low-

potassium foods (e.g., apple juice) rather than foods that have higher levels of potassium (e.g., citrus

fruits). Because the patient is using spironolactone as a diuretic, the nurse would not encourage the

patient to increase fluid intake. Teach patients to avoid salt substitutes, which are high in potassium.


A patient with new-onset confusion and hyponatremia is being admitted. When making room

assignments, the charge nurse should take which action?


a. Assign the patient to a semi-private room.


b. Assign the patient to a room near the nurse's station.


c. Place the patient in a room nearest to the water fountain.


d. Place the patient on telemetry to monitor for peaked T waves.. - Ans:✔✔-ANS: B


The patient should be placed near the nurse's station if confused for the staff to closely monitor the

patient. To help improve serum sodium levels, water intake is restricted. Therefore a confused patient

should not be placed near a water fountain. Peaked T waves are a sign of hyperkalemia, not

hyponatremia. A confused patient could be distracting and disruptive for another patient in a

semiprivate room.




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