A nurse is caring for a client who has metabolic alkalosis and is receiving sodium chloride and potassium chloride IV fluids. The nurse should monitor for which of the following complications of this therapy?

Hypernatremia.

Hypokalemia.

Hyperchloremic acidosis.

Hypochloremic alkalosis.

Answer and Explanation

The Correct Answer is C

Choice A reason:

Hypernatremia is not a likely complication of sodium chloride and potassium chloride IV fluids, because these fluids do not contain excessive amounts of sodium. Hypernatremia is more likely to occur with hypertonic saline solutions or excessive sodium intake.

Choice B reason:

Hypokalemia is not a likely complication of sodium chloride and potassium chloride IV fluids, because these fluids contain potassium, which can help prevent or correct hypokalemia. Hypokalemia is more likely to occur with diuretic therapy, vomiting, or diarrhea.

Choice C reason:

Hyperchloremic acidosis is a likely complication of sodium chloride and potassium chloride IV fluids, because these fluids can increase the serum chloride level and lower the serum bicarbonate level, resulting in a metabolic acidosis. Hyperchloremic acidosis can also worsen the client's existing metabolic alkalosis by impairing the renal excretion of hydrogen ions.

Choice D reason:

Hypochloremic alkalosis is not a likely complication of sodium chloride and potassium chloride IV fluids, because these fluids do not cause a loss of chloride or an increase in bicarbonate. Hypochloremic alkalosis is more likely to occur with vomiting, gastric suctioning, or diuretic therapy.

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Correct Answer is B

Explanation

Choice A: Hypercalcemia. This is a condition of having too much calcium in the blood. It can cause muscle weakness, constipation, nausea, vomiting, confusion, and irregular heartbeat. However, it does not typically cause paresthesias (tingling or numbness), diarrhea, or crackles in the lungs.

Choice B:

Hypokalemia. This is a condition of having too low potassium in the blood. It can cause muscle weakness, paresthesias, irregular heartbeat, shallow respirations, and increased risk of digoxin toxicity (a medication used to treat heart failure) It can also cause vomiting and diarrhea, which can worsen the potassium loss. This choice matches the symptoms of the patient.

Choice C:

Hypermagnesemia. This is a condition of having too much magnesium in the blood. It can cause muscle weakness, nausea, vomiting, low blood pressure, bradycardia (slow heart rate), and respiratory depression. However, it does not usually cause paresthesias, diarrhea, or crackles in the lungs.

Choice D:

Hypophosphatemia. This is a condition of having too low phosphate in the blood. It can cause muscle weakness, bone pain, rickets (softening of bones), and impaired cellular function. However, it does not typically cause paresthesias, irregular heartbeat, shallow respirations, or crackles in the lungs.

A. Increase intake of foods high in potassium. B. Decrease intake of foods high in sodium. C. Increase intake of foods high in calcium. D. Decrease intake of foods high in protein. E. Increase intake of fluids as tolerated.

Correct Answer is ["A","B"]

Explanation

Choice A reason:

Furosemide is a potassium-wasting diuretic that may reduce the potassium level in your blood. To counteract the loss of potassium, you should try to eat enough potassium-rich foods in your diet. Some examples of potassium-rich foods include bananas, orange juice, apricots, acorn squash, butternut squash, Hubbard squash, prunes, raisins, and bran products.

Choice B reason:

Furosemide is used to treat high blood pressure and edema by causing the kidneys to get rid of unneeded water and salt from the body into the urine. To enhance the effect of furosemide and prevent fluid retention, you should decrease intake of foods high in sodium. Some examples of sodium-rich foods include processed meats, canned soups, pickles, cheese, salted nuts, and snack foods.

Choice C reason:

Furosemide does not affect the calcium level in your blood significantly. Therefore, there is no need to increase intake of foods high in calcium when taking furosemide. However, you should still consume adequate amounts of calcium for your bone health and other functions. Some examples of calcium-rich foods include milk, yogurt, cheese, broccoli, kale, and fortified cereals.

Choice D reason:

Furosemide does not affect the protein level in your blood significantly. Therefore, there is no need to decrease intake of foods high in protein when taking furosemide. However, you should still consume moderate amounts of protein for your muscle health and other functions. Some examples of protein-rich foods include eggs, fish, poultry, meat, beans, nuts, and seeds.

Choice E reason:

Furosemide can cause dehydration and electrolyte imbalance by increasing urine output. Therefore, you should increase intake of fluids as tolerated to prevent these complications. You should drink enough water to keep your urine clear or pale yellow. You should also avoid alcohol and caffeine as they can worsen dehydration.

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A nurse is caring for a client who has metabolic alkalosis and is receiving sodium chloride and potassium chloride IV fluids. The nurse should monitor for which of the following complications of this therapy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A nurse is providing discharge instructions to a client who has chronic heart failure and is prescribed furosemide, a loop diuretic. Which of the following dietary modifications should the nurse include in the teaching? (Select all that apply.)

Correct Answer is ["A","B"]

Explanation

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