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 ["A","B","C","D"]

Explanation

Choice A reason:

Jugular vein distension is a sign of fluid overload because it indicates increased pressure in the right atrium and superior vena cava due to excess blood volume.

Choice B reason:

Weight gain of 2 kg in one day is a sign of fluid overload because it reflects fluid retention in the body. A weight gain of 1 kg (2.2 lb) is equivalent to 1 L of fluid.

Choice C reason:

Decreased hematocrit is a sign of fluid overload because it indicates hemodilution or dilution of the blood due to excess fluid in the intravascular space.

Choice D reason:

Bounding pulse is a sign of fluid overload because it reflects increased cardiac output and stroke volume due to excess blood volume.

Choice E reason:

Flat neck veins are not a sign of fluid overload, but rather a sign of fluid deficit or dehydration. In fluid overload, neck veins will be distended or elevated.

A. Monitor blood glucose levels. B. Check for signs of phlebitis at the IV site. C. Assess for fluid overload. D. Evaluate serum sodium levels. E. Observe for signs of hypoglycemia.

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

Explanation

Choice A reason:

The nurse should monitor blood glucose levels because dextrose 10% in water (D10W) is a hypertonic solution that contains glucose and can raise the blood sugar level of the patient. The nurse should check the blood glucose level before and after administering D10W to prevent hyperglycemia or hypoglycemia.

Choice B reason:

The nurse should check for signs of phlebitis at the IV site because D10W is acidic and can cause venous irritation. Phlebitis is inflammation of the vein that can result from chemical, mechanical or bacterial causes. Signs of phlebitis include pain, redness, swelling, warmth and tenderness at the IV site.

Choice C reason:

The nurse should assess for fluid overload because D10W is quickly metabolized, leaving behind water that can move into the interstitial space. Fluid overload can cause edema, dyspnea, crackles, distended neck veins, increased blood pressure and decreased urine output. The nurse should monitor the intake and output, vital signs, weight and breath sounds of the patient.

Choice D reason:

The nurse does not need to evaluate serum sodium levels because D10W does not contain sodium or affect the sodium balance of the patient. D10W is used to provide some nutrition with glucose, not to correct electrolyte imbalances.

Choice E reason:

The nurse does not need to observe for signs of hypoglycemia because D10W is unlikely to cause hypoglycemia unless there is a sudden interruption or discontinuation of the infusion. Hypoglycemia is a low blood sugar level that can cause shakiness, diaphoresis, confusion, weakness, hunger and headache. The nurse should monitor the blood glucose level and administer D10W at a steady rate to prevent hypoglycemia.

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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

A nurse is assessing a client who has fluid overload. Which of the following findings should the nurse report to the provider? (Select all that apply.)

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

Explanation

A nurse is administering dextrose 10% in water (D10W) to a patient who needs some nutrition with glucose. Which of the following assessments should the nurse perform? (Select all that apply.)

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

Explanation

A nurse is planning care for a client who has overhydration and hyponatremia. Which of the following actions should the nurse include in the plan? (Select all that apply.)

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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?

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A nurse is evaluating the effectiveness of IV fluid therapy for a client who has dehydration. Which of the following findings indicates improvement?

A nurse is caring for a client who has metabolic alkalosis as a result of prolonged nasogastric suctioning. The nurse should expect which of the following arterial blood gas values?

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