A nurse is reviewing the laboratory results of a client who has metabolic acidosis. The nurse should expect to see which of the following changes in the client's electrolyte levels?

Choice A reason:

Administering IV fluids as prescribed is not an appropriate intervention for a client who has fluid overload due to renal failure. IV fluids will increase the fluid volume and worsen the condition. The nurse should monitor the client's fluid intake and output, and report any signs of fluid overload to the provider.

Choice B reason:

Restricting sodium intake is an appropriate intervention for a client who has fluid overload due to renal failure. Sodium causes water retention and increases the fluid volume in the body. The nurse should limit the client's sodium intake to less than 2 g per day, and avoid foods that are high in sodium, such as canned soups, processed meats, cheese, and salted snacks.

Choice C reason:

Elevating the head of the bed is an appropriate intervention for a client who has fluid overload due to renal failure. Elevating the head of the bed helps to reduce the pressure on the lungs and improve the client's breathing. The nurse should also monitor the client's respiratory status, and administer oxygen therapy as prescribed.

Choice D reason:

Encouraging ambulation is not an appropriate intervention for a client who has fluid overload due to renal failure. Ambulation may increase the workload on the heart and lungs, and exacerbate the symptoms of fluid overload. The nurse should assist the client with activities of daily living, and provide rest periods between activities.

Choice A reason:

Decreased skin turgor is a sign of dehydration because the skin loses elasticity when the body loses water. The nurse can assess this by pinching the skin on the back of the hand or the forehead and observing how quickly it returns to its normal position. If it takes longer than a few seconds, it indicates decreased skin turgor.

Choice B reason:

Increased heart rate is a sign of dehydration because the heart has to work harder to pump blood when the blood volume is low. The body also tries to compensate for the fluid loss by increasing the heart rate and constricting the blood vessels.

Choice C reason:

Crackles in the lungs are not a sign of dehydration, but rather a sign of fluid overload or pulmonary edema. Crackles are caused by fluid accumulation in the alveoli, which interferes with gas exchange and produces a crackling sound when breathing. This choice is incorrect.

Choice D reason:

Low urine output is a sign of dehydration because the kidneys try to conserve water by producing less urine. The urine also becomes more concentrated and darker in color when the body is dehydrated.

Choice E reason:

Dry mucous membranes are a sign of dehydration because the body loses moisture from the mouth, nose, and eyes when it is dehydrated. The nurse can assess this by looking at the lips, tongue, and oral cavity for dryness and cracking.