A postoperative patient is diagnosed with ﬂuid volume overload. What should the nurse expect to assess in this patient?

Concentrated hemoglobin and hematocrit levels

Distended neck veins

Decreased urine output

Poor skin turgor

Answer and Explanation

The Correct Answer is B

Choice A: Concentrated hemoglobin and hematocrit levels are not a sign of ﬂuid volume overload, but rather of ﬂuid volume deficit. This is a condition that occurs when the body loses more ﬂuid than it gains. This can happen in patients who have excessive bleeding, vomiting, diarrhea, or diaphoresis. Concentrated hemoglobin and hematocrit levels indicate hemoconcentration, which is an increase in the ratio of blood cells to plasma.

Choice B: Distended neck veins are a sign of ﬂuid volume overload, because this condition occurs when the body retains more ﬂuid than it excretes. This can happen in patients who have heart failure, kidney failure, or excessive ﬂuid intake. Distended neck veins indicate increased central venous pressure, which is a measure of the pressure in the right atrium of the heart.

Choice C: Decreased urine output is not a sign of ﬂuid volume overload, but rather of oliguria or anuria. These are conditions that occur when the urine output is less than 400 mL or 50 mL per day, respectively. These can happen in patients who have acute or chronic kidney injury, urinary obstruction, or shock. Decreased urine output indicates impaired renal function and decreased glomerular filtration rate.

Choice D: Poor skin turgor is not a sign of ﬂuid volume overload, but rather of dehydration. This is a condition that occurs when the body loses more water than it gains. This can happen in patients who have fever, diabetes insipidus, or hyperglycemia. Poor skin turgor indicates decreased skin elasticity and delayed return to normal shape after being pinched.

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Correct Answer is D

Explanation

Choice A: Anticipating the administration of intravenous sodium bicarbonate is incorrect because this would increase the pH and worsen the alkalosis. Sodium bicarbonate is used to treat metabolic acidosis, not respiratory alkalosis.

Choice B: Preparing to start an intravenous ﬂuid bolus using isotonic ﬂuids is incorrect because this would not aﬀect the pH or the PaCO2. Isotonic ﬂuids are used to treat ﬂuid volume deficit, not respiratory alkalosis.

Choice C: Immediately administering oxygen via a mask and monitoring oxygen saturation is incorrect because this would decrease the respiratory drive and increase the PaCO2. Oxygen therapy is used to treat hypoxemia, not respiratory alkalosis.

Choice D: Encouraging the patient to breathe in and out slowly into a paper bag is correct because this would increase the PaCO2 and lower the pH. Rebreathing carbon dioxide is a common treatment for respiratory alkalosis caused by hyperventilation.

A. Calcium-containing antacids B. Increased vitamin D intake C. Potassium phosphate D. Additional milk intake E. IV normal saline

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

Explanation

Choice A: Calcium-containing antacids are prescribed for patients with high serum phosphate levels, because calcium binds with phosphate and lowers its concentration in the blood. Calcium-containing antacids also help to prevent or treat hypocalcemia, which is a common complication of hyperphosphatemia.

Choice B: Increased vitamin D intake is not prescribed for patients with high serum phosphate levels, because vitamin D enhances the absorption of both calcium and phosphate from the intestines. Increased vitamin D intake can worsen hyperphosphatemia and hypocalcemia.

Choice C: Potassium phosphate is not prescribed for patients with high serum phosphate levels, because potassium phosphate is a source of phosphate that increases its concentration in the blood. Potassium phosphate can also cause hyperkalemia, which is a dangerous condition that aﬀects the heart rhythm.

Choice D: Additional milk intake is not prescribed for patients with high serum phosphate levels, because milk is rich in both calcium and phosphate. Additional milk intake can worsen hyperphosphatemia and hypocalcemia.

Choice E: IV normal saline is prescribed for patients with high serum phosphate levels, because normal saline helps to dilute the blood and lower the concentration of phosphate. Normal saline also helps to maintain ﬂuid and electrolyte balance in the body.

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A postoperative patient is diagnosed with ﬂuid volume overload. What should the nurse expect to assess in this patient?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient who is anxious and dizzy following a traumatic experience. The arterial blood gas findings include: pH 7.48, PaO2 110, PaCO2 25, and HCO3 24. Which intervention should the nurse expect to be prescribed to correct this problem?

Correct Answer is D

Explanation

A patient has a serum phosphate level of 4.7 mg/dL. Which treatments should the nurse expect to be prescribed for this patient? Select all that apply.

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

Explanation

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