An older adult nursing home resident who has always been alert and oriented is now showing signs of dehydration and has become confused. Which electrolyte imbalance is most likely involved?

Hypercalcemia

Hypomagnesemia

Hyponatremia

Hypernatremia

Answer and Explanation

The Correct Answer is C

A. Hypercalcemia: Hypercalcemia may cause confusion but is less likely associated with dehydration.

B. Hypomagnesemia: This can cause neuromuscular symptoms but is less commonly linked to confusion in dehydration.

C. Hyponatremia: Low sodium levels disrupt brain cell function, leading to confusion and neurological symptoms, which are common in dehydrated older adults.

D. Hypernatremia: While dehydration may cause hypernatremia, it is less likely to present with confusion in this context compared to hyponatremia.

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Correct Answer is D

Explanation

A. Vital signs: Vital signs can reflect changes in fluid status, but they are not always sensitive to small shifts in fluid balance and can be affected by many other factors like medications.

B. Skin turgor: Skin turgor can be useful for assessing dehydration but is not a reliable indicator for tracking fluid balance over time, especially in older adults where skin elasticity naturally declines.

C. Daily input and output: Monitoring intake and output is useful, but it is not the most reliable for evaluating overall fluid balance, especially in cases of insensible loss or shifts in third spaces.

D. Daily weights: Weighing the patient daily is the most reliable method for monitoring fluid balance because it directly reflects changes in fluid retention or loss, particularly in acute or chronic conditions like heart failure or dehydration.

A. A patient who lost 2 liters of blood during surgery B. A patient who received 6 liters of IV fluid C. A patient with UTI on po iv meds D. A patient with congestive heart failure

Correct Answer is A

Explanation

A. A patient who lost 2 liters of blood during surgery: This is the most acute and severe form of hypovolemia due to significant blood loss, requiring immediate fluid replacement and hemodynamic monitoring.

B. A patient who received 6 liters of IV fluid: This patient is at risk for hypervolemia, not hypovolemia, due to fluid overload.

C. A patient with UTI on PO meds: While dehydration may occur, it is typically mild and does not cause hypovolemia.

D. A patient with congestive heart failure: CHF usually leads to fluid retention, making hypovolemia unlikely unless there are other complicating factors.

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An older adult nursing home resident who has always been alert and oriented is now showing signs of dehydration and has become confused. Which electrolyte imbalance is most likely involved?

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Naxlex Comprehensive Predictor Exams

Which is the most reliable method for monitoring improvement when restoring fluid balance?

Correct Answer is D

Explanation

The nurse is caring for a group of patients. Which patient is at highest risk for hypovolemia?

Correct Answer is A

Explanation

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