ATI Fluid Electrolyte and Acid-Base Regulation

Correct Answer: B

Rationale: The correct answer is B: Sodium bicarbonate 100 mEq diluted in 1 L of D5W. In this case, the client is experiencing metabolic acidosis due to low HCO3 levels (16 mEq/L) with a low pH (7.28). Sodium bicarbonate helps correct metabolic acidosis by increasing the HCO3 levels. Furosemide (A) is a diuretic and can worsen the client's electrolyte imbalance. Mechanical ventilation (C) is not indicated for metabolic acidosis. Indwelling urinary catheter (D) does not address the underlying acid-base imbalance. Therefore, the nurse should expect the provider to order sodium bicarbonate to correct the metabolic acidosis.

Correct Answer: B

Rationale: The correct answer is B: Dilute urine. Hypokalemia can lead to kidney dysfunction, causing the kidneys to excrete more water along with electrolytes, resulting in dilute urine. This is a manifestation of the body's attempt to compensate for low potassium levels by excreting excess water. The other choices are incorrect because: A) Diarrhea is more commonly associated with hyperkalemia, not hypokalemia. C) Increased muscle tone is not a typical sign of hypokalemia; rather, hypokalemia can lead to muscle weakness or paralysis due to impaired muscle function. D) Joint pain is not a typical symptom of hypokalemia; joint pain is more commonly associated with other conditions such as arthritis or inflammation.

Correct Answer: A

Rationale: The correct answer is A: Cardiac rate and rhythm. In an acid-base imbalance, the pH is below the normal range indicating acidosis. The nurse should assess the cardiac rate and rhythm first because acidosis can have negative effects on the cardiovascular system. Acidosis can lead to arrhythmias and decreased cardiac output. Monitoring the cardiac rate and rhythm is crucial to detect any cardiac complications early. Choices B, C, and D are not the priority in this situation as they are not directly impacted by acid-base imbalances.

Correct Answer: A

Rationale: The correct answer is A: Substantially reduced renal function. In older adults, elevated serum creatinine levels can indicate impaired kidney function, as the kidneys may not filter waste products as efficiently. This can lead to a buildup of creatinine in the blood. Acute kidney injury (Choice B) is a sudden decline in kidney function and would typically present with a more significant increase in creatinine levels. Decreased cardiac output (Choice C) would not directly cause elevated creatinine levels. Alterations in the ratio of body fluids to muscle mass (Choice D) would not be a common cause of elevated creatinine levels in this scenario.

Correct Answer: D

Rationale: The correct answer is D: Fluid volume status. Assessment of specific gravity helps to determine the concentration of solutes in the urine, indicating the degree of hydration or dehydration. In SIADH, there is water retention leading to diluted urine, resulting in low specific gravity. Monitoring specific gravity every 4 hours is crucial in assessing the patient's fluid volume status and response to treatment. A: Nutritional status is not directly assessed by specific gravity. B: Potassium balance is not directly assessed by specific gravity. C: Calcium balance is not directly assessed by specific gravity.