Fluid and Electrolytes ATI

Correct Answer: B

Rationale: Tetany is the most characteristic manifestation of hypocalcemia and hypomagnesemia. Sensations of tingling may occur in the tips of the fingers, around the mouth, and less commonly in the feet. Taking a normal blood pressure could illicit a carpal spasm if it creates slight ischemia of the ulnar nerve.

Correct Answer: A

Rationale: Signs and symptoms of hypomagnesemia are largely confined to the neuromuscular system and include confusion, tremor, tetany, laryngeal stridor, and ataxia.

Correct Answer: A

Rationale: Daily weights show trends and can assist medical management by indicating if interventions and medications are effective. Laboratory data are objective data that indicate whether electrolyte levels are within normal limits for the patient with fluid balance problems. However, if a patient is dehydrated, some laboratory data can show false elevations. Intake and output is extremely important, but matching the two is difficult because fluid is also lost through breathing, perspiration, stool, and surgical tubes. Vital signs may or may not be helpful because heart rate and blood pressure can be elevated by either depletion or excess of fluids in some situations.

Correct Answer: C

Rationale: The diuretics act on the ascending loop of Henle to prevent re-absorption of water, potassium, and sodium. Because of this, potassium and sodium levels should be monitored when a patient is receiving diuretics.

Correct Answer: C

Rationale: Before preparing the skin, the nurse should ask the patient if he or she is allergic to latex or iodine, which are products commonly used in setting up for IV therapy. A local reaction could result in irritation to the IV site or, in the extreme, it could result in anaphylaxis, which can be life threatening.