Question

Please answer and give rationale

1 A client is admitted to the hospital with a serum sodium of 150 mEq/L. The nurse should anticipate

a. placing the client on a strict bedrest

b. restricting the client;s oral fluid intake

c. monitoring the client for increased urinary output

d. administering hypotonic IV fluids to the client

2 A nurse is caring for a client following a gastric bypass surgery. Which of the following recommendations should the nurse include in the client's plan of care to meet her nutritional needs?

a. eat three times a day

b. consume protein at eat meal

c. limit total intake at meal to 12 oz

d take at least 20 min to consume each meal

3 A nurse is administering fluids intravenously to a client who developed shock following a pulmonary embolism. Which of the following findings best indicate adequate fluid replacement?

a. warm, dry skin

b. urine output of 30 ml/hr

c. right atrial pressure of 2 mmHg

d level of consciousness alert and oriented

4 A nurse is providing education to a client who has a coronary artery bypass graft surgery. Which of the following should the nurse include in the teaching?

a. wait 4 weeks before returning to work

b. begin walking a half of a mile everyday

c. report weight gain of 3 pounds in 1 week to the provider

d. call the provider if you need to take sublingual nitroglycerin

Answer 1

1.Hypernatremia is an increased level of sodium ,this can happen due to the loss of the cellular fluids or fluid volume deficit and increasing the sodium concentration in the cells.So the fluid has to be replaced to relieve the concentrated cells with sodium.Usually 5% Dextrose or 0.45%NS is administered which are hypotonic in nature.Placing the patient in strict bedrest is mandatory when there is full altered mental status. Urine output has to be monitored after fluid administration, because the patient might experience decreased urine in hypernatremia.

Ans:d.administering hypotonic solution to the client

2.The following education is necessary

• Eat in smaller quantity and six meals
• A high protein diet ,low calorie, low fat diet
• Drink at least 2 litres of fluids a day to prevent dehydration or about 64oz
• Each meals should be taken for about 20 to 30 minutes

Ans:d.take atleast 20 minutes to consume each meal

3.warm ,dry skin is a symptom lack of fluid in the body

Always the fluid balance or fluid replacement can be best understood with the amount of urine eliminated per hour.The normal level is 30ml /hr

Atrial blood pressure can be read only when their is adequate blood in the circulatory system

The mental status assessment is the initial thing when a patient loses consciousness

Ans:b.urine output of 30ml/hrs

4.The o as patient can resume to work after 6 to 8 weeks

Walking should be slow,low intensity and to a tolerable distance not walking for a long distance at a single stretch or at the first time

Weight gain of 3 pounds in a day and about 5 to 6 pounds in a week indicates fluid retention and to be addressed to provider

Chest discomfort can be experience for few months but settles down gradually ,NTG is recommended during an marginal attack so it has to be reported before taking

Ans:d.call the provider if you need to take sublingual nitroglycerin