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HESI RN Fundamentals Exam / Latest Solution/ Q&A With Elaborations

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The nurse should plan care knowing that which client is at risk for a potassium deficit? (ANS- The client receiving nasogastric suction Rationale: Potassium-rich gastrointestinal (GI) fluids ar... e lost through GI suction, which places the client at risk for hypokalemia The nurse reviews a client's electrolyte results and notes a potassium level of 5.5 mEq/L. The nurse understands that a potassium value at this level should be noted with which condition? (ANS- Traumatic burn Rationale: A serum potassium level that exceeds 5.0 mEq/L is indicative of hyperkalemia. Clients who experience the cellular shifting of potassium, as in the early stages of massive cell destruction (i.e., with trauma, burns, sepsis, or metabolic or respiratory acidosis), are at risk for hyperkalemia. The client with Cushing's syndrome or diarrhea and the client who has been overusing laxatives are at risk for hypokalemia. The nurse reviews a client's electrolyte results and notes that the potassium level is 5.4 mEq/L. Which should the nurse observe for on the cardiac monitor as a result of this laboratory value? (ANS- Narrow, peaked T waves Rationale: A serum potassium level of 5.4 mEq/L is indicative of hyperkalemia. Cardiac changes include a wide, flat P wave; a prolonged PR interval; a widened QRS complex; and narrow, peaked T waves. "insensible fluid loss of approximately 800 mL daily." Which client is at risk for this loss? (ANS- Client with a fast respiratory rate Rationale: Sensible losses are those that the person is aware of, such as those that occur through wound drainage, GI tract losses, and urination. Insensible losses may occur without the person's awareness. Insensible losses occur daily through the skin and the lungs. [Show More]

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