Sherpath: Electrolyte Balance: Implement and Take Action; Evaluate

Question 1 of 12

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Which patient conditions would benefit from electrocardiogram (ECG) monitoring because of an electrolyte imbalance?

• • HyponatremiaHyponatremia does not usually cause cardiac dysrhythmias, which would require ECG monitoring.
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  • HypokalemiaHypokalemia can lead to cardiac dysrhythmias, so ECG monitoring is an important intervention.
• • HyperphosphatemiaHyperphosphatemia can cause hypocalcemia symptoms but does not typically lead to dysrhythmias requiring ECG.
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  • HypocalcemiaLow serum calcium levels can lead to cardiac dysrhythmias.
• Correct
  • HypomagnesemiaLow serum magnesium levels can lead to cardiac dysrhythmias.

Question 2 of 12

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Which action would be taken by a nurse who is administering intravenous (IV) potassium to a patient who is experiencing acute hypokalemia?

• • Administering over a short period of timeIV potassium should never be administered quickly.
• • Administering the dose by IV pushIV potassium should never be administered by IV push.
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  • Administering the solution slowlyIV potassium must always be given slowly as an IV infusion.
• • Administering to replenish fluid and electrolyte lossIV potassium is only used to replenish potassium in the event of hypokalemia.

Question 3 of 12

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Which parameter would a nurse monitor when providing care to a patient prescribed intravenous (IV) normal saline (NS) for a prolonged period?

• • HyponatremiaProlonged use of NS will not result in hyponatremia.
• Correct
  • Fluid volume excessProlonged use of IV NS puts a patient at risk for fluid volume excess.
• • HyperkalemiaNS use does not cause hyperkalemia.
• • HypokalemiaProlonged use of NS does not cause hypokalemia.

Question 4 of 12

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Which foods would a nurse teach the patient to avoid when prescribed a low sodium diet for hypernatremia?

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  • Canned soupCanned or processed foods should be avoided by patients with a sodium restriction as they are high in sodium.
• • Fresh vegetablesFresh vegetables are low in sodium and are not restricted in a low sodium diet.
• Correct
  • Sports drinksSports drinks contain sodium and should not be consumed by patients who are on a low sodium diet.
• • ApplesFresh fruit is low in sodium and is not restricted in a low sodium diet.
• Correct
  • Table saltTable salt should be avoided as it adds large amounts of sodium to food.

Question 5 of 12

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Which food item would a nurse who is providing education to a patient with hypermagnesemia teach the patient to avoid?

• • Table saltTable salt is not a source of magnesium; therefore, it need not be restricted for a hypermagnesemia patient.
• • Dairy productsIncreased consumption of dairy products is indicated for patients with a low serum calcium level. This is not a food that should be avoided for a patient diagnosed with hypermagnesemia.
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  • Green, leafy vegetablesGreen, leafy vegetables are an excellent source of magnesium and should be avoided in patients with hypermagnesemia.
• • Canned or processed foodCanned or processed foods are high in sodium; a patient diagnosed with hypermagnesemia need not avoid these foods.

Question 6 of 12

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Which instruction would a nurse give to a patient experiencing hypermagnesemia?

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  • Avoid taking antacids.Antacids are magnesium based and contribute to elevated serum magnesium levels. Patients with high magnesium should avoid antacids.
• • Increase green, leafy vegetables.Green, leafy vegetables are a source of magnesium and will not reduce the level in a patient with hypermagnesemia.
• • Reduce the amount of sodium intake.Reducing intake of sodium will not affect magnesium levels.
• • Increase fluid intake.Increasing fluid intake will not have an effect on magnesium levels.

Question 7 of 12

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Which patient electrolyte level would require the nurse to prepare for cardiac monitoring?

• • A magnesium level of 5.2 mEq/LA magnesium level of 5.2 mEq/L is within the normal range.
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  • A potassium level of 2.4 mEq/LA potassium level less than 2.5 mEq/L can result in potentially fatal dysrhythmias.
• • A calcium level of 4.22 mEq/LA calcium level of 4.22 mEq/L is within the normal range.
• • A sodium level of 139 mEq/LA sodium level of 139 mEq/L is within the normal range.

Question 8 of 12

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Which electrolytes are critical for proper cardiac functioning and would be included in a teaching session on cardiac telemetry?

• • SodiumSodium is an electrolyte that is not critical for proper cardiac functioning.
• Correct
  • PhosphatePhosphate is an electrolyte that is critical for proper cardiac functioning.
• Correct
  • MagnesiumMagnesium is an electrolyte that is critical for proper cardiac functioning.
• Correct
  • CalciumCalcium is an electrolyte that is critical for proper cardiac functioning.
• Correct
  • PotassiumPotassium is an electrolyte that is critical for proper cardiac functioning.

Question 9 of 12

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Which advantage of cardiac telemetry would the nurse include when teaching a patient with an electrolyte imbalance?

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  • Allows the patient’s cardiac activity to be monitored remotely without affecting the patient’s mobilityCardiac telemetry provides a convenient and nonrestrictive way to monitor a patient’s cardiac activity.
• • Provides ongoing assessment of the patient’s electrolyte levelsCardiac telemetry will provide assessment of cardiac activity but is not an indicator of electrolyte levels.
• • Provides documentation for causes of cardiac dysrhythmiasCardiac telemetry is not a method of documenting causes of cardiac dysrhythmias.
• • Indicates which nursing interventions are needed to correct specific electrolyte abnormalitiesCardiac telemetry will not indicate which interventions are needed to correct specific electrolyte abnormalities.

Question 10 of 12

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Which nursing actions would be implemented prior to a patient receiving a dialysis treatment?

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  • Obtaining vital signsBaseline vital signs should be obtained before dialysis to ensure that the patient has adequate cardiac output to support dialysis.
• • Increasing oral fluid intakeIncreasing oral fluid intake is not an intervention that must be done prior to dialysis.
• Correct
  • Assessing laboratory dataLaboratory data should be evaluated prior to dialysis to ensure that the electrolyte levels require dialysis and there is no risk of a dangerous electrolyte imbalance.
• Correct
  • Providing instruction about what the patient should expectPatients should always be provided with information about any treatment or medications.
• • Restricting oral intake 4 hours prior to the treatmentThe patient is permitted oral intake prior to and during dialysis.

Question 11 of 12

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Which observation would the nurse expect after dialysis in a patient with a serum potassium level of 7.0 mEq/L?

• • There will be no change in the patient’s potassium level.When the body is unable to get rid of excess electrolytes, dialysis will help bring high electrolyte levels back to normal.
• • The serum potassium concentration will increase.Electrolyte levels will not increase as a result of dialysis.
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  • The serum potassium concentration will decrease.After dialysis, there should be a significant decrease in the patient’s serum potassium level.
• • What will happen to the serum potassium cannot be determined.The purpose of dialysis is to remove wastes and excess electrolytes. There will be a decrease in electrolyte levels after effective dialysis.

Question 12 of 12

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Which patient statement indicates understanding after a nurse completes education for a patient prescribed to receive dialysis to treat an electrolyte imbalance?

• • “Dialysis will improve my kidney function.”Dialysis does the work of the kidneys when the kidneys cannot function sufficiently.
• • “Dialysis will correct any fluid imbalances in the body.”Dialysis will correct fluid volume excess; it does not correct fluid volume deficit.
• • “Dialysis can correct my dangerously low electrolyte levels.”Dialysis will remove electrolytes from the body but should not be done when electrolyte levels are low.
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  • “Dialysis removes excess wastes and electrolytes from my body.”Dialysis does the work of the kidneys in patients with decreased renal function. This includes removing wastes and electrolytes from the body.