Author Question: A patient is admitted with orthopnea, cough, pulmonary crackles, and peripheral edema. The patient's ... (Read 29 times)

jace · **on:** Jul 23, 2018

A patient is admitted with orthopnea, cough, pulmonary crackles, and peripheral edema. The patient's urine specific gravity is 1.002. The nurse will expect this patient's provider to order which treatment?

a. Diuretics
b. Colloidal IV fluids
c. Hypertonic IV fluids
d. Hypotonic IV fluids

Question 2

The nurse is caring for a patient who will receive intravenous calcium gluconate. Which nursing actions are appropriate when giving this solution? (Select all that apply.)

a. Administering through a central line
b. Assessing for Trousseau's and Chvostek's signs
c. Giving as a rapid intravenous bolus
d. Mixing in a solution containing sodium bicarbonate
e. Monitoring the patient's electrocardiogram (ECG)
f. Reporting a serum calcium level >2.5mEq/L

honnalora · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: A
This patient has signs of fluid volume excess. Diuretics are prescribed to reduce fluid overload.

Answer to Question 2

ANS: B, E, F
Trousseau's and Chvostek's signs indicate hypocalcemia, and patients receiving calcium should be monitored closely for signs of calcium imbalance. Hypercalcemia can cause ECG changes. A serum calcium level greater than 2.5mEq/L indicates hypercalcemia and therefore should be reported. Calcium does not require infusion through a central line and should not be given as a rapid IV bolus. Calcium should not be added to a solution containing bicarbonate, because rapid precipitation occurs.