A nurse is calculating a client's fluid intake over the past 8 hr. The client had one 8-oz cup of coffee, 3 oz of juice, and 12 oz of soda. The client's water pitcher had 300 ml and 200 ml remains. The client also had IV fluids infusing as 40 mL/hr via an infusion pump. How many ml should the nurse document as the client's total Intake for the shift?
The Correct Answer is ["1110"]
8-oz cup of coffee = 8 oz (since 1 fluid ounce is approximately 30 ml, this is roughly 240 ml).
3 oz of juice = 3 oz (approximately 90 ml).
12 oz of soda = 12 oz (approximately 360 ml).
Water pitcher had 300 ml, and 200 ml remains, so the client consumed 300 ml - 200 ml = 100 ml of water.
IV fluids infusing at 40 mL/hr for 8 hours = 40 ml/hr * 8 hr = 320 ml.
Now, sum up these values:
240 ml (coffee) + 90 ml (juice) + 360 ml (soda) + 100 ml (water) + 320 ml (IV fluids) = 1,110 ml
So, the nurse should document the client's total intake for the shift as 1,110 ml.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Upper left quadrant: Pain in the upper left quadrant of the abdomen can be associated with issues related to the spleen, stomach, or parts of the colon. It's not a typical location for pain related to diverticular disease.
B. Upper right quadrant: Pain in the upper right quadrant is often associated with issues related to the liver, gallbladder, or part of the colon. Again, not a typical location for diverticular disease-related pain.
C. Lower left quadrant: This is the correct answer. Diverticular disease often causes pain in the lower left quadrant of the abdomen, particularly if the inflammation or infection is in the sigmoid colon, which is a common site for diverticula.
D. Lower right quadrant: Pain in the lower right quadrant can be related to issues with the appendix or parts of the colon. It's not a typical location for diverticular disease-related pain.
Correct Answer is C
Explanation
A. "I will use caution when eating high fiber foods."Clients with an ileostomy should be cautious with high-fiber foods as they can cause blockages.
B. "I will empty my pouch when it becomes one third full."
This statement is correct. Regularly emptying the pouch prevents it from becoming too heavy and ensures comfort for the client.
C. "I will be certain to take enteric-coated medications."This statement indicates a need for further teaching. Enteric-coated medications are designed to dissolve in the intestine, but with an ileostomy, the medication may pass through the digestive system too quickly to be absorbed effectively. Clients should be advised to consult their healthcare provider about medication forms, as liquid or non-enteric-coated medications may be more appropriate.
D. "I will change my entire pouch system at least weekly."
This statement is correct. Changing the pouch system regularly helps maintain hygiene and prevents skin irritation.
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