Adult Health Exam 1 Review Questions And Responses
If a patient has hypokalemia, what diuretic would most likely be appropriate? o
Spironolactone (Aldactone)
If a patient presents with hypermagnesemia, develops a drop in BP, the nurse needs to
o call the MD and call for help immediately. Rapid Response
Hypophosphatemia- o have + trousseau’s sign because calcium will be low.
o Treat with a phosphate replacement but watch for elevated levels.
If a patient is taking a lot of antacids and drinks a lot of milk, they are at risk for
o low potassium and metabolic alkalosis
Someone received a thyroidectomy, what electrolyte imbalance would you see? o Low
calcium and treat it with calcium gluconate IV
If a patient has hypernatremia, they need to o avoid processed foods.
If a patient has hyperkalemia and is taking digoxin:
o patient could develop digoxin toxicity- drops the heart rate lower than 60.
Severe hypernatremia- o should be on seizure precautions
If a patient is NPO, getting D5W IV, they will be at risk for o low sodium.
Using Salt Substitutes could put patients at a greater risk for o hyperkalemia
What group of people would be at a greater risk of low magnesium?
o Alcoholics
If a person has LOW Potassium, the EKG would show o inverted and flat T waves
If a patient has HIGH Potassium, the EKG would show o tall tented T waves
NG tube- loses o Na, K, Ca- put on monitor to watch for flat t waves
Parathyroid regulates the o calcium levels
Patient has high potassium- o will administer kayexalate enema for quick response
If a patient has Metabolic Alkalosis- o they will likely have low potassium and low
calcium- common with NG patients
A patient receiving diuretics and laxatives is at a greater risk for
o losing potassium
If a patient is taking thiazide diuretics, what electrolyte should be watched?
o Loss of Potassium.
Hyperventilation would result in respiratory alkalosis.
o Calcium lowers, and may cause tetany
If a patient has pneumonia and is afebrile- o respiratory acidosis
If a patient has pneumonia and is febrile- o respiratory alkalosis
Pancreatitis= o metabolic acidosis
Cushing syndrome= o metabolic alkalosis- (retain sodium)
Metabolic alkalosis causes o low potassium
pH is regulated by the o kidneys and lungs
Partial compensation- o all three levels are abnormal
Bicarb 20 is o metabolic acidosis
, Kidney Failure= o metabolic acidosis
Diabetic ketoacidosis= o metabolic acidosis
COPD=
o respiratory acidosis
Retaining Bicarb= o metabolic alkalosis
Trousseau’s sign- o blood pressure cuff- causes contraction
Chvosteks signo stimulation of face
Hyperkalemia, a high potassium level, manifests as weakness, fatigue, and cardiac
dysrhythmias.
Cardiac – Peak or Tall T waves
GI- hyperactive, nausea, diarrhea, intestinal colic
See on Test Questions
Hypocalcemia, a low calcium level, is associated with muscle spasms and tetany.
Calcium-preserving drugs are:
Thiazide diuretics (Hydrochlorothiazide HCTZ)- Calcium excretion is decreased
Vitamin D supplements- help you to absorb more calcium
Foods High in Calcium
Young Sally’s calcium serum continues to randomly mess-up.
Yogurt
Sardines
Cheese
Spinach
Collard greens
Tofu
Rhubarb
Milk
Vegetables high in calcium- Collard greens, turnip greens, arugula, bok choy or Chinese
cabbage, okra and broccoli
Fruits that are high in calcium are dried apricots, plums, dried figs, kiwi, kumquats,
prickly pears, tangerines and oranges.
See on Test Questions
Hypercalcemia, a high calcium level, is associated with calcium kidney stones
Administer calcium reabsorption inhibitors: Calcitonin (bone in),
Bisphosphonates, prostaglandin synthesis inhibitors (ASA, NSAIDS)
increase fluids to 3000ml/day
Nursing Interventions for Hypercalcemia
Mild cases of Hypercalcemia-
, Keep patient hydrated- increase fluids to 3000ml/day (decrease chance of renal stone
formation)
Keep patient safe from falls or injury (less Ca++ in bones)
Monitor cardiac, GI, renal, neuro status
Assess for complaints of flank or abdominal pain & strain urine to look for stone
formation
Decrease calcium rich foods and intake of calcium-preserving drugs like thiazides,
Vitamin D supplements
Moderate cases of Hypercalcemia
Administer calcium reabsorption inhibitors: Calcitonin,
Bisphosphonates, prostaglandin synthesis inhibitors (ASA, NSAIDS)
Severe cases of Hypercalcemia- Prepare patient for dialysis
Test Question Low Mag
Hypomagnesemia is a frequent consequence of alcoholism.
Signs and symptoms include disorientation, mood changes, and tachycardia.
Signs & Symptoms of Hypomagnesemia (TWITCHING)
This is the OPPOSITE in hypermagnesemia where everything system of the body is lethargic.
Trouesseau’s (positive due to hypocalcemia) if see low Mag may also see low Ca++ and low
K+
Weak respirations
Irritability
Torsades de pointes (abnormal heart rhythm that leads to sudden cardiac death…seen in
alcoholism), Tetany (seizures)
Cardiac EKG changes & Chvostek’s sign (positive which goes along with hypocalcemia) Flat
T waves
Hypertension, hyperreflexia
Involuntary movements
Nausea
GI issues (decreased bowel sounds and mobility)
Foods rich in Magnesium
“Always Get Plenty Of Foods Containing Large Numbers of Magnesium”
Avocado
Green leafy vegetables
Peanut Butter, potatoes, pork
Oatmeal
Fish (canned white tuna/mackerel)
Cauliflower, chocolate (dark)
Legumes
Nuts
If a patient has hypokalemia, what diuretic would most likely be appropriate? o
Spironolactone (Aldactone)
If a patient presents with hypermagnesemia, develops a drop in BP, the nurse needs to
o call the MD and call for help immediately. Rapid Response
Hypophosphatemia- o have + trousseau’s sign because calcium will be low.
o Treat with a phosphate replacement but watch for elevated levels.
If a patient is taking a lot of antacids and drinks a lot of milk, they are at risk for
o low potassium and metabolic alkalosis
Someone received a thyroidectomy, what electrolyte imbalance would you see? o Low
calcium and treat it with calcium gluconate IV
If a patient has hypernatremia, they need to o avoid processed foods.
If a patient has hyperkalemia and is taking digoxin:
o patient could develop digoxin toxicity- drops the heart rate lower than 60.
Severe hypernatremia- o should be on seizure precautions
If a patient is NPO, getting D5W IV, they will be at risk for o low sodium.
Using Salt Substitutes could put patients at a greater risk for o hyperkalemia
What group of people would be at a greater risk of low magnesium?
o Alcoholics
If a person has LOW Potassium, the EKG would show o inverted and flat T waves
If a patient has HIGH Potassium, the EKG would show o tall tented T waves
NG tube- loses o Na, K, Ca- put on monitor to watch for flat t waves
Parathyroid regulates the o calcium levels
Patient has high potassium- o will administer kayexalate enema for quick response
If a patient has Metabolic Alkalosis- o they will likely have low potassium and low
calcium- common with NG patients
A patient receiving diuretics and laxatives is at a greater risk for
o losing potassium
If a patient is taking thiazide diuretics, what electrolyte should be watched?
o Loss of Potassium.
Hyperventilation would result in respiratory alkalosis.
o Calcium lowers, and may cause tetany
If a patient has pneumonia and is afebrile- o respiratory acidosis
If a patient has pneumonia and is febrile- o respiratory alkalosis
Pancreatitis= o metabolic acidosis
Cushing syndrome= o metabolic alkalosis- (retain sodium)
Metabolic alkalosis causes o low potassium
pH is regulated by the o kidneys and lungs
Partial compensation- o all three levels are abnormal
Bicarb 20 is o metabolic acidosis
, Kidney Failure= o metabolic acidosis
Diabetic ketoacidosis= o metabolic acidosis
COPD=
o respiratory acidosis
Retaining Bicarb= o metabolic alkalosis
Trousseau’s sign- o blood pressure cuff- causes contraction
Chvosteks signo stimulation of face
Hyperkalemia, a high potassium level, manifests as weakness, fatigue, and cardiac
dysrhythmias.
Cardiac – Peak or Tall T waves
GI- hyperactive, nausea, diarrhea, intestinal colic
See on Test Questions
Hypocalcemia, a low calcium level, is associated with muscle spasms and tetany.
Calcium-preserving drugs are:
Thiazide diuretics (Hydrochlorothiazide HCTZ)- Calcium excretion is decreased
Vitamin D supplements- help you to absorb more calcium
Foods High in Calcium
Young Sally’s calcium serum continues to randomly mess-up.
Yogurt
Sardines
Cheese
Spinach
Collard greens
Tofu
Rhubarb
Milk
Vegetables high in calcium- Collard greens, turnip greens, arugula, bok choy or Chinese
cabbage, okra and broccoli
Fruits that are high in calcium are dried apricots, plums, dried figs, kiwi, kumquats,
prickly pears, tangerines and oranges.
See on Test Questions
Hypercalcemia, a high calcium level, is associated with calcium kidney stones
Administer calcium reabsorption inhibitors: Calcitonin (bone in),
Bisphosphonates, prostaglandin synthesis inhibitors (ASA, NSAIDS)
increase fluids to 3000ml/day
Nursing Interventions for Hypercalcemia
Mild cases of Hypercalcemia-
, Keep patient hydrated- increase fluids to 3000ml/day (decrease chance of renal stone
formation)
Keep patient safe from falls or injury (less Ca++ in bones)
Monitor cardiac, GI, renal, neuro status
Assess for complaints of flank or abdominal pain & strain urine to look for stone
formation
Decrease calcium rich foods and intake of calcium-preserving drugs like thiazides,
Vitamin D supplements
Moderate cases of Hypercalcemia
Administer calcium reabsorption inhibitors: Calcitonin,
Bisphosphonates, prostaglandin synthesis inhibitors (ASA, NSAIDS)
Severe cases of Hypercalcemia- Prepare patient for dialysis
Test Question Low Mag
Hypomagnesemia is a frequent consequence of alcoholism.
Signs and symptoms include disorientation, mood changes, and tachycardia.
Signs & Symptoms of Hypomagnesemia (TWITCHING)
This is the OPPOSITE in hypermagnesemia where everything system of the body is lethargic.
Trouesseau’s (positive due to hypocalcemia) if see low Mag may also see low Ca++ and low
K+
Weak respirations
Irritability
Torsades de pointes (abnormal heart rhythm that leads to sudden cardiac death…seen in
alcoholism), Tetany (seizures)
Cardiac EKG changes & Chvostek’s sign (positive which goes along with hypocalcemia) Flat
T waves
Hypertension, hyperreflexia
Involuntary movements
Nausea
GI issues (decreased bowel sounds and mobility)
Foods rich in Magnesium
“Always Get Plenty Of Foods Containing Large Numbers of Magnesium”
Avocado
Green leafy vegetables
Peanut Butter, potatoes, pork
Oatmeal
Fish (canned white tuna/mackerel)
Cauliflower, chocolate (dark)
Legumes
Nuts
