QUESTIONS AND VERIFIED ANSWERS |100%
CORRECT| GRADE A- NIGHTINGALE
Hypokalemia appearance on EKG - CORRECT ANSWER -- U waves
- inverted T waves
- depressed ST segment
Potassium chloride intravenously is prescribed for a client with heartBfailure experiencing hypokalemia.
Which actions should the nurse take to plan for preparation and administration of the potassium?
Select all that apply.
1. Obtain an intravenous (IV) infusion pump.
2. Monitor urine output during administration.
3. Prepare the medication for bolus administration.
4. Monitor the IV site for signs of infiltration or phlebitis.
5. Ensure that the medication is diluted in the appropriate volume of fluid.
6. Ensure that the bag is labeled so that it reads the volume of potassium in the solution. -
CORRECT ANSWER -1. Obtain an intravenous (IV) infusion pump.
2. Monitor urine output during administration.
4. Monitor the IV site for signs of infiltration or phlebitis.
5. Ensure that the medication is diluted in the appropriate volume of fluid.
6. Ensure that the bag is labeled so that it reads the volume of potassium in the solution.
Potassium chloride administered intravenously must always be diluted in IV fluid and infused via an infu
sion pump. Potassium chloride is never given by bolus (IV push). Giving Bpotassium chloride by IV push c
an result in cardiac arrest. The nurse should ensure that the potassium is diluted in the appropriate amo
unt of diluent or fluid. The IV bag containing the potassium chloride should always be labeled with the v
olume of potassium it contains. The IV site is monitored closely, because potassium chloride is irritating
to the veins and there is risk of phlebitis. In addition, the nurse should monitor for infiltration. The nurs
e monitors urinary output during administration and contacts the primary health care provider if the uri
nary output is less than 30 mL/hr.
,The nurse is assessing a client with a lactose intolerance disorder for a suspected diagnosis of hypocalce
mia. Which clinical manifestation would the nurse expect to note in the client?
1. Twitching
2. Hypoactive bowel sounds
3. Negative Trousseau's sign
4. Hypoactive deep tendon reflexes - CORRECT ANSWER -1. Twitching
: A client with lactose intolerance is at risk for developing hypocalcemia, because food products that con
tain calcium also contain lactose. The normal serum calcium level is 9 to 10.5 mg/dL (2.25 to 2.75 mmol
/L). A serum calcium level lower than 9 mg/dL (2.25 mmol/L) indicates hypocalcemia. Signs of hypocalce
mia include paresthesias followed by numbness, hyperactive deep tendon reflexes, and a 267 positive Tr
ousseau's or Chvostek's sign. Additional signs of hypocalcemia include increased neuromuscular excitabi
lity, muscle cramps, twitching, tetany, seizures, irritability, and anxiety. Gastrointestinal symptomsBinclud
e increased gastric motility, hyperactive bowel sounds, abdominal cramping, and diarrhea.
. The nurse isBcaring for a client with Crohn's disease who has a calcium level of 8 mg/dLB(2 mmol/L). W
hich patterns would the nurse watch for on the electrocardiogram? Select all that apply.
1. U waves
2. Widened T wave
3. Prominent U wave
4. Prolonged QT interval
5. Prolonged ST segment - CORRECT ANSWER -4. Prolonged QT interval
5. Prolonged ST segment
A client with Crohn's disease is at risk for hypocalcemia. The normal serum calcium level is 9 to 10.5 mg
/dL (2.25 to 2.75 mmol/L). A serum calcium level lower than 9 mg/dL (2.25 mmol/L) indicates hypocalce
mia. Electrocardiographic changes that occur in a client with hypocalcemia include a prolonged QT inter
val and prolonged ST segment. A shortened ST segment and a widened T wave occur with hypercalcemi
a. ST depression and prominent U waves occur with hypokalemia.
The nurse reviews the electrolyte results of a client with chronic kidney disease and notes that the pota
ssium level is 5.7 mEq/L (5.7 mmol/L). Which patterns would the nurse watch for on the cardiac monitor
as a result of the laboratory value? Select all that apply.
, 1. ST depression
2. Prominent U wave
3. Tall peaked T waves
4. Prolonged ST segment
5. Widened QRS complexesB- CORRECT ANSWER -3. Tall peaked T waves
5. Widened QRS complexes
The client with chronic kidney disease is at risk for hyperkalemia. The normal potassium level is 3.5 to 5.
0 mEq/L (3.5 to 5.0 mmol/L). A serum potassium level greater than 5.0 mEq/L (5.0 mmol/L) indicates hy
perkalemia. Electrocardiographic changes associated with hyperkalemia include flat P waves, prolonged
PR intervals, widened QRS complexes, and tall peaked T waves. ST depression and a prominent U wave
occurs in hypokalemia. A prolonged ST segment occurs in hypocalcemia.
The nurse is caring for a client with heart failure who is receiving high doses of a diuretic. On assessmen
t, the nurse notes that the client has flat neck veins, generalized muscle weakness, and diminished deep
tendon reflexes. The nurse suspects hyponatremia. What additional signs would the nurse expect to no
te in a client with hyponatremia?
1. Muscle twitches
2. Decreased urinary output
3. Hyperactive bowel sounds
4. Increased specific gravity of the urine - CORRECT ANSWER -3. Hyperactive bowel sounds
The normal serum sodium level is 135 to 145 mEq/LB(135 to 145 mmol/L). Hyponatremia is evidenced b
y a serum sodium level lower than 135 mEq/L (135 mmol/L). Hyperactive bowel sounds indicate hypona
tremia. The remaining options are signs of hypernatremia. In hyponatremia, muscle weakness, increase
d urinary output, and decreased specific gravity of the urine would be noted.
The nurse reviews a client's laboratory report and notes that the client's serum phosphorus (phosphate)
level is 1.8 mg/dL (0.58 mmol/L). Which 264 condition most likely caused this serum phosphorus level?
1. Malnutrition
2. Renal insufficiency
3. Hypoparathyroidism
4. Tumor lysis syndrome - CORRECT ANSWER -1. Malnutrition