A charge nurse is providing an in-service to a group of nurses about hypomagnesemia. Which of the following should the charge nurse include as risk factors for this condition? (Select all that apply.)

Clients who have had gastric bypass surgery

Clients who have renal failure

Clients receiving opioid pain medications

Clients who are in the intensive care unit

Clients undergoing hemodialysis

Answer and Explanation

Correct Answer : A,B,D,E

A. Clients who have had gastric bypass surgery: Gastric bypass surgery can lead to decreased absorption of nutrients, including magnesium, making these clients at higher risk for hypomagnesemia.

B. Clients who have renal failure: Renal failure can impair the kidneys' ability to excrete magnesium, potentially leading to hypomagnesemia.

C. Clients receiving opioid pain medications: Opioids are not directly associated with hypomagnesemia. They may have other side effects but do not typically cause low magnesium levels.

D. Clients who are in the intensive care unit: ICU patients are at risk for various electrolyte imbalances, including hypomagnesemia, due to critical illness, medications, and other factors.

E. Clients undergoing hemodialysis: Hemodialysis can lead to loss of magnesium, making these patients more susceptible to hypomagnesemia.

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Correct Answer is D

Explanation

A. Impaired carbon dioxide elimination due to shunting: Shunting in ARDS affects oxygenation rather than carbon dioxide elimination. ARDS primarily results in impaired gas exchange due to inflammation and fluid accumulation in the alveoli, affecting oxygen rather than CO2.

B. Decreased pulmonary arterial pressure due to ventilation-perfusion (V/Q) mismatch: ARDS typically leads to increased pulmonary arterial pressure due to inflammation and decreased lung compliance. The V/Q mismatch contributes to impaired gas exchange, often resulting in elevated pulmonary arterial pressure rather than decreased.

C. Hypoxemia due to dead space: In ARDS, hypoxemia is primarily due to impaired gas exchange from damaged alveoli, not due to dead space. Dead space refers to areas where ventilation occurs without adequate blood flow, which is not the main issue in ARDS.

D. Decreased pulmonary compliance due to stiffness: ARDS is characterized by decreased pulmonary compliance due to the stiffness of the lung tissue caused by inflammation and edema. This decreased compliance makes lung expansion more difficult, which is a central feature of ARDS.

A. The client has developed confusion. B. The client's serum sodium is 140 mEq/L (135 to 145 mEq/L). C. The client has a positive Chvostek's sign. D. The client's blood urea nitrogen (BUN) level is 18 mg/dL (10 to 20 mg/dL).

Correct Answer is A

Explanation

A. The client has developed confusion: Hypotonic fluids can cause a rapid shift of water into cells, potentially leading to cerebral edema. This can manifest as confusion or altered mental status, which is a serious adverse effect requiring immediate attention.

B. The client's serum sodium is 140 mEq/L (135 to 145 mEq/L): A serum sodium level within the normal range indicates that the hypotonic fluid therapy is likely effective in correcting hypernatremia, and does not suggest an adverse effect.

C. The client has a positive Chvostek's sign: A positive Chvostek's sign is indicative of hypocalcemia rather than an adverse effect of hypotonic fluid administration. This sign is related to low calcium levels and is not a direct result of hypotonic fluid therapy.

D. The client's blood urea nitrogen (BUN) level is 18 mg/dL (10 to 20 mg/dL): This BUN level is within normal limits and does not suggest an adverse effect of hypotonic fluid therapy. BUN levels can be affected by various factors, but this value alone is not indicative of an adverse reaction.

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A charge nurse is providing an in-service to a group of nurses about hypomagnesemia. Which of the following should the charge nurse include as risk factors for this condition? (Select all that apply.)

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