A client diagnosed with diabetes mellitus is admitted to the emergency department (ED) and the cardiac monitor shows multifocal premature ventricular contractions (PVCs). Initial laboratory findings are as follows: The nurse recognizes that the client's PVCs are most likely caused by:
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Potassium 2.8 mEq/L |
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|
Sodium 133 mEq/L |
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Chloride 90 mEq/L |
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Glucose 200 mg/dl |
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Magnesium 2.5 mg/dL |
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Calcium 8.0 mg/dL |
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hypermagnesemia.
hypocalcemia.
hypokalemia.
hyperglycemia.
The Correct Answer is C
A. Hypermagnesemia: Hypermagnesemia (high magnesium levels) can cause bradycardia, hypotension, and prolonged PR and QRS intervals. While it can affect cardiac rhythm, it's less commonly associated with PVCs. The client's magnesium level of 2.5 mg/dL is within the normal range (1.5-2.5 mg/dL).
B. Hypocalcemia: While the calcium level of 8.0 mg/dL is slightly low (normal: ~8.5–10.5 mg/dL), mild hypocalcemia is less commonly associated with PVCs compared to hypokalemia. It can affect cardiac contractility but is not the most likely cause of these arrhythmias.
C. Hypokalemia: The potassium level is 2.8 mEq/L, which is significantly below normal (normal: 3.5–5.0 mEq/L). Potassium is a crucial electrolyte for maintaining normal cardiac electrical activity. Hypokalemia increases myocardial excitability and can lead to various cardiac dysrhythmias and a known cause of ventricular irritability, including multifocal PVCs, and increases the risk of life-threatening arrhythmias in clients with cardiac or metabolic conditions.
D. Hyperglycemia: The glucose level of 200 mg/dL is elevated but not severely high. While it reflects poor glycemic control, it is not directly linked to the occurrence of PVCs. Electrolyte imbalances, particularly low potassium, are more arrhythmogenic.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Benign Prostatic Hyperplasia: Tamsulosin is an alpha-1 adrenergic blocker specifically prescribed to relieve urinary symptoms caused by benign prostatic hyperplasia (BPH). It works by relaxing the smooth muscles in the bladder neck and prostate, improving urine flow and decreasing bladder outlet obstruction.
B. Congestive Heart Failure: Tamsulosin is not indicated for heart failure management. Medications used in heart failure typically include ACE inhibitors, beta blockers, diuretics, and aldosterone antagonists not selective alpha-1 blockers like tamsulosin.
C. Rheumatic Fever: Rheumatic fever is linked to valvular heart disease, not urinary retention or prostate enlargement. Tamsulosin does not have a role in its treatment or management.
D. Coronary Artery Disease: Tamsulosin does not have any therapeutic effect in managing coronary artery disease. CAD is typically managed with medications such as beta blockers, statins, antiplatelets, and nitrates, depending on the clinical scenario.
Correct Answer is ["200"]
Explanation
Volume ordered is 1 L.
Convert the total volume to milliliters (mL)
1 L = 1000 mL.
Total volume in mL = 1 L × 1000 mL/L = 1000 mL
Total infusion time = 5 hours
Calculate the infusion rate in milliliters per hour (mL/hr).
Infusion rate (mL/hr) = Total volume (mL) / Total infusion time (hours)
= 1000 mL / 5 hours
= 200
The appropriate setting is 200 mL/hr.
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