A nurse is assessing a client who has an electrolyte imbalance with an elevated total calcium level of 12.8 mg/dL. Which of the following findings should the nurse expect?
Hyperreflexia
Diarrhea
Muscle twitching
Lethargy
The Correct Answer is D
A) Hyperreflexia:
Hyperreflexia is typically associated with low calcium levels (hypocalcemia), not elevated levels. An elevated calcium level often results in reduced neuromuscular excitability, leading to diminished reflexes rather than heightened ones.
B) Diarrhea:
Elevated calcium levels are more likely to cause constipation rather than diarrhea. Hypercalcemia often slows gastrointestinal motility, which can lead to decreased bowel movements and constipation.
C) Muscle twitching:
Muscle twitching is generally a symptom of hypocalcemia rather than hypercalcemia. Elevated calcium levels tend to depress neuromuscular activity, making muscle twitching less likely.
D) Lethargy:
Lethargy is a common symptom of hypercalcemia. High calcium levels can depress the central nervous system, leading to symptoms such as fatigue, weakness, confusion, and lethargy. This makes lethargy a likely finding in a client with an elevated total calcium level.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Drowsiness: While drowsiness can be a symptom of elevated magnesium levels, it is not the most critical finding to report immediately. Drowsiness can be observed with other conditions as well.
B) Diminished patellar reflexes: This can be indicative of hypermagnesemia, but it is a less immediate concern compared to other symptoms. Monitoring reflexes is important, but not the priority.
C) Generalized muscle weakness: Muscle weakness is a common symptom of elevated magnesium levels, but it is less urgent compared to cardiac issues. Although important, it does not pose an immediate risk like bradycardia.
D) Bradycardia: Elevated magnesium levels can cause serious cardiac complications, including bradycardia. This can be life-threatening and requires prompt attention to prevent severe outcomes, making it the priority to report to the provider.
Correct Answer is D
Explanation
A) "Limit sodium intake to 3,500 milligrams per day.":
Limiting sodium intake is crucial for managing heart failure to prevent fluid retention and exacerbation of symptoms. However, the recommended limit is typically much lower, around 1,500 to 2,000 milligrams per day, not 3,500 milligrams.
B) "Take ibuprofen for discomfort.":
Ibuprofen and other NSAIDs are not recommended for clients with heart failure as they can cause fluid retention, worsen heart failure symptoms, and increase the risk of kidney problems. Alternatives such as acetaminophen are generally safer for pain relief.
C) "Increase the distance you walk by 100 feet daily, even if you feel fatigued.":
While regular exercise is important, clients with heart failure should not push through fatigue, as overexertion can lead to worsening symptoms. Exercise recommendations should be tailored to the individual's tolerance and should be adjusted based on their energy levels.
D) "Include no more than 2,000 milliliters of fluid intake in 24 hours.":
Restricting fluid intake to 2,000 milliliters per day helps prevent fluid overload, which is critical for managing heart failure. Monitoring and limiting fluid intake can help control symptoms such as edema and shortness of breath.
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