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

Answer and Explanation

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.

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Correct Answer is B

Explanation

A) Maintain the client on bed rest for 48 hr following surgery: While some bed rest is recommended initially post-surgery, maintaining bed rest for 48 hours is excessive and can increase the risk of complications like deep vein thrombosis. Early mobilization is generally encouraged to enhance recovery.

B) Check the tubing for kinks and blood clots at least every 2 hr: Regularly checking the catheter tubing for kinks and blood clots is essential to ensure the continuous flow of urine and prevent catheter blockage. This can help in reducing the risk of complications such as bladder distension and urinary retention.

C) Irrigate the client's bladder continuously using 5% dextrose in Ringer's lactate: Continuous bladder irrigation is often done post-TURP to prevent clot formation, but 5% dextrose in Ringer's lactate is not the recommended solution. Typically, normal saline is used to minimize the risk of electrolyte imbalance and maintain the correct osmolarity.

D) Remove the catheter if the client reports severe bladder spasms: Severe bladder spasms can occur post-TURP, but removing the catheter is not the immediate solution. The catheter is necessary for drainage and should be managed with antispasmodic medications or adjusting the irrigation flow rather than removal.

A. "Central vision loss is affected first." B. "Straining during a bowel movement can increase the progression of the disease C. "Plan to include high doses of Vitamin E in your diet." D. "Remove glasses before performing the Amsler grid test at home."

Correct Answer is A

Explanation

A) "Central vision loss is affected first.": This statement is accurate as macular degeneration primarily affects the macula, which is responsible for central vision. Clients with macular degeneration typically experience a loss of central vision first, which can severely impact activities such as reading, driving, and recognizing faces.

B) "Straining during a bowel movement can increase the progression of the disease.": This statement is not supported by evidence related to macular degeneration. While general health and avoiding strain are important, there is no specific connection between straining during bowel movements and the progression of macular degeneration.

C) "Plan to include high doses of Vitamin E in your diet.": Although antioxidants like Vitamin E can be beneficial for eye health, especially in the context of a balanced diet including other vitamins and minerals, there is no specific recommendation for high doses of Vitamin E alone to manage macular degeneration. The AREDS (Age-Related Eye Disease Study) formulation includes a combination of vitamins and minerals.

D) "Remove glasses before performing the Amsler grid test at home.": When using the Amsler grid test to monitor for changes in vision due to macular degeneration, clients should wear their glasses or contact lenses to ensure they are viewing the grid with their usual visual correction. This helps in accurately detecting any distortions or changes in vision.

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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?

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