A nurse is assessing a client who has chronic kidney disease. Which of the following findings is a manifestation of hyperkalemia?
Wheezing
Decreased deep tendon reflexes
Cerebral edema
Hypoactive bowel sounds
The Correct Answer is B
A. Wheezing is not typically associated with hyperkalemia. It can be seen in conditions such as asthma or chronic obstructive pulmonary disease (COPD).
B. Hyperkalemia can lead to neuromuscular manifestations, including decreased deep tendon reflexes due to suppression of neuromuscular excitability.
C. Cerebral edema is not a typical manifestation of hyperkalemia. It may occur in conditions such as hyponatremia or severe metabolic acidosis.
D. Gastrointestinal manifestations of hyperkalemia are typically related to smooth muscle involvement and can include hyperactive bowel sounds or diarrhea.
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Correct Answer is C
Explanation
A. The pH is alkalotic, and the PaCO2 is within the normal range, indicating respiratory alkalosis, which is not typically seen in chronic kidney disease.
B. The pH is alkalotic, and the HCO3 level is lower than normal, indicating metabolic acidosis, which can occur in chronic kidney disease, but the PaCO2 is not typically decreased in metabolic acidosis.
C. This choice fits the pattern of metabolic acidosis commonly seen in CKD patients. In patients with chronic kidney disease (CKD), the kidneys are less able to excrete acid, leading to metabolic acidosis. Therefore, the expected arterial blood gas values would show a lower pH indicating acidemia, a decreased bicarbonate (HCO3-) level, and a normal or low partial pressure of carbon dioxide (PaCO2) as the lungs try to compensate by blowing off CO2.
D. The pH is acidic, and the HCO3 level is within the normal range, indicating respiratory acidosis, which is not typically seen in chronic kidney disease.
Correct Answer is B
Explanation
A. A urine output of 50 mL in 4 hours is inadequate and may indicate decreased renal perfusion. Magnesium sulfate can further compromise renal perfusion, so this finding warrants careful evaluation and potential adjustment of the infusion rate.
B. This indicates that the client is not experiencing respiratory depression, a potential side effect of magnesium sulfate toxicity.
C. Diminished deep tendon reflexes is an expected finding in magnesium sulfate toxicity.
D. A heart rate of 56/min is below the normal range for an adult but may be a common finding in clients receiving magnesium sulfate due to its cardiac depressant effects.
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