A nurse is caring for a client who had a total thyroidectomy and a low serum calcium level of 7.4 mg/dL. Which of the following findings should the nurse expect?

Constipation

Negative Trousseau’s sign

BP of 180/88

Numbness and tingling of the extremities

Answer and Explanation

The Correct Answer is D

A. Constipation: Hypocalcemia causes diarrhea, while hypercalcemia causes constipation.

B. Negative Trousseau’s sign: A positive Trousseau’s sign (carpal spasm during BP cuff inflation) is expected with hypocalcemia.

C. BP of 180/88: Severe hypocalcemia may cause hypotension, not hypertension.

D. Numbness and tingling of the extremities: Hypocalcemia can occur after a total thyroidectomy due to accidental removal or damage to the parathyroid glands. Neuromuscular excitability, including paresthesia (numbness and tingling), tetany, and muscle spasms, are classic signs.

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Correct Answer is A

Explanation

A. Prepare the client for dialysis: A potassium level of 8.3 mEq/L is critically high (normal range: 3.5–5.3 mEq/L), putting the client at immediate risk for life-threatening cardiac arrhythmias (e.g., ventricular fibrillation). Emergency dialysis is needed to remove excess potassium if other interventions (e.g., insulin, calcium gluconate) fail.

B. Start an IV and run normal saline at 50mL/hour: Fluid administration alone does not lower potassium quickly enough in a life-threatening situation.

C. Repeat the electrolyte values later in the day: Delaying treatment would increase the risk of cardiac arrest.

D. Monitor urine output: Although important, monitoring alone does not treat the emergency. Clients with acute renal failure often have little to no urine output.

A. "The microwave in my kitchen can warm the solution before I use it.” B. "The fluid from my abdomen will be clear or slightly yellow.” C. "The catheter can become infected even with sterile precautions.” D. "The volume of the output solution should be greater than the input solution."

Correct Answer is A

Explanation

A. "The microwave in my kitchen can warm the solution before I use it." Heating dialysis fluid in a microwave is dangerous as it can cause uneven heating and burns inside the peritoneal cavity. Dialysis solutions should be warmed using a heating pad or a specialized warmer.

B. "The fluid from my abdomen will be clear or slightly yellow." Normal peritoneal dialysis effluent should be clear. Cloudy effluent indicates infection (peritonitis).

C. "The catheter can become infected even with sterile precautions." Peritoneal dialysis catheters have a high risk of infection, even with proper care.

D. "The volume of the output solution should be greater than the input solution." More fluid should come out than goes in, as excess fluid and toxins are being removed.

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A nurse is caring for a client who had a total thyroidectomy and a low serum calcium level of 7.4 mg/dL. Which of the following findings should the nurse expect?

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