A nurse is caring for a client who has a fluid imbalance due to excessive vomiting. The nurse should monitor the client for which of the following electrolyte imbalances?

Choice A reason:

Hyponatremia is a condition of low sodium level in the blood, which can result from excessive vomiting. Sodium is an important electrolyte that helps regulate fluid balance, nerve and muscle function, and blood pressure. When a person vomits, they lose sodium and water from the stomach, which can lead to dehydration and hyponatremia. Symptoms of hyponatremia include confusion, headache, weakness, nausea, muscle cramps, and seizures.

Choice B reason:

Hyperkalemia is a condition of high potassium level in the blood, which can result from kidney failure, certain medications, or excessive intake of potassium-rich foods. Potassium is an important electrolyte that helps regulate heart rhythm, muscle contraction, and nerve impulses. When a person has hyperkalemia, they may experience irregular heartbeat, chest pain, muscle weakness, numbness, or paralysis. Vomiting does not usually cause hyperkalemia unless the person has other risk factors.

Choice C reason:

Hypercalcemia is a condition of high calcium level in the blood, which can result from hyperparathyroidism, certain cancers, or excessive intake of calcium or vitamin D supplements. Calcium is an important electrolyte that helps regulate bone health, blood clotting, muscle contraction, and nerve function. When a person has hypercalcemia, they may experience nausea, vomiting, constipation, abdominal pain, confusion, lethargy, kidney stones, or cardiac arrhythmias. Vomiting does not usually cause hypercalcemia unless the person has other risk factors.

Choice D reason:

Hypomagnesemia is a condition of low magnesium level in the blood, which can result from malnutrition, alcoholism, diarrhea, diuretics, or certain medications. Magnesium is an important electrolyte that helps regulate muscle and nerve function, blood pressure, blood sugar, and protein synthesis. When a person has hypomagnesemia, they may experience muscle twitching, cramps, tremors, seizures, irregular heartbeat, or changes in mental status. Vomiting does not usually cause hypomagnesemia unless the person has other risk factors.

Choice A reason:

Sodium is not likely to be elevated in a client who has chronic kidney disease because the kidneys tend to lose sodium along with water. Sodium levels may be low (hyponatremia) or normal in these clients, depending on their fluid status and dietary intake.

Choice B reason:

Potassium is likely to be elevated in a client who has chronic kidney disease because the kidneys are unable to excrete excess potassium. Potassium levels may be high (hyperkalemia) or normal in these clients, depending on their medication use and dietary intake.

Choice C reason:

Calcium is not likely to be elevated in a client who has chronic kidney disease because the kidneys are unable to activate vitamin D, which is needed for calcium absorption. Calcium levels may be low (hypocalcemia) or normal in these clients, depending on their parathyroid hormone levels and supplementation.

Choice D reason:

Phosphorus is likely to be elevated in a client who has chronic kidney disease because the kidneys are unable to excrete excess phosphorus. Phosphorus levels may be high (hyperphosphatemia) or normal in these clients, depending on their dietary intake and phosphate binders.

Choice E reason:

Magnesium is likely to be elevated in a client who has chronic kidney disease because the kidneys are unable to excrete excess magnesium. Magnesium levels may be high (hypermagnesemia) or normal in these clients, depending on their dietary intake and antacid use.