A nurse is caring for a client who has fluid volume excess (FVE) due to heart failure (HF). Which of the following manifestations should the nurse associate with FVE? (Select all that apply.)

Rationale:
A. This is not represented by the P wave. Repolarization of the ventricular conduction system is a component of the later part of the ECG, mainly within the T wave.

B. The P wave corresponds to atrial depolarization, which is the electrical activity that triggers atrial contraction. Proper identification of the P wave helps the nurse evaluate rhythm, rate, and atrial conduction.

C. Ventricular depolarization is represented by the QRS complex, not the P wave. This reflects the spread of electrical impulses through the ventricles, leading to ventricular contraction.

D. Early repolarization of the ventricles occurs at the beginning of the ST segment and is not associated with the P wave.

Rationale:

A. Hypokalemia (low potassium levels) can significantly affect skeletal and cardiac muscle function, leading to generalized fatigue, muscle weakness, cramping, and in severe cases, paralysis or life-threatening arrhythmias. Clients taking loop diuretics (e.g., furosemide) or thiazide diuretics are particularly at risk, as these medications increase potassium excretion in the urine. Monitoring for early signs of hypokalemia allows timely intervention with dietary potassium or supplementation.

B. Shortness of breath is more indicative of pulmonary congestion or fluid overload associated with heart failure rather than low potassium levels. While hypokalemia can indirectly affect cardiac function, dyspnea is not a primary manifestation.

C. Reduced urine output is associated with renal insufficiency, dehydration, or hypovolemia, not directly with hypokalemia from diuretic use.

D. Edema results from excess fluid retention in the interstitial space, often related to heart failure or renal disease, and is not a direct sign of hypokalemia.