A nurse is caring for a client who has hyponatremia and is receiving an infusion of a prescribed hypertonic solution.
Which of the following findings should indicate to the nurse that the treatment is effective?
Improved cognition.
Cardiac arrhythmias absent.
Decreased vomiting.
Absent Chvostek’s sign.
The Correct Answer is A
Hyponatremia is a condition where the sodium level in the blood is too low, which can cause confusion, lethargy, seizures, and coma. A hypertonic solution is a fluid that has a higher concentration of solutes than the blood, which can help raise the sodium level and reduce the brain swelling caused by hyponatremia. Therefore, improved cognition indicates that the treatment is effective.
Choice B. Cardiac arrhythmias absent.
Cardiac arrhythmias are not a common symptom of hyponatremia unless it is severe or rapid in onset.
Therefore, their absence does not necessarily indicate that the treatment is effective.
Choice C. Decreased vomiting.
Vomiting can be a cause or a consequence of hyponatremia, depending on the underlying condition.
Decreased vomiting may indicate that the patient is less nauseated, but it does not reflect the sodium level or the brain status.
Choice D. Absent Chvostek’s sign.
Chvostek’s sign is a facial twitching that occurs when tapping on the cheek, which indicates hypocalcemia (low calcium level).
It is not related to hyponatremia or hypertonic solution.
Normal ranges for sodium are 135 to 145 mEq/L and for calcium are 8.5 to 10.5 mg/dL.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Lisinopril is an angiotensin converting enzyme (ACE) inhibitor that is used to treat high blood pressure and heart failure. It works by relaxing the blood vessels and increasing the supply of blood and oxygen to the heart. However, one of the common side effects of lisinopril is hypotension, which means low blood pressure. Hypotension can cause dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position. Therefore, the nurse should monitor the client’s blood pressure when administering lisinopril and report any signs of hypotension to the doctor.
Choice A is wrong because tinnitus, which means ringing or buzzing in the ears, is not a common or serious side effect of lisinopril.
Tinnitus can be caused by other factors such as ear infections, loud noises, or medications such as aspirin or antibiotics.
Choice C is wrong because hypokalemia, which means low potassium levels in the blood, is not a common or serious side effect of lisinopril. In fact, lisinopril can cause hyperkalemia, which means high potassium levels in the blood, especially in patients with kidney problems or diabetes. Hyperkalemia can cause irregular heartbeats, muscle weakness, or numbness. Therefore, the nurse should monitor the client’s potassium levels when administering lisinopril and avoid giving potassium supplements or salt substitutes that contain potassium.
Choice D is wrong because bradycardia, which means slow heart rate, is not a common or serious side effect of lisinopril.
Lisinopril does not affect the heart rate directly, but it can lower the blood pressure and improve the heart function.
Bradycardia can be caused by other factors such as heart block, sinus node dysfunction, or medications such as beta blockers or calcium channel blockers.
Correct Answer is A
Explanation
The nurse should advise the client to avoid taking St. John’s Wort with sertraline because it can increase the risk of a rare but serious condition called serotonin syndrome. Serotonin syndrome can cause symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhoea.
Choice B. Black cohosh is wrong because it is a herbal supplement that is used to treat menopausal symptoms and has no known interaction with sertraline.
Choice C. Coenzyme Q is wrong because it is a natural substance that is involved in energy production and has no known interaction with sertraline.
Choice D. Ginger root is wrong because it is a spice that is used to treat nausea and has no known interaction with sertraline.
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