A nurse is caring for a client who is taking lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances?

Hypomagnesemia

Hypocalcemia

Hyponatremia

Hypokalemia

Answer and Explanation

The Correct Answer is C

Choice A Reason:
Hypomagnesemia is incorrect. Lithium therapy itself is not a direct cause of hypomagnesemia. While exercise can affect magnesium levels to some extent, it's not a primary electrolyte imbalance that is typically associated with lithium use or considered a significant concern specifically due to lithium.
Choice B Reason:
Hypocalcemia is incorrect. Similarly, lithium therapy is not a direct cause of hypocalcemia. Exercise can affect calcium metabolism, but it's not a primary electrolyte imbalance typically associated with lithium use or considered a significant concern specifically due to lithium.
When a client taking lithium begins a new exercise program, the nurse should primarily assess for the risk of:
Choice C Reason:
Hyponatremia is correct. Lithium can affect the body's regulation of sodium, and excessive sweating due to increased exercise can lead to sodium loss. This combination can potentially contribute to the development of hyponatremia (low sodium levels). Therefore, when a client on lithium starts a new exercise regimen that may induce sweating, monitoring for signs of hyponatremia becomes crucial. Symptoms of hyponatremia can include confusion, headaches, nausea, and in severe cases, seizures or coma.
Choice D Reason:
Hypokalemia is incorrect. Lithium itself does not commonly cause hypokalemia. Exercise can lead to potassium loss through sweating, but hypokalemia is not the primary electrolyte imbalance typically associated with lithium use or considered a significant concern specifically due to lithium.

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Correct Answer is B

Explanation

Choice A Reason:
Using the applicator paper is appropriate for measuring the dosage accurately, but simply measuring the dosage is not the only step; the medication needs to be spread over the specified area of the skin.
Choice B Reason:
Spread the medication over a 12.7 cm (5 in) area of the client's skin. Nitroglycerin ointment is typically measured using a specific paper or measuring tape provided with the medication to ensure accurate dosing. The ointment is spread thinly and evenly over a specific measured area of the skin, usually about 12.7 cm (5 inches) in length, to maintain consistent dosing.
Choice C Reason:
Covering the medication with a sterile gauze pad is not typically done with nitroglycerin ointment. The ointment is meant to be absorbed through the skin, and covering it may interfere with its absorption.
Choice D Reason:
Nitroglycerin ointment is often applied to different sites to prevent skin irritation and tolerance from developing at one site. It's usually rotated to different clean areas of the skin to prevent skin irritation and tolerance buildup. Applying it to the same site for three consecutive days is not standard practice.

A. Absence of deep-tendon reflexes B. Report of chills C. Decreased level of consciousness D. Systolic blood pressure 130 mm Hg E. Urine output 80 mL in 4 hr.

Correct Answer is ["A","C"]

Explanation

Choice A Reason:
Absence of deep-tendon reflexes is correct. The absence or decrease in deep-tendon reflexes can be a sign of magnesium toxicity. Magnesium sulfate, when given in excessive amounts or in the case of accumulation due to impaired renal function, can lead to muscle weakness, hyporeflexia, and in severe cases, loss of deep-tendon reflexes. Discontinuation of magnesium sulfate and administration of calcium gluconate is warranted in severe cases of magnesium toxicity to counteract its effects.
Choice B Reason:
Report of chills is incorrect. Chills are non-specific symptoms and are not typically associated specifically with magnesium toxicity. They are less indicative of a need for calcium gluconate administration in the context of magnesium sulfate infusion.
Choice C Reason:
Decreased level of consciousness is correct. Severe magnesium toxicity can affect the central nervous system, leading to symptoms like confusion, drowsiness, and eventually decreased level of consciousness. In these cases, discontinuation of magnesium sulfate and administration of calcium gluconate is crucial to counteract the effects of excessive magnesium.
Choice D Reason:
Systolic blood pressure of 130 mm Hg is incorrect. A systolic blood pressure of 130 mm Hg, by itself, is not an indicator of magnesium toxicity that necessitates the administration of calcium gluconate. Blood pressure within this range is not typically a cause for concern related to magnesium sulfate administration.
Choice EReason:
Urine output of 80 mL in 4 hours is incorrect. While decreased urine output might indicate potential renal issues or compromised kidney function, it's not a specific indication for the administration of calcium gluconate in the context of magnesium sulfate infusion. It can signal the need for further assessment but is not a direct sign of magnesium toxicity requiring calcium gluconate administration.

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A nurse is caring for a client who is taking lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer nitroglycerin topical ointment to a client. Which of the following actions should the nurse plan to take?

Correct Answer is B

Explanation

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Correct Answer is ["A","C"]

Explanation

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