A nurse is caring for a client with severe anemia. The provider placed an order for one unit of packed red blood cells (PRBCs) x 1 now. The nurse should anticipate the blood will be completely infused after how much time?

A) Dysphagia: While dysphagia (difficulty swallowing) can occur in individuals with long-term alcohol use, especially if there is coexisting neurological damage or esophageal disorders, it is not specifically associated with vomiting and diarrhea in the context of this scenario. The primary concern here involves electrolyte imbalances.

B) Hypoactive deep tendon reflexes (DTR): Hypoactive DTRs are typically associated with hypermagnesemia rather than hypomagnesemia. In this case, the client's condition is more likely to lead to electrolyte deficiencies, including hypomagnesemia, due to vomiting, diarrhea, and poor nutritional intake.

C) Hypomagnesemia: Chronic alcohol use often results in nutritional deficiencies, and vomiting and diarrhea can further exacerbate this by depleting electrolytes. Hypomagnesemia is a common finding in long-term alcoholics due to poor dietary intake, gastrointestinal losses, and renal losses. This can lead to symptoms such as muscle weakness, tremors, and altered mental status. Hypomagnesemia is particularly concerning because it can affect cardiovascular stability and neuromuscular function.

D) Positive Chvostek sign: A positive Chvostek sign is indicative of hypocalcemia, which can occur secondary to hypomagnesemia. However, it is not as directly associated with chronic alcoholism as hypomagnesemia itself. The positive Chvostek sign involves a facial muscle spasm in response to tapping the facial nerve and indicates neuromuscular irritability due to low calcium levels. While related, the primary electrolyte imbalance expected here is hypomagnesemia.

A) Hyperactive bowel sounds:

Hyperactive bowel sounds are more commonly associated with conditions like diarrhea or gastrointestinal obstruction. Hypokalemia, or low potassium levels, typically affects muscle function rather than bowel activity directly.

B) Muscle weakness:

Muscle weakness is a key manifestation of hypokalemia. Potassium is crucial for muscle function, and a deficiency can lead to significant weakness and fatigue, which is a common symptom in individuals with low potassium levels.

C) Increased thirst:

Increased thirst is more commonly associated with dehydration or hypernatremia rather than hypokalemia. While hypokalemia can cause fluid imbalances, increased thirst is not a primary symptom of low potassium levels.

D) Cerebral edema:

Cerebral edema is not typically associated with hypokalemia. It is more commonly related to conditions such as head injury, infection, or other fluid and electrolyte imbalances. Hypokalemia primarily affects muscle function and heart rhythm.