A nurse is caring for four clients who have drainage tubes. The nurse should identify the client who has which of the following tubes as being at risk for hypokalemia?

A nephrostomy tube to a drainage bag

An NG tube to suction

An indwelling urinary catheter to gravity drainage

A chest tube to water-seal drainage

Answer and Explanation

The Correct Answer is B

A. A nephrostomy tube to a drainage bag:
A nephrostomy tube drains urine from the kidney to a drainage bag. While it's essential for urinary drainage, it doesn't lead to significant potassium loss, as potassium is primarily excreted through the urine.

B. An NG tube to suction:
An NG tube (Nasogastric tube) is inserted through the nose into the stomach. When connected to suction, it can remove stomach contents, including gastric acid and potassium. Excessive suctioning can lead to significant potassium loss, potentially causing hypokalemia.

C. An indwelling urinary catheter to gravity drainage:
An indwelling urinary catheter drains urine from the bladder into a drainage bag by gravity. While potassium can be found in urine, the drainage through a catheter does not cause significant potassium loss unless there are underlying kidney issues, which are not specified in this scenario.

D. A chest tube to water-seal drainage:
A chest tube removes air or fluid from the pleural space around the lungs. While chest tubes are vital for lung expansion, they don't result in significant potassium loss as they are not connected to body fluids rich in potassium, like gastric acid or urine.

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Correct Answer is B

Explanation

A. Slight bleeding of the stoma site: This is typically normal in the immediate postoperative period. It's caused by surgical trauma and should improve with time. However, if it becomes excessive, it should be reported.

B. Purplish colored stoma: A purplish or bluish color of the stoma can be an indication of inadequate blood supply (ischemia). This is a concerning finding and should be reported promptly to the provider.

C. No stool noted in the collection bag: It's normal not to have stool in the collection bag immediately after surgery since the digestive system needs time to resume normal function. This is usually not a concern within the first 12 hours postoperatively. However, if it continues beyond this time frame, it should be reported.

D. Edematous stoma: Some edema or swelling around the stoma site can be normal initially after surgery. However, if the stoma becomes significantly edematous or starts to compromise blood flow, this should be reported to the provider.

A. Thirty minutes before breakfast and the evening meal B. One hour before breakfast and the evening meal C. At the time the client takes an antacid D. At the time the client takes a proton-pump inhibitor

Correct Answer is A

Explanation

A. Thirty minutes before breakfast and the evening meal: This is the correct option. Sucralfate is typically administered 30 minutes before meals or on an empty stomach to allow it to form a protective coating over ulcers without interference from food.

B. One hour before breakfast and the evening meal: This choice is not typical for sucralfate administration. Waiting for a whole hour before meals might cause the patient to miss the window where the medication is most effective.

C. At the time the client takes an antacid: Administering sucralfate simultaneously with an antacid is not recommended because antacids can interfere with its effectiveness by neutralizing the stomach acid needed to activate sucralfate.

D. At the time the client takes a proton-pump inhibitor: Sucralfate should not be administered simultaneously with proton-pump inhibitors. Proton-pump inhibitors reduce stomach acid, which is needed to activate sucralfate.

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A nurse is caring for four clients who have drainage tubes. The nurse should identify the client who has which of the following tubes as being at risk for hypokalemia?

Nursing Test Bank

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