A nurse is caring for four clients who have drainage tubes.
Which of the following clients should the nurse recognize as being at risk for hypokalemia?

The client who has a nasogastric (NG) tube to suction.

The client who has a tracheostomy tube attached to humidified oxygen.

The client who has an indwelling urinary catheter to gravity drainage.

The client who has a chest tube to water seal.

Answer and Explanation

The Correct Answer is A

Choice A rationale
Patients with a nasogastric (NG) tube to suction are at risk for hypokalemia. Hypokalemia, or low potassium levels, can occur due to increased losses from the gastrointestinal tract, which can occur with NG tube suction. Potassium is an essential electrolyte that plays a vital role in many bodily functions, particularly in the heart and cardiovascular system. Therefore, any condition or intervention that leads to a significant loss of potassium, such as NG tube suction, can potentially lead to hypokalemia.
Choice B rationale

A tracheostomy tube attached to humidified oxygen is primarily used to help a patient breathe. It does not typically contribute to potassium loss or imbalance. Therefore, it is not likely to increase the risk of hypokalemia.
Choice C rationale
An indwelling urinary catheter to gravity drainage is used to drain urine from the bladder. While the kidneys do play a role in maintaining potassium balance, the use of a urinary catheter itself does not typically lead to significant potassium loss or increase the risk of hypokalemia.
Choice D rationale
A chest tube to water seal is used to remove air, fluid, or pus from the pleural space to help the lungs expand properly. It does not typically contribute to potassium loss or imbalance.
Therefore, it is not likely to increase the risk of hypokalemia.

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Correct Answer is D

Explanation

Choice A rationale
Increasing calorie intake by 200 cal per day may not be beneficial for this client. The client has a BMI of 26, which is considered overweight. Therefore, a goal to increase calorie intake may contribute to further weight gain.
Choice B rationale
Listing foods that are high in calcium which should be avoided is not a relevant goal for this client. Calcium is an essential nutrient and there is no indication that the client needs to avoid it.
Choice C rationale
Replacing cigarettes with smokeless tobacco products is not a healthy goal. Smokeless tobacco products also contain harmful chemicals and can lead to health problems.
Choice D rationale

Walking for 30 min 5 days a week is a beneficial goal for this client. Regular physical activity can help manage weight, lower blood pressure, and reduce the risk of heart disease. It can also help the client quit smoking by reducing cravings and withdrawal symptoms.

A. You will need to monitor for manifestations of liver issues. B. It is important to watch for manifestations of pancreatic cancer. C. Follow-up with an endocrinologist as your risks for diabetes increases. D. It is important to follow up with a GI specialist for recommended surveillance for Barrett’s esophagus.

Correct Answer is D

Explanation

Choice A rationale
While liver issues can be a concern with certain medications or diseases, they are not typically associated with GERD. GERD is a digestive disorder that affects the lower esophageal sphincter, the ring of muscle between the esophagus and stomach. Therefore, monitoring for liver issues would not be directly relevant to a patient with GERD.
Choice B rationale
Pancreatic cancer is a serious condition, but it is not directly related to GERD. GERD is primarily an issue of the esophagus and stomach, not the pancreas. While it’s always important to be vigilant about potential health issues, there is no specific reason for a patient with GERD to watch for manifestations of pancreatic cancer.
Choice C rationale
While diabetes is a significant health concern, it is not directly linked to GERD. GERD does not increase the risk for diabetes. An endocrinologist specializes in hormonal disorders, including

diabetes, but would not typically be involved in the management of GERD unless there were other co-existing endocrine issues.
Choice D rationale
This is the correct answer. Barrett’s esophagus is a condition that can develop in people who have long-term GERD. It changes the color and composition of the esophagus lining, which can increase the risk of esophageal cancer. Therefore, it is important for patients with long-term GERD symptoms to follow up with a GI specialist for recommended surveillance for Barrett’s esophagus.

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A nurse is caring for four clients who have drainage tubes. Which of the following clients should the nurse recognize as being at risk for hypokalemia?

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A nurse is caring for four clients who have drainage tubes.
Which of the following clients should the nurse recognize as being at risk for hypokalemia?