A nurse is collecting data on a client who has diarrhea. Which of the following findings is a manifestation of hypokalemia?

Choice A: Taking the client to the bathroom every 2 hours while awake is not an effective strategy for bowel training. This may disrupt the client's natural bowel rhythm and cause unnecessary stress and frustration. Bowel training aims to establish a regular and predictable time for elimination, not a frequent and arbitrary one¹².
Choice B: Taking the client to the bathroom when they have the urge to defecate is the best option for bowel training. This helps the client to respond to their body's signals and avoid suppressing or delaying the urge. It also reinforces the association between the urge and the act of defecation, which can improve bowel control and prevent constipation¹².
Choice C: Taking the client to the bathroom immediately before meals is not a good idea for bowel training. This may interfere with the client's appetite and digestion, as well as their social and emotional well-being. Bowel training should not be associated with negative or unpleasant feelings. Moreover, eating stimulates the gastrocolic reflex, which increases the motility of the colon and the likelihood of having a bowel movement after a meal¹³.
Choice D: Taking the client to the bathroom after they feel abdominal cramping is not a reliable method for bowel training. Abdominal cramping may indicate various conditions, such as irritable bowel syndrome, food intolerance, infection, or inflammation. It may not always be related to the need to defecate. Waiting for cramping to occur may also delay the evacuation and worsen the symptoms¹³.

Choice A reason: Crackles auscultated over the client's lung fields are not a sign of pleural effusion. Crackles are abnormal breath sounds that indicate fluid or secretions in the alveoli. They can be heard in conditions such as pneumonia, heart failure, or pulmonary edema.

Choice B reason: Crepitus palpated on the client's chest is not a sign of pleural effusion. Crepitus is a crackling sensation that occurs when air leaks into the subcutaneous tissue. It can be felt in conditions such as pneumothorax, chest trauma, or chest surgery.

Choice C reason: Substernal retractions noted on the client's chest are not a sign of pleural effusion. Substernal retractions are inward movements of the chest wall below the sternum that indicate increased respiratory effort. They can be seen in conditions such as asthma, bronchiolitis, or croup.

Choice D reason: Dullness percussed over the client's lung fields is a sign of pleural effusion. Dullness is a flat sound that indicates the presence of a solid or liquid mass in the thoracic cavity. It can be detected in conditions such as pleural effusion, atelectasis, or consolidation.