A nurse is providing care for a client who has hypervolemia, ketoacidosis, and metabolic acidosis. Which of the following lab values should the nurse be concerned about?
Serum potassium levels
Serum calcium levels
Serum sodium levels
Blood urea nitrogen (BUN)
The Correct Answer is A
The correct answer is a) Serum potassium levels.
Choice A reason:
Serum potassium levels are crucial to monitor in clients with hypervolemia, ketoacidosis, and metabolic acidosis. Potassium imbalances are common in these conditions due to shifts between intracellular and extracellular compartments. In diabetic ketoacidosis (DKA), for example, insulin deficiency and acidosis cause potassium to move out of cells, leading to hyperkalemia. However, once treatment with insulin begins, potassium shifts back into cells, which can cause hypokalemia. Both hyperkalemia and hypokalemia can have serious cardiac implications, making it essential to monitor and manage potassium levels closely.
Choice B reason:
Serum calcium levels are important for overall health, but they are not the primary concern in the context of hypervolemia, ketoacidosis, and metabolic acidosis. While calcium imbalances can occur, they are less common and less immediately life-threatening compared to potassium imbalances. Monitoring calcium is still necessary, but it does not require the same level of immediate intervention.
Choice C reason:
Serum sodium levels are also important to monitor, especially in conditions like hypervolemia where fluid balance is disrupted. However, sodium imbalances are typically managed through fluid management and do not pose the same immediate risk as potassium imbalances in the context of ketoacidosis and metabolic acidosis. Hyponatremia or hypernatremia can cause neurological symptoms, but these are generally less acute compared to the cardiac risks associated with potassium imbalances.
Choice D reason:
Blood urea nitrogen (BUN) levels provide information about kidney function and hydration status. Elevated BUN can indicate dehydration or renal impairment, which are relevant in the context of hypervolemia and ketoacidosis. However, BUN levels do not require the same level of immediate intervention as potassium levels. Monitoring BUN is important for overall management but is not the primary concern in acute settings.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Insulin is stable at room temperature (between 59°F and 86°F) for up to one month. This is important for patients to know, especially if they do not have immediate access to refrigeration. However, it is crucial to avoid exposing insulin to extreme temperatures, such as direct sunlight or freezing conditions, as these can degrade the medication’s effectiveness.
Choice B Reason:
While some types of insulin can be mixed in the same syringe, this practice is not universally applicable to all insulin types. For example, rapid-acting and intermediate-acting insulins can sometimes be mixed, but long-acting insulins should not be mixed with other insulins. Therefore, this statement is not entirely accurate and should be clarified based on the specific types of insulin being used.
Choice C Reason:
Storing insulin in the freezer is not recommended as freezing can damage the insulin, rendering it ineffective. Insulin should be stored in a refrigerator at temperatures between 36°F and 46°F. If insulin is accidentally frozen, it should not be used.
Choice D Reason:
While it is advisable for clients with type 1 diabetes to have backup medication and supplies, storing them in a car is not recommended due to the potential for extreme temperature fluctuations. Insulin and other diabetes supplies should be kept in a stable, controlled environment to ensure their efficacy.
Correct Answer is A
Explanation
Choice A: Dietary and Fluid Restrictions
Dietary and fluid restrictions are crucial for patients with heart failure. These restrictions help manage symptoms and prevent complications. Limiting sodium intake can reduce fluid retention, which decreases the workload on the heart. Fluid restrictions help prevent fluid overload, which can lead to worsening heart failure symptoms. Patients are often advised to monitor their weight daily to detect fluid retention early. This choice is essential for managing heart failure effectively.
Choice B: Encouraging Increased Mobility
While physical activity is generally beneficial for overall health, it must be approached cautiously in patients with heart failure. Encouraging increased mobility without proper medical guidance can lead to overexertion and exacerbate heart failure symptoms. Exercise programs for heart failure patients should be tailored and supervised by healthcare professionals to ensure safety and effectiveness. Therefore, this choice is not as immediately critical as dietary and fluid restrictions.
Choice C: Cessation of Hormonal Supplements
Hormonal supplements can have various effects on the cardiovascular system, but their cessation is not a standard recommendation for all heart failure patients. The impact of hormonal supplements depends on the specific type and the patient’s overall health condition. This choice is less relevant compared to dietary and fluid restrictions, which have a direct and significant impact on heart failure management.
Choice D: Cessation of Intravenous (IV) Drug Use
Cessation of intravenous drug use is important for overall health and preventing infections, but it is not specific to heart failure management. While IV drug use can lead to complications that may affect the heart, it is not a primary lifestyle modification recommended for heart failure patients. The focus should be on managing fluid balance and dietary intake
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