A nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which of the following abnormalities on the client's EKG should the nurse interpret as a sign of hypokalemia?

Inverted P wave

Wide ORS

Elevated ST segment

Abnormally prominent U wave

Answer and Explanation

The Correct Answer is D

A. Inverted P wave: An inverted P wave may indicate atrial depolarization abnormalities but is not typically associated with hypokalemia. It can be seen in conditions such as atrial enlargement or atrial ischemia. However, in hypokalemia, the P wave may become flattened or have a decreased amplitude, but it is less likely to be inverted.
B. Wide QRS: A wide QRS complex may indicate conduction abnormalities or bundle branch blocks, but it is not specifically associated with hypokalemia. Wide QRS complexes are more commonly seen in conditions such as bundle branch blocks or electrolyte imbalances like hyperkalemia. Hypokalemia tends to cause a prolongation of the QT interval rather than widening of the QRS complex.
C. Elevated ST segment: An elevated ST segment is typically associated with myocardial injury or infarction, not hypokalemia. It can be indicative of conditions such as myocardial ischemia or pericarditis. In hypokalemia, ST segment changes are more likely to be flattened or depressed rather than elevated.
D. Abnormally prominent U wave: An abnormally prominent U wave is a classic EKG finding in hypokalemia. Hypokalemia prolongs the repolarization phase of the cardiac action potential, leading to the appearance of U waves following the T wave. These U waves can become more pronounced as potassium levels decrease. Therefore, an abnormally prominent U wave is a significant indicator of hypokalemia on an EKG, especially in a patient with prolonged vomiting, which can lead to potassium depletion. Thus, it is the most pertinent abnormality to interpret in this context.

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Correct Answer is D

Explanation

A. Relieve the client's pain: While pain management is important for client comfort and recovery, it is not the priority immediately following intermaxillary fixation. Pain relief can be addressed once the more urgent concerns, such as preventing aspiration, are addressed.
B. Promote oral hygiene: Promoting oral hygiene is essential for preventing complications such as infection, but it is not the priority immediately after surgery and intermaxillary fixation. The client's airway and respiratory status should be the primary focus at this time.
C. Ensure adequate nutrition: Ensuring adequate nutrition is important for the client's overall recovery, but it is not the immediate priority after surgery and intermaxillary fixation. The priority is to prevent complications such as aspiration and maintain the client's airway.
D. Prevent aspiration: This is the priority action for the nurse. Intermaxillary fixation restricts the client's ability to open their mouth, increasing the risk of aspiration if vomiting occurs. The nurse should ensure that the client's airway is clear and that measures are in place to prevent aspiration, such as positioning the client appropriately and monitoring for signs of respiratory distress.

A. "Crushing the medication might cause you to have a stomachache or indigestion B. "Crushing the medication is a good idea, and I can mix it in some ice cream for you. C. Crushing is unsafe, as it destroys the ingredients in the medication. D. "Crushing the medication would release all the medication at once, rather than over time.

Correct Answer is D

Explanation

A. "Crushing the medication might cause you to have a stomachache or indigestion."
This response provides a potential adverse effect of crushing the medication but does not directly address the reason why the aspirin should not be crushed.
B. "Crushing the medication is a good idea, and I can mix it in some ice cream for you."
This response suggests a solution to the client's difficulty swallowing medication but does not address the safety or efficacy concerns associated with crushing enteric-coated aspirin.
C. "Crushing is unsafe, as it destroys the ingredients in the medication."
While crushing enteric-coated aspirin may alter its release properties, it does not necessarily "destroy" the ingredients. This statement may be too absolute and not entirely accurate.
D. "Crushing the medication would release all the medication at once, rather than over time."
This response accurately explains why enteric-coated aspirin should not be crushed. Enteric coating is designed to prevent dissolution of the medication in the stomach and instead release it in the small intestine to reduce the risk of gastric irritation or ulceration. Crushing the medication would bypass this delayed release mechanism, potentially leading to increased gastric irritation or adverse effects.

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A nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which of the following abnormalities on the client's EKG should the nurse interpret as a sign of hypokalemia?

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