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 B

Explanation

A. "There is no way to predict how long it will last in each individual client." This response acknowledges the variability among individuals but does not provide specific information about urinary frequency during pregnancy. While it's true that the duration of urinary frequency can vary from person to person, the response lacks guidance or reassurance for the client.
B. "It occurs during the first trimester and near the end of the pregnancy." This response correctly identifies the pattern of urinary frequency during pregnancy. Urinary frequency is common during the first trimester due to hormonal changes and the growing uterus pressing on the bladder. It may also occur near the end of pregnancy as the fetus descends into the pelvis, putting pressure on the bladder again.
C. "In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone." This response suggests that urinary frequency typically resolves by the 12th week of pregnancy but may persist if the client has poor bladder tone. While urinary frequency may improve for some women after the first trimester, attributing its continuation solely to poor bladder tone oversimplifies the issue.
D. "It’s a minor inconvenience, which you should ignore." This response minimizes the client's concerns and does not provide helpful information about urinary frequency during pregnancy. Urinary frequency can be distressing for some pregnant individuals and should not be dismissed as a minor inconvenience.

A. "I will feel less hungry during meals while I am taking orlistat" B. "I will eat a no-fat diet to prevent side effects from the medication" C. "I will stop taking orlistat and call my doctor if my urine gets darker in color." D. "I will take my dose of orlistat every morning an hour before breakfast"

Correct Answer is C

Explanation

A. "I will feel less hungry during meals while I am taking orlistat": Orlistat works by blocking the absorption of dietary fat in the intestines rather than suppressing appetite. Therefore, it does not typically reduce hunger during meals.
B. "I will eat a no-fat diet to prevent side effects from the medication": Orlistat can cause gastrointestinal side effects such as oily stools, fecal incontinence, and flatulence, particularly when consumed with high-fat meals. While reducing fat intake can help minimize these side effects, it is not necessary to eliminate fat entirely from the diet. The statement is partially correct but not the best response indicating full understanding.
C. "I will stop taking orlistat and call my doctor if my urine gets darker in color": Dark urine can indicate liver problems, which are a potential side effect of orlistat. Therefore, it is crucial for the client to monitor for this symptom and contact their healthcare provider if it occurs. This response indicates that the client understands the potential adverse effects of the medication.
D. "I will take my dose of orlistat every morning an hour before breakfast": Orlistat is typically taken with meals or up to one hour after eating. Taking it on an empty stomach before breakfast is not recommended.

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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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