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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?

A.

Inverted P wave

B.

Wide ORS

C.

Elevated ST segment

D.

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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Related Questions

Correct Answer is C

Explanation

A. Stop the enema and document that the client did not tolerate the procedure:
This option may be appropriate if the client's discomfort is severe or if there are signs of distress. However, abdominal cramps are a common sensation during the administration of an enema, especially if the bowel is distended or constipated. Therefore, stopping the procedure may not be necessary at this point.
B. Encourage the client to bear down:
Bearing down might help the client expel the enema solution and relieve some discomfort. However, if the client is already experiencing abdominal cramps, bearing down could exacerbate the discomfort and is not likely to provide immediate relief.
C. Lower the height of the solution container:
This is the correct action to take. Lowering the height of the solution container reduces the flow rate of the enema solution, which can help alleviate abdominal cramps by slowing the rate of distension of the bowel. Slowing the infusion rate allows the client's colon to accommodate to the enema more comfortably.
D. Allow the client to expel some fluid before continuing:
Allowing the client to expel some fluid before continuing may provide some relief, but it does not directly address the cause of the discomfort. Lowering the height of the solution container is a more appropriate action to address the discomfort caused by abdominal cramps during the administration of the enema.

Correct Answer is ["0.5"]

Explanation

Let's convert the digoxin dosage from mcg (micrograms) to mg (milligrams) and then divide it by the amount of digoxin per tablet to find out how many tablets are needed.

Steps to solve:

  1. Convert digoxin dose from mcg to mg:
    • We know 1 mg is equal to 1000 mcg.
    • Digoxin dose (mg) = Digoxin dose (mcg) / 1000 mcg/mg
    • Digoxin dose (mg) = 125 mcg / 1000 mcg/mg
    • Digoxin dose (mg) = 0.125 mg
  2. Calculate the number of tablets required:
    • Number of tablets = Digoxin dose (mg) / Digoxin per tablet (mg)
    • Number of tablets = 0.125 mg / 0.25 mg/tablet

Since the result is 0.5, we need to round to the nearest tenth.

Answer: The nurse should administer 0.5 tablets per dose.

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