A nurse is reviewing the laboratory results of a client who has chronic kidney disease. Which of the following electrolytes should the nurse expect to be elevated in this client? (Select all that apply.)

Choice A reason:

Tachycardia is not a sign of magnesium toxicity. Magnesium sulfate can cause bradycardia or slow heart rate as a side effect.

Choice B reason:

Diarrhea is not a sign of magnesium toxicity. Magnesium sulfate can cause constipation or decreased bowel movements as a side effect.

Choice C reason:

Respiratory depression is a sign of magnesium toxicity. Magnesium sulfate can cause decreased respiratory rate or difficulty breathing as a side effect. This is a serious complication that requires immediate intervention by the nurse, such as discontinuing the infusion and administering calcium gluconate as an antidote.

Choice D reason:

Hyperthermia is not a sign of magnesium toxicity. Magnesium sulfate can cause hypothermia or low body temperature as a side effect.

Choice A reason:

Sodium is not likely to be elevated in a client who has chronic kidney disease because the kidneys tend to lose sodium along with water. Sodium levels may be low (hyponatremia) or normal in these clients, depending on their fluid status and dietary intake.

Choice B reason:

Potassium is likely to be elevated in a client who has chronic kidney disease because the kidneys are unable to excrete excess potassium. Potassium levels may be high (hyperkalemia) or normal in these clients, depending on their medication use and dietary intake.

Choice C reason:

Calcium is not likely to be elevated in a client who has chronic kidney disease because the kidneys are unable to activate vitamin D, which is needed for calcium absorption. Calcium levels may be low (hypocalcemia) or normal in these clients, depending on their parathyroid hormone levels and supplementation.

Choice D reason:

Phosphorus is likely to be elevated in a client who has chronic kidney disease because the kidneys are unable to excrete excess phosphorus. Phosphorus levels may be high (hyperphosphatemia) or normal in these clients, depending on their dietary intake and phosphate binders.

Choice E reason:

Magnesium is likely to be elevated in a client who has chronic kidney disease because the kidneys are unable to excrete excess magnesium. Magnesium levels may be high (hypermagnesemia) or normal in these clients, depending on their dietary intake and antacid use.