A nurse is reviewing the laboratory results of a client who has fluid volume excess. Which of the following electrolytes is most likely to be elevated in this client?

Choice A reason:

Sodium is the most likely electrolyte to be elevated in a client who has fluid volume excess. This is because fluid volume excess, or hypervolemia, is caused by an increase in total body sodium content and an increase in total body water. Sodium is the main electrolyte that regulates fluid balance in the body. When sodium levels are high, the body retains water to dilute it. This leads to fluid overload and edema. Therefore, a client with fluid volume excess would have high sodium levels in their blood.

Choice B reason:

Potassium is not likely to be elevated in a client who has fluid volume excess. Potassium is mainly found inside the cells, and its levels are regulated by the kidneys. Potassium levels can be affected by acid-base balance, insulin, aldosterone, and cell damage. A client with fluid volume excess may have low potassium levels due to dilution or increased excretion by the kidneys.

Choice C reason:

Calcium is not likely to be elevated in a client who has fluid volume excess. Calcium is mostly bound to albumin, a protein in the blood. Calcium levels can be affected by parathyroid hormone, vitamin D, phosphate, and albumin levels. A client with fluid volume excess may have low calcium levels due to dilution or low albumin levels.

Choice D reason:

Magnesium is not likely to be elevated in a client who has fluid volume excess. Magnesium is mainly found inside the cells and bones, and its levels are regulated by the kidneys. Magnesium levels can be affected by renal function, intestinal absorption, hormonal factors, and medications. A client with fluid volume excess may have low magnesium levels due to dilution or increased excretion by the kidneys.

Choice A reason:

Muscle weakness is not a typical symptom of hypocalcemia. Muscle weakness can be caused by many other conditions, such as electrolyte imbalance, dehydration, or muscle injury. Hypocalcemia usually causes muscle cramps or spasms, especially in the back and legs.

Choice B reason:

Constipation is not a common symptom of hypocalcemia. Constipation can be caused by many other factors, such as diet, medication, or lack of physical activity. Hypocalcemia usually affects the nervous system and the muscles, not the digestive system.

Choice C reason:

Facial twitching is a characteristic symptom of hypocalcemia. Facial twitching is also known as Chvostek's sign, which is a test to diagnose hypocalcemia. It involves tapping the facial nerve near the ear and observing if the facial muscles contract involuntarily. Facial twitching occurs because hypocalcemia makes the nerves and muscles more excitable and sensitive to stimulation.

Choice D reason:

Decreased deep tendon reflexes are not a sign of hypocalcemia. Decreased deep tendon reflexes can be caused by many other conditions, such as peripheral neuropathy, spinal cord injury, or hypothyroidism. Hypocalcemia usually causes increased deep tendon reflexes, which is also known as Trousseau's sign. It involves inflating a blood pressure cuff on the arm and observing if the hand and fingers curl inward. This happens because hypocalcemia reduces the threshold for nerve and muscle activation.