A nurse is reviewing the laboratory results of a client who is taking a loop diuretic and notes the client's potassium level is 3.0 mEq/L. Which of the following physiological responses should the nurse expect related to the client's hypokalemia?
Hypoglycemia.
Cardiac dysrhythmias.
Increased appetite.
Hyperreflexia.
The Correct Answer is B
Choice A rationale:
Hypoglycemia Hypokalemia (low potassium levels) is not typically associated with hypoglycemia (low blood sugar). Hypokalemia primarily affects the function of muscles and nerves, and it does not directly influence blood glucose levels.
Choice B rationale:
Cardiac dysrhythmias Hypokalemia can lead to cardiac dysrhythmias. Potassium plays a crucial role in maintaining the electrical activity of the heart, and low potassium levels can disrupt normal cardiac rhythms, potentially leading to life-threatening arrhythmias. Cardiac dysrhythmias are a well-recognized complication of severe hypokalemia, making this choice the correct one.
Choice C rationale:
Increased appetite Hypokalemia is not associated with an increased appetite. In fact, it can lead to gastrointestinal disturbances, such as nausea, vomiting, and abdominal pain, which may decrease appetite. The primary manifestations of hypokalemia are related to muscle weakness and cardiac abnormalities.
Choice D rationale:
Hyperreflexia Hyperreflexia (excessive reflex responses) is not a typical manifestation of hypokalemia. Hypokalemia is more commonly associated with muscle weakness, cramps, and cardiac disturbances. Hyperreflexia is often seen in conditions of excessive calcium levels (hypercalcemia) or neurological disorders, not hypokalemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is choice C: “I will follow a diet high in calories and protein.”
Here are the rationales for each choice:
Choice A rationale:“I will drink about 34 ounces of fluid every day.” While staying hydrated is important for overall health, this statement does not specifically address a key self-management strategy for emphysema. Adequate fluid intake can help thin mucus, making it easier to expel, but it is not the most critical aspect of managing emphysema.
Choice B rationale:“I will inhale slowly through pursed lips to help me breathe better.” This statement is incorrect because the correct technique is toexhalethrough pursed lips, not inhale. Pursed-lip breathing helps to keep the airways open longer, reduce shortness of breath, and improve the exchange of oxygen and carbon dioxide.
Choice C rationale:“I will follow a diet high in calories and protein.” This is the correct answer. Emphysema can increase the body’s energy expenditure due to the effort required for breathing. A diet high in calories and protein helps maintain muscle mass and provides the necessary energy to support respiratory function.
Choice D rationale:“I will lie on my stomach to practice abdominal breathing every day.” This statement is not recommended for emphysema management. While abdominal or diaphragmatic breathing can be beneficial, lying on the stomach is not a typical position for practicing this technique. It is usually done while sitting or lying on the back.
Correct Answer is D
Explanation
Choice A rationale:
Having the client cough and expectorate secretions is a reasonable intervention for managing respiratory distress, but it is not the top priority. The nurse should first assess the client's overall respiratory status to determine the severity of the problem.
Choice B rationale:
Instructing the client to use a pursed-lip breathing technique is a helpful strategy to improve breathing in some cases. However, it should not be the top priority when a client is experiencing difficulty breathing. Assessment should come first.
Choice C rationale:
Increasing the oxygen flow to 3 L/min without a proper assessment is not advisable. It's essential to evaluate the client's respiratory status before making any adjustments to the oxygen therapy.
Choice D rationale:
"Evaluate the client's respiratory status" is the correct response. When a client with COPD and oxygen therapy reports difficulty breathing, the nurse's priority is to assess the client's respiratory status. This assessment will help determine the cause of the breathing difficulty and guide appropriate interventions. The nurse should also check the oxygen saturation levels, respiratory rate, and auscultate lung sounds to assess the severity of the issue.
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