A nurse is reviewing the laboratory results of a client who takes furosemide. Which of the following results should the nurse identify as the priority finding?
Phosphorus 4.5 mEq/L.
Potassium 2.9 mEq/L.
Calcium 8.2 mg/dL.
Sodium 145 mEq/L.
The Correct Answer is B
Choice A rationale:
A phosphorus level of 4.5 mEq/L falls within the normal range, which is typically between 2.5 to 4.5 mEq/L. Although it's essential to monitor phosphorus levels, it is not the priority finding in this scenario.
Choice B rationale:
A potassium level of 2.9 mEq/L is the priority finding. The normal range for potassium is typically between 3.5 to 5.0 mEq/L. A potassium level of 2.9 mEq/L indicates severe hypokalemia, which can lead to life-threatening cardiac arrhythmias and muscle weakness. Immediate intervention is necessary to address the potassium imbalance.
Choice C rationale:
A calcium level of 8.2 mg/dL falls within the normal range (typically 8.5 to 10.2 mg/dL). While calcium levels are essential to monitor, they do not take precedence over the critically low potassium level in this situation.
Choice D rationale:
A sodium level of 145 mEq/L falls within the normal range, which is usually around 135 to 145 mEq/L. Although monitoring sodium levels is important, it is not the priority finding when compared to the critically low potassium level.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Other electrolyte disturbances.
Choice A rationale:
Drug toxicity is not directly related to hypocalcemia. The main concern in hypocalcemia is the calcium imbalance itself, not drug toxicity.
Choice B rationale:
Other electrolyte disturbances should be assessed because imbalances in other electrolytes, such as potassium and magnesium, are often associated with hypocalcemia. Electrolyte imbalances can interact and exacerbate each other, potentially leading to more severe complications.
Choice C rationale:
Hypertension is not a typical assessment finding in hypocalcemia. Hypertension is not directly related to calcium levels but may have other underlying causes.
Choice D rationale:
Visual disturbances are not commonly associated with hypocalcemia. Hypocalcemia is more likely to present with neuromuscular and cardiovascular symptoms, rather than visual disturbances.
Correct Answer is ["A","B","C"]
Explanation
Choice A rationale:
The nurse considered contraction of facial muscles as a finding of hypocalcemia because it is associated with Chvostek's sign, which indicates neuromuscular irritability due to low calcium levels.
Choice B rationale:
Complaints of fingers tingling are indicative of hypocalcemia since tingling sensations (paresthesias) in the extremities can result from decreased calcium levels affecting nerve function.
Choice C rationale:
Carpal spasm with blood pressure measurement is known as Trousseau's sign and is associated with hypocalcemia. When the blood pressure cuff is inflated above systolic pressure, it can cause tetany in the hand if the calcium levels are low.
Choice D rationale:
Asking when foot numbness would go away does not directly relate to hypocalcemia or its symptoms. It is not a finding used to come to the conclusion of hypocalcemia in this scenario.
Choice E rationale:
The heart rate being 88 and regular does not directly indicate hypocalcemia. While hypocalcemia can lead to cardiac arrhythmias, a heart rate of 88 and regular is within the normal range and not a specific finding for hypocalcemia.
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