A nurse is reviewing the laboratory values of a client who is receiving total parenteral nutrition (TPN): glucose 72 mg/dL, chloride 100 mEq/L sodium 138 mEq/L, and potassium 3.0 mEq/L. Which of the following actions should the nurse plan to take?

Check the client for a positive Chvostek’s sign

Discontinue the TPN infusion.

Request a potassium replace

Administer glucagon IM

Answer and Explanation

The Correct Answer is C

A. Check the client for a positive Chvostek’s sign:
Chvostek's sign is a clinical sign of hypocalcemia, not related to the given laboratory values. The symptoms include facial muscle twitching when the facial nerve (VII) is tapped. There's no indication for this assessment based on the provided information.

B. Discontinue the TPN infusion:
The glucose level is within the normal range (70-99 mg/dL). Discontinuing TPN based solely on this glucose level is not warranted.

C. Request a potassium replacement:
The potassium level is low (normal range typically 3.5-5.0 mEq/L). Given the low potassium level, the nurse should plan to request a potassium replacement. Potassium is crucial for various physiological functions, and a deficiency can lead to significant complications.

D. Administer glucagon IM:
Glucagon is used to treat hypoglycemia, but the client's glucose level is within the normal range, so administering glucagon is not indicated.

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Correct Answer is ["A","B","E"]

Explanation

A. "I will consume less caffeine and spicy foods":
Spicy foods and caffeine can irritate the esophagus, exacerbating symptoms of hiatal hernia. Avoiding these can help in managing symptoms.

B. "I will sleep with the head of my bed elevated”:
Keeping the head elevated can prevent stomach acid from flowing back into the esophagus, reducing symptoms like heartburn. This is a helpful strategy for managing hiatal hernia.

C. "I will lie down for one half hour after meals”:
Lying down after meals can worsen symptoms because gravity can't help keep stomach acid in the stomach. Staying upright after eating helps prevent acid reflux.

D. "I will drink less fluid":There is no need to reduce fluid intake. Staying hydrated is important, and fluids do not typically contribute to hiatal hernia symptoms. However, drinking large amounts of fluid with meals should be avoided as it can increase stomach pressure.

E. "I will try not to gain weight”:
Maintaining a healthy weight is important. Excess weight can increase pressure on the abdomen, potentially worsening hiatal hernia symptoms.

A. Diabetes mellitus B. Hepatitis A C. Cirrhosis D. Cholecystitis

Correct Answer is C

Explanation

A. Diabetes mellitus
Diabetes mellitus can cause easy bruising and slow wound healing, but it is not typically associated with frequent nosebleeds.

B. Hepatitis A
Hepatitis A primarily affects the liver and does not cause frequent bruising and nosebleeds.

C. Cirrhosis
Cirrhosis, which is scarring of the liver tissue due to long-term liver damage, can lead to impaired liver function. One consequence of cirrhosis is decreased production of clotting factors, which can result in easy bruising. Additionally, the enlarged spleen in cirrhosis can lead to thrombocytopenia (low platelet count), contributing to bleeding tendencies, including nosebleeds. Cirrhosis is the most likely condition given the symptoms described.

D. Cholecystitis
Cholecystitis is inflammation of the gallbladder and is not directly associated with frequent bruising and nosebleeds.

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A nurse is reviewing the laboratory values of a client who is receiving total parenteral nutrition (TPN): glucose 72 mg/dL, chloride 100 mEq/L sodium 138 mEq/L, and potassium 3.0 mEq/L. Which of the following actions should the nurse plan to take?

Nursing Test Bank

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