A nurse is reviewing the medical record of a client who has a potassium level of 3.0 mEq/L. Which of the following findings should the nurse recognize as a potential causative factor?
Client has an NG tube to gastric suction.
Client has a history of alcohol abuse disorder.
Client reports drinking 3.5 to 4 L of water each day.
Client is currently prescribed spironolactone.
The Correct Answer is A
The correct answer is choice A. Client has an NG tube to gastric suction.
Choice A rationale:
Having an NG tube to gastric suction can lead to hypokalemia because the suctioning process removes potassium from the stomach contents, leading to a decrease in serum potassium levels.
Choice B rationale:
While a history of alcohol abuse disorder can lead to various electrolyte imbalances, it is not the most direct cause of hypokalemia compared to gastric suction.
Choice C rationale:
Drinking 3.5 to 4 liters of water each day can lead to dilutional hyponatremia but is less likely to cause hypokalemia directly.
Choice D rationale:
Spironolactone is a potassium-sparing diuretic, which means it helps retain potassium in the body. Therefore, it is not a causative factor for hypokalemia.
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Correct Answer is B
Explanation
Choice B rationale:
The patient's tachycardia, pale, cool skin, and decreased urine output are signs of the body's natural compensatory mechanisms in response to fluid volume deficit. When the body
experiences a decrease in fluid volume, it tries to compensate by increasing heart rate (tachycardia) to maintain blood flow to vital organs and constricting blood vessels to preserve fluid and maintain blood pressure. Pale, cool skin is a result of vasoconstriction, and decreased urine output is a way the body conserves water during dehydration.
Choice A rationale:
Effects of rapidly infused intravenous fluids are not the cause of the patient's current findings. In fact, the nurse's notes indicate that the IV fluid therapy (0.9% sodium chloride) was initiated at 125 mL/hr, which is a relatively standard and cautious rate. Rapidly infused fluids could potentially cause fluid overload, but that is not the situation here.
Choice C rationale:
Pharmacological effects of a diuretic are not relevant to this patient's presentation. There is no mention of diuretic use in the nurse's notes, and the symptoms presented are more consistent with fluid volume deficit and dehydration rather than diuretic use.
Choice D rationale:
Cardiac failure is not the correct answer, as there is no indication of heart failure in the patient's presentation or nurse's notes. The symptoms and findings described are more indicative of fluid volume deficit, which is not synonymous with cardiac failure.
Correct Answer is A
Explanation
Choice A rationale:
The arterial blood gas results show a low pH (acidosis) and an elevated Paco2 (partial pressure of carbon dioxide), which indicates respiratory acidosis. This condition occurs when there is inadequate removal of carbon dioxide through ventilation, leading to an accumulation of carbonic acid in the blood and a decrease in pH.
Choice B rationale:
Metabolic acidosis would present with a low pH and a low bicarbonate (HCO3-) level, not an elevated Paco2.
Choice C rationale:
Metabolic alkalosis would present with a high pH and an elevated bicarbonate (HCO3-) level, not an elevated Paco2.
Choice D rationale:
Respiratory alkalosis would present with a high pH and a decreased Paco2, not an elevated Paco2 as seen in this case.
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