A patient prescribed spironolactone is demonstrating ECG changes and complaining of muscle weakness. The nurse realizes this patient is exhibiting signs of which electrolyte imbalance?

Choice A rationale:

Hypocalcemia refers to low levels of calcium in the blood, which can present with symptoms like muscle cramps, numbness, and tingling. However, this choice is not relevant to the patient's symptoms in the scenario.

Choice B rationale:

Hypercalcemia is an electrolyte imbalance characterized by high levels of calcium in the blood. It can lead to ECG changes and symptoms like muscle weakness, confusion, and constipation. However, this is not the correct answer in the given scenario.

Choice C rationale:

The patient's symptoms of ECG changes and muscle weakness are consistent with hyperkalemia. Spironolactone is a potassium-sparing diuretic, and its use can lead to increased potassium levels in the blood (hyperkalemia), which can affect the heart's electrical activity and cause muscle weakness.

Choice D rationale:

Hypokalemia is a condition where there is a low level of potassium in the blood. It can lead to muscle weakness, ECG changes, and other symptoms, but it is not the correct answer in this specific situation involving spironolactone use.

Cerebral bleeding. Choice A rationale:

Stress fractures are not directly related to hypernatremia. Hypernatremia is an electrolyte imbalance, and its main effects are related to cellular dehydration and neurological symptoms rather than bone fractures.

Choice B rationale:

This is the correct answer because hypernatremia can lead to severe dehydration and cause neurological complications, including cerebral bleeding. The brain cells can shrink due to water loss, causing blood vessels to rupture, leading to bleeding in the brain.

Choice C rationale:

Atrial dysrhythmias are not directly associated with hypernatremia. Hypernatremia primarily affects the central nervous system and can lead to neurological symptoms rather than cardiac dysrhythmias.

Choice D rationale:

Pulmonary edema is not a likely consequence of hypernatremia. Pulmonary edema is associated with fluid volume excess, not fluid volume deficit, which is characteristic of hypernatremia.