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?
Hypocalcemia.
Hypercalcemia.
Hyperkalemia.
Hypokalemia.
The Correct Answer is C
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Metabolic alkalosis.
Choice A rationale:
The given blood gas results show a pH of 7.53, which is alkaline (above the normal range of
7.35 to 7.45), and a high bicarbonate level of 36 mEq/L (normal range is 22 to 26 mEq/L). This combination indicates metabolic alkalosis, a condition where there is an excessive accumulation of bicarbonate in the blood, leading to increased pH.
Choice B rationale:
Metabolic alkalosis is characterized by increased blood bicarbonate levels, which can occur due to conditions like vomiting, diuretic use, or excessive ingestion of bicarbonate-containing substances. It results in symptoms such as muscle twitching, tetany, and respiratory depression.
Choice C rationale:
Respiratory alkalosis is characterized by an elevated blood pH and low carbon dioxide levels (hypocapnia). However, the bicarbonate level is not directly related to respiratory alkalosis, making this choice incorrect based on the given information.
Choice D rationale:
Metabolic acidosis is characterized by a decreased blood pH and low bicarbonate levels. The presented blood gas results show an alkaline pH and high bicarbonate, making this choice incorrect.
Correct Answer is A
Explanation
Choice A rationale:
Hypophosphatemia is a condition characterized by low levels of phosphate in the blood, which can be caused by various factors, including malnutrition. In this case, the patient has a history of stomach ulcers, which might have contributed to poor nutrient absorption. The nurse should request a dietitian consult to ensure the patient receives an appropriate diet rich in phosphorus, which is essential for cellular function, bone health, and energy metabolism.
Choice B rationale:
Providing aluminum hydroxide antacids as prescribed is not the appropriate intervention for hypophosphatemia. Aluminum hydroxide antacids can bind to phosphate in the gastrointestinal tract, reducing its absorption and potentially worsening the patient's already low phosphate levels.
Choice C rationale:
Instructing the patient to avoid poultry, peanuts, and seeds is not suitable for this situation. These foods are good sources of phosphorus, and avoiding them would further deplete the patient's already low phosphate levels.
Choice D rationale:
Instructing the patient to avoid the intake of sodium phosphate is not necessary for hypophosphatemia. While sodium phosphate preparations are used as laxatives, there is no indication that the patient is taking them, and they are not relevant to the management of hypophosphatemia.
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