A patient with anorexia nervosa shows signs of malnutrition and is prescribed parenteral nutrition. If the client develops refeeding syndrome, what laboratory tests does the nurse expect the healthcare provider to order? (Select all that apply.)
Serum phosphorus
Serum blood glucose
Serum calcium
Serum potassium
Serum magnesium
Correct Answer : A,C,D,E
A. Serum phosphorus is crucial to monitor in patients at risk for refeeding syndrome. Hypophosphatemia is a key sign of the syndrome and can lead to severe complications, such as respiratory failure and cardiac arrhythmias.
B. Serum blood glucose levels are important to monitor, especially since refeeding syndrome can cause rapid shifts in glucose metabolism. However, it is not a primary test to diagnose refeeding syndrome. Blood glucose monitoring will be part of the overall management, but not the core test for the syndrome.
C. Serum calcium should be monitored because it can also decrease in refeeding syndrome due to shifts in phosphate and magnesium levels, which may affect calcium metabolism.
D. Serum potassium is essential to monitor because hypokalemia often occurs in refeeding syndrome as the body shifts electrolytes into cells. This can cause muscle weakness, arrhythmias, and other serious complications.
E. Serum magnesium is also important to check, as hypomagnesemia is commonly seen in refeeding syndrome and can contribute to neurological and cardiac symptoms.
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Related Questions
Correct Answer is C
Explanation
A. Hypermagnesemia is not typically associated with refeeding syndrome. In fact, hypomagnesemia is more common due to the rapid shift of electrolytes and the body's increased demand during refeeding.
B. Hyponatremia is not a hallmark of refeeding syndrome. This condition more commonly leads to electrolyte imbalances like hypophosphatemia, hypokalemia, and hypomagnesemia rather than low sodium levels.
C. Hypophosphatemia is a hallmark finding in refeeding syndrome. As the body shifts from catabolic to anabolic states during refeeding, phosphorus is rapidly used in cellular processes, and its levels drop, which can lead to muscle weakness, respiratory failure, and other complications.
D. Hyperkalemia is not typically associated with refeeding syndrome. The condition is more likely to cause hypokalemia due to the shift of potassium into cells during the anabolic process after refeeding.
Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"A"}
Explanation
Rationale:
Hypoxia: The client's decreased oxygen saturation (SaO2) despite oxygen therapy and the presence of respiratory distress (tachypnea, shortness of breath) indicate hypoxia.
Pneumonia: The client's fever, increased respiratory rate, decreased oxygen saturation, and crackles in the lungs are indicative of pneumonia, particularly in the right lower lobe as evidenced by the chest X-ray.
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