An older adult patient who is malnourished presents to the emergency department with a serum albumin that is low with total protein that is also low. Which clinical manifestation should the nurse expect?

Restlessness

Edema

Pallor

Confusion

Answer and Explanation

The Correct Answer is B

Rationale:

A. Restlessness can occur with electrolyte imbalances or hypoxia, but it is not a hallmark of low albumin or protein malnutrition.

B. Low serum albumin and total protein decrease plasma oncotic pressure, allowing fluid to shift from the vascular space into interstitial tissues, leading to peripheral and sometimes generalized edema (anasarca).

C. Pallor is more indicative of anemia, which may coexist but is not a direct effect of hypoalbuminemia.

D. Confusion can result from electrolyte disturbances, hypoxia, or hepatic encephalopathy, but it is not a direct manifestation of low albumin.

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Correct Answer is C

Explanation

Rationale:
A. Extreme thirst is associated with hypernatremia, not hypokalemia.
B. Hypokalemia typically causes hyporeflexia, not hyperactive reflexes.
C. Weak, irregular pulse is expected with hypokalemia because low potassium affects cardiac conduction and muscle contractility, increasing the risk of dysrhythmias.
D. Hypokalemia usually causes hypoactive bowel sounds due to decreased smooth muscle activity.

A. Electrolyte imbalance risk B. Acute appendicitis C. Severe dehydration D. Regular use of laxatives E. History of bowel surgery F. Normal bowel function G. Increased fluid intake

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

Explanation

Rationale:
A. Tap water enemas are hypotonic, and repeated or large-volume use can lead to hyponatremia or other electrolyte disturbances, particularly in infants, elderly clients, or those with renal or cardiac issues.

B. Administering a tap water enema in a client with suspected appendicitis can increase intra-abdominal pressure, potentially causing perforation or worsening the condition.

C. Tap water enemas can further disrupt fluid and electrolyte balance in clients who are already dehydrated, exacerbating their condition.

D. Regular use of laxatives is not a strict contraindication for a tap water enema but may reduce its effectiveness over time due to bowel adaptation.

E. Clients with recent bowel surgery or structural abnormalities are at higher risk for perforation or injury when receiving an enema.

F. Tap water enemas are not indicated for clients with normal bowel function because they are unnecessary and can cause discomfort or dependence.

G. While maintaining hydration is important, it does not contraindicate the use of a tap water enema; it may actually support bowel function.

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An older adult patient who is malnourished presents to the emergency department with a serum albumin that is low with total protein that is also low. Which clinical manifestation should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has hypokalemia as a result of nausea, vomiting, and diarrhea. Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

Which of the following are contraindications for administering a tap water enerna? (Select all that apply)

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

Explanation

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