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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. The pH of 7.3 indicates acidemia (normal range 7.35–7.45). The PaCO2 of 50 mm Hg is elevated (normal 35–45 mm Hg), indicating a respiratory cause. This combination is consistent with respiratory acidosis.
B. Respiratory alkalosis would present with a high pH and low PaCO2.
C. Metabolic acidosis would show a low pH and low HCO3-.
D. Metabolic alkalosis would show a high pH and elevated HCO3-.
Correct Answer is []
Explanation
Rationale:
- Potential Condition: The client with acute pancreatitis developed positive Chvostek and Trousseau signs, both classic indicators of hypocalcemia. Pancreatitis often causes calcium to bind to necrotic fat (saponification), lowering serum calcium.
- Actions to Take:
- Increasing IV fluids may be prescribed to improve intravascular volume and help stabilize electrolytes.
- Requesting a STAT ECG is essential because hypocalcemia can prolong the QT interval and predispose to life-threatening arrhythmias.
- Parameters to Monitor:
- Intake and output helps assess hydration status, especially with diarrhea and ongoing fluid/electrolyte losses.
- Bowel sounds should be monitored because hypocalcemia may cause abdominal cramping and changes in GI motility.
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