A nurse is providing care for a client with hypokalemia. Which condition should the nurse monitor for?

Choice A reason: Increased Thirst, Increased Urine Output, and Weight Loss

Increased thirst, increased urine output, and weight loss are symptoms commonly associated with diabetes mellitus, particularly uncontrolled diabetes. These symptoms occur due to the body’s attempt to eliminate excess glucose through urine, leading to dehydration and subsequent weight loss. However, these symptoms are not typically associated with elevated TSH levels, which indicate hypothyroidism.

Choice B reason: Fatigue, Constipation, Weight Gain

Fatigue, constipation, and weight gain are classic symptoms of hypothyroidism2. When the thyroid gland is underactive, it produces insufficient thyroid hormones, leading to a slowdown in the body’s metabolism. This results in fatigue, weight gain, and constipation, among other symptoms. Elevated TSH levels are a compensatory response by the pituitary gland to stimulate the thyroid to produce more hormones, confirming hypothyroidism.

Choice C reason: Anxiety, Unintended Weight Loss, Palpitations

Anxiety, unintended weight loss, and palpitations are symptoms typically associated with hyperthyroidism, not hypothyroidism. Hyperthyroidism occurs when the thyroid gland produces excessive thyroid hormones, leading to an accelerated metabolism. This results in symptoms such as weight loss, increased heart rate (palpitations), and anxiety. Elevated TSH levels would not be expected in hyperthyroidism; instead, TSH levels would be low due to negative feedback from high thyroid hormone levels.

Choice D reason: Shakiness, Sweating, Nausea

Shakiness, sweating, and nausea can be symptoms of various conditions, including hypoglycemia (low blood sugar), anxiety, or panic attacks. These symptoms are not specific to thyroid dysfunction and are not typically associated with elevated TSH levels. Hypothyroidism, indicated by high TSH levels, usually presents with symptoms related to a slowed metabolism, such as fatigue and weight gain, rather than shakiness and sweating.

Choice A Reason:

A history of myocardial infarction (heart attack) and the need for stent placement are significant risk factors for developing atrial flutter. Atrial flutter is often associated with structural heart disease, including coronary artery disease, which can lead to myocardial infarction. The damage to the heart muscle and the changes in the heart’s electrical system following a myocardial infarction can predispose a person to atrial flutter.

Choice B Reason:

While a family history of atrial flutter can indicate a genetic predisposition to arrhythmias, it is not as strong a risk factor as having a history of myocardial infarction and stent placement. Genetic factors can play a role, but they are typically less influential compared to direct cardiac events.

Choice C Reason:

Recovering from an illness that caused vomiting and diarrhea is not a direct risk factor for atrial flutter. These conditions can lead to electrolyte imbalances, which might temporarily affect heart rhythm, but they do not typically cause atrial flutter.

Choice D Reason:

Increased stress can contribute to various health issues, including heart problems, but it is not a primary risk factor for atrial flutter. Chronic stress can exacerbate existing heart conditions, but it is not as significant a risk factor as a history of myocardial infarction.