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Labs

LAB	Result	Normal Range
Potassium	2.8 mEq/L	3.5-5.3mEq/L
Sodium	133 mEq/L	135-145 mEqL
Chloride	90 mEq/L	97-107 mEqL
Glucose	200 mg/dL	70mg/dL to 110mg/dL
Magnesium	2.5 mg/dL	1.6-2.2 mg/dL

Calcium

8.0 mg/dL

8.2-10.2 mg/dL:

The nurse observes the rhythm below for a client on the telemetry unit. Which laboratory value result would the nurse suspect contributed to the development of this dysrhythmia?

Sodium

Magnesium

Calcium

Potassium

Answer and Explanation

The Correct Answer is B

A.   Sodium is crucial for maintaining normal cellular function, especially for nerve impulses and muscle contractions. However, sodium imbalances typically affect the general function of the heart, and sodium abnormalities are not commonly associated with torsades de pointes, which is a type of polymorphic ventricular tachycardia.
B.   Magnesium plays a critical role in the electrical stability of the heart and helps regulate potassium and calcium channels, which are involved in the cardiac action potential. Hypomagnesemia (low magnesium) is a well-known risk factor for torsades de pointes, a specific type of polymorphic ventricular tachycardia that is associated with QT interval prolongation. In this case, the magnesium level is 2.5 mg/dL, which is above the normal range (1.6-2.2 mg/dL), suggesting hypermagnesemia.
C.   Calcium is vital for proper muscle function, including the heart muscle, and is essential for electrical conduction. Hypocalcemia (low calcium) can lead to QT interval prolongation, which in turn increases the risk for arrhythmias such as torsades de pointes. However, in this case, the calcium level is 8.0 mg/dL, which is only slightly below the normal range (8.2-10.2 mg/dL), making calcium a less likely primary contributor to torsades de pointes in this situation.
D.   Potassium plays a crucial role in regulating the resting membrane potential and action potentials in cardiac cells. Hypokalemia (low potassium) can lead to QT prolongation and increase the risk of arrhythmias, including torsades de pointes. However, in this case, the potassium level is 2.8 mEq/L, which is low (normal range: 3.5-5.3 mEq/L), and hypokalemia is more commonly associated with arrhythmias such as torsades de pointes than hyperkalemia (high potassium).

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Correct Answer is A

Explanation

A. Clients with left-sided heart failure often experience symptoms like shortness of breath, fatigue, and fluid retention, which limit physical activity. However, they may still feel relatively comfortable when resting.
B. These symptoms are more commonly associated with allergic reactions or side effects of medications (such as ACE inhibitors) rather than heart failure.
C. This is not typical in the later stages of left-sided heart failure. In fact, clients may experience reduced urine output due to poor kidney perfusion.
D. Chest pain can occur due to ischemia, but this is not a hallmark symptom of left-sided heart failure, which is more characterized by dyspnea and fatigue.

A. Heart rate 100 beats per minute B. + 3 peripheral edema C. Respiratory rate of 24 at rest D. Alert and oriented X 3

Correct Answer is D

Explanation

A. A heart rate of 100 beats per minute is considered tachycardia (a heart rate above 100 bpm). This is not an indicator of improvement in heart failure, as it suggests the heart is working harder than usual. Chronic heart failure can lead to compensatory mechanisms such as tachycardia, but it’s typically not a sign of improvement.
B. Peripheral edema (swelling in the legs, ankles, or feet) is a common symptom of heart failure, resulting from fluid buildup due to poor cardiac output. A rating of +3 edema indicates moderate to severe swelling, which suggests fluid retention and poor circulation. This is a sign of worsening or poorly controlled heart failure, not improvement.
C. A respiratory rate of 24 breaths per minute is slightly elevated, as the normal resting respiratory rate for adults is typically between 12 to 20 breaths per minute. A higher respiratory rate can be a sign of respiratory distress or compensatory breathing due to insufficient oxygenation or fluid buildup in the lungs (pulmonary edema), which are both symptoms of heart failure exacerbation.
D. Being alert and oriented X 3 means the client is aware of time, place, and person, indicating no signs of confusion or cognitive impairment. In the context of chronic heart failure, mental status changes (like confusion or disorientation) can occur due to decreased cerebral perfusion, low oxygen levels, or medications (such as diuretics or digitalis.

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Review the monitor tab and the Labs tab Monitor

Labs

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who is in the later stages of left-sided heart failure. Which chief complaint would the nurse expect the client to report?

Correct Answer is A

Explanation

Which clinical manifestation would the nurse use to best indicate that the status of an elderly client's chronic heart failure condition is Improving?

Correct Answer is D

Explanation

The nurse notes that the client's rhythm strip indicates a PR-interval of 0.28 seconds. What is the nurse's analysis of this problem?

Which physical assessment findings would the nurse anticipate for a client with rapid atrial flutter?

The nurse is caring for a client diagnosed with disseminated intravascular coagulation (DIC). When completing an assessment for decreased perfusion from clotting, the nurse would observe for which manifestation?

The nurse is caring for a client with acute heart failure who is severely dyspneic and extremely anxious. The nurse anticipates that increased cardiac output and decreased anxiety may be promoted by the IV administration of:

A nurse is assessing a client who has fluid overload. Which of the following findings should the nurse expect? (Select all that apply.)

A patient is ordered 1 mg/kg of furosemide IV push. The patient weights 121 Ibs. The medication is supplied 40 mg/10 mL. How many mL should the nurse administer? (round to the nearest tenth)

The client with heart failure exhibits bibasilar crackles, dyspnea and a respiratory rate of 26/min. The physician prescribes furosemide 40 mg IV. Which parameter would the nurse use to best evaluate if the client is responding to this medication?

Review the monitor tab and the Labs tab

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