Review the monitor tab and the Labs tab

Monitor

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 D

Explanation

A. Instructing the client to remain quiet may reduce stress or activity but does not address the issue of the pacemaker not sensing properly.
B. Continuing to monitor without addressing the malfunction is inappropriate because this could lead to complications or inappropriate pacing.
C. Assessing blood pressure and pulse is important for patient safety but the priority is addressing the pacemaker's malfunction by notifying the healthcare provider.
D. The pacemaker should sense the client's intrinsic beats to avoid inappropriate pacing. If it is firing on the T wave or at inappropriate times, it indicates a sensing issue that needs to be addressed by the healthcare provider.

A. Serum sodium level is 135 mEq/L (normal 135-145mEq/L) B. Respiratory rate of 16/minute C. Blood pressure reading of 120/80 D. Urine output 120 mL one hour following administration

Correct Answer is B

Explanation

A. Serum sodium level of 135 mEq/L (normal 135-145mEq/L) - Although important, sodium levels do not directly assess the effectiveness of furosemide in relieving fluid overload.
B. Respiratory rate of 16/minute - A decrease in respiratory rate following the administration of furosemide indicates that the client is improving, as furosemide works to reduce fluid overload and ease breathing.
C. Blood pressure reading of 120/80 - While blood pressure may be influenced by fluid status, it is not the best indicator for the effectiveness of diuretics in this case.
D. Urine output 120 mL one hour following administration - While urine output is important, a single hour’s output may not show the full effectiveness of the diuretic, and output can vary depending on the client’s hydration status.

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Review the monitor tab and the Labs tab Monitor

Labs

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who has had a temporary transvenous pacemaker inserted. The cardiac monitor shows pacemaker spikes occurring at various points in the client's own beats such as on the T wave. What action is the nurse's priority?

Correct Answer is D

Explanation

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?

Correct Answer is B

Explanation

The client problem of Activity Intolerance related to decrease in cardiac reserve is identified for a client with chronic heart failure. Which intervention should the nurse include in the plan of care related to this problem?

Complete the following sentences with the list of drop down The nurse assesses the client's rhythm on the monitor. The patient is unresponsive with no pulse. The nurse identifies the rhythm asdropdown. The nurse's priority action isdropdown

The nurse is performing an admission assessment of an older adult client with a history of chronic heart failure. The client exhibits +2 pitting edema of the ankles and bibasilar crackles. Based on these findings what action should the nurse take next?

The nurse is caring for a client diagnosed with acute heart failure on the telemetry unit. Which laboratory result does the nurse know is most indicative of this diagnosis?

The nurse would assess the client diagnosed with disseminated intravascular coagulation (DIC) for which manifestation of the disorder?

The client diagnosed with acute heart failure is prescribed an infusion of dopamine at a low dose. Which assessment parameter should the nurse use to best evaluate the effectiveness of this medication?

Upon assessment of the client's lungs, the nurse hears continuous, high-pitched, musical sounds. This should be documented as:

Labs

Review the monitor tab and the Labs tab

Monitor