The nurse is caring for client who has had partial removal the parathyroid gland. The client reports numbness and tingling of the hands and fingers. Which lab value would the nurse expect to see?

Chloride 112

Calcium 7.5

Potassium 4.0

Calcium 12.1

Answer and Explanation

The Correct Answer is B

A) Chloride 112:
Chloride levels are typically not directly associated with numbness or tingling of the hands and fingers. Elevated chloride levels (greater than 108 mEq/L) may indicate metabolic acidosis, but they would not directly explain the symptoms seen in this client following parathyroidectomy. Therefore, this value is unlikely to be relevant in this scenario.

B) Calcium 7.5:
After the partial removal of the parathyroid glands, the client may experience hypocalcemia, or low calcium levels, due to the reduced production of parathyroid hormone (PTH). PTH helps regulate calcium levels in the blood. When the parathyroid glands are removed or damaged, there may be insufficient PTH to maintain normal calcium levels, leading to hypocalcemia. Symptoms of hypocalcemia include numbness and tingling, especially in the hands and fingers. A calcium level of 7.5 mg/dL is below the normal range (8.5–10.5 mg/dL), indicating hypocalcemia, which is consistent with the patient's symptoms.

C) Potassium 4.0:
A potassium level of 4.0 mEq/L is within the normal range (3.5–5.0 mEq/L) and does not typically cause numbness or tingling. Although potassium imbalances can cause neuromuscular symptoms, they would not be the most likely cause of the symptoms in this case, especially in relation to parathyroidectomy.

D) Calcium 12.1:
A calcium level of 12.1 mg/dL is elevated and would suggest hypercalcemia. Hypercalcemia can cause symptoms like fatigue, confusion, and weakness, but it does not typically cause numbness and tingling in the hands and fingers. Elevated calcium levels are more likely to occur in conditions such as hyperparathyroidism or malignancy, not typically following parathyroid gland removal. Therefore, this is not the expected lab result in this scenario.

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Correct Answer is D

Explanation

A) A client who has heart failure and peripheral edema:
While heart failure and peripheral edema are significant conditions that require medical attention, they are chronic issues that, in most cases, are not immediately life-threatening in an emergency department setting unless there is acute decompensated heart failure or signs of severe fluid overload or respiratory distress.

B) A client who reports urinary burning and a temperature of 29.2° C (102.5°F):
This client is febrile, which suggests an infection, possibly a urinary tract infection (UTI). Although fever and urinary burning are concerning, infection-related fevers generally don't pose an immediate life threat unless there is sepsis or severe systemic involvement. A temperature of 102.5°F is significant, but the client's condition is not as urgent as other life-threatening emergencies like an arrhythmia or severe cardiovascular instability.

C) A client who has cirrhosis of the liver and bruising on their arms:
Bruising in a client with cirrhosis of the liver could indicate bleeding tendencies, which is an important concern. However, unless there is active bleeding or signs of severe liver failure (e.g., confusion, ascites, jaundice), this is not an immediate, life-threatening situation.

D) A client who has a new onset of atrial fibrillation and a heart rate of 152/min:
A new onset of atrial fibrillation (AF) with a heart rate of 152/min is an immediate priority. This is a life-threatening arrhythmia that can lead to decreased cardiac output, risk of stroke, and hemodynamic instability. A heart rate of 152 beats per minute is dangerously high, which could lead to tachycardia-induced cardiomyopathy or cardiogenic shock. Immediate intervention is needed to manage the arrhythmia and prevent further complications.

A. Teach the use of an incentive spirometer to a postoperative client B. Irrigate and perform a dressing change for a client who has a pressure injury wound C. Administer oral PRN pain medication to a client who has arthritis D. Obtain a daily weight on a client who has heart failure

Correct Answer is D

Explanation

A) Teach the use of an incentive spirometer to a postoperative client:
Teaching a patient how to use an incentive spirometer involves assessment, education, and clinical judgment. This task requires the nurse's expertise to ensure that the patient understands how to use the device correctly and to assess for any potential complications, such as inadequate lung expansion.

B) Irrigate and perform a dressing change for a client who has a pressure injury wound:
Irrigating and changing the dressing of a pressure injury involves clinical judgment, the need for sterile technique, and the assessment of the wound. These tasks should be performed by a registered nurse (RN), who can assess the condition of the wound, evaluate for signs of infection, and make decisions regarding further care.

C) Administer oral PRN pain medication to a client who has arthritis:
Administering PRN pain medication requires assessment of the patient's pain level, consideration of the medication’s effects, and clinical judgment regarding the appropriateness of the medication. This is a nursing responsibility because it involves both medication management and the evaluation of therapeutic effects.

D) Obtain a daily weight on a client who has heart failure:
Obtaining a daily weight is a task that can be safely delegated to an assistive personnel (AP). Weight is an important measurement for monitoring fluid status, especially in clients with heart failure. The AP can accurately weigh the client, ensuring that the same scale and conditions (such as time of day, after the patient has voided) are followed each time.

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The nurse is caring for client who has had partial removal the parathyroid gland. The client reports numbness and tingling of the hands and fingers. Which lab value would the nurse expect to see?

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