Which intervention would the nurse implement when providing care for a patient with hypercalcemia?

congestive heart failure

due to inefficient pumping of excessive fluids

Which medical diagnosis would cause the nurse to include nursing interventions appropriate for hyponatremia in the plan of care?

tumor lysis syndrome

causes movement of potassium from the intracellular fluid (ICF) to the extracellular fluid (ECF)

Which syndrome would the nurse suspect when a patient has a potassium level of 6.2 mEq/dL?

Loop Diuretics

contraindicated during episodes of hypokalemia because these medications cause the kidneys to excrete sodium and potassium. Thus administration of this type of medication at this time would worsen the hypokalemia, putting the patient at risk for dysrhythmias. The prescribing health care provider should be consulted for potassium replacement therapy, and the drug should be withheld until the potassium has returned to normal range.

The morning laboratory results of a patient admitted with heart failure reveal a serum potassium level of 2.9 mEq/L.
Which classification of medications would be withheld until consulting with the health care provider?

4.5 mEq/L

The normal range for serum potassium is 3.5 to 5 mEq/L

The patient presents with a one-time prescription for potassium chloride 20 mEq in 250 mL of normal saline IV, to be given immediately.
Upon reviewing a more recent potassium level, which result would trigger the nurse to seek clarification of the patient's prescription?

Tolvaptan (Samsca)

acts by blocking the activity of antidiuretic hormone.

Which medication would the nurse associate to the treatment of a patient with hyponatremia secondary to heart failure and liver cirrhosis?

Magnesium may affect neuromuscular excitability and contractility

Alterations in serum magnesium levels profoundly affect neuromuscular excitability and contractility because magnesium directly acts on the myoneural junction
The electrolyte is a cofactor in many enzyme systems such as regulation of blood glucose control and BP.
Excess magnesium inhibits acetylcholine release at the myoneural junction and calcium movement into cells, impairing nerve and muscle function.
Initial manifestations include hypotension.
A decrease in blood magnesium levels increases the BP.
Magnesium is the second most abundant intracellular cation.
The majority of the body's magnesium is present in the bones. "Causing extracellular fluid overload," "being the most abundant intracellular cation," and "the patient being at risk for hypotension" are not relevant to this situation.

Which rationale supports the nurse's assessment of a patient's magnesium level?

Respiratory alkalosis
Diabetic ketoacidosis
Malabsorption syndrome

For which conditions would the nurse include plan of care interventions related to the potential development of hypophosphatemia?

Renal failure
Tumor lysis syndrome

For which conditions would the nurse include plan of care interventions related to the potential development of hyperphosphatemia?

Increased phosphate levels

increased concentration of phosphates in the body because of renal damage caused by the sickle cells thus causing hyperphosphatemia.

The nurse would assess for which common electrolyte imbalance while providing care for the patient with sickle cell anemia?

hyperparathyroidism

Hypercalcemia- increased calcium levels

tumor lysis syndrome

Hyperkalemia- increased potassium levels

diabetic ketoacidosis

Hypermagnesemia- increased magnesium levels, i

0.9% sodium chloride

An isotonic fluid such as 0.9% sodium chloride is used to rapidly replace fluid volume.

The nurse admits a patient reporting severe diarrhea for several days from a Clostridium difficile infection.
Which IV fluid would the nurse associate with the need to rapidly replace the patient's fluid volume?

dairy products

Dairy products, including milk, cheese, and yogurt, are rich in calcium

To prevent a recurrence of hypocalcemia, the nurse would encourage the patient to increase intake of which foods?

Prolonged QT segment

Which clinical manifestation would the nurse expect to see when assessing a patient with hypocalcemia?

Decreased calcium levels

reduced renal activity, which limits calcium absorption

Which laboratory findings would the nurse expect when providing care for a patient with low levels of parathyroid hormone?

Hypocalcemia

An inadvertent removal of the parathyroid glands occurred during a patient's scheduled thyroidectomy. Which electrolyte disturbance would the nurse assess for the presence of Trousseau's sign and serum electrolyte results?

Congestive heart failure

due to inefficient pumping of excessive fluids

Which medical diagnosis would cause the nurse to include nursing interventions appropriate for hyponatremia in the plan of care?

Hyperkalemia

Sodium polystyrene sulfonate binds with potassium in exchange for sodium

Which laboratory finding would the nurse determine is the rationale for administering sodium polystyrene sulfonate rectally to a patient with an irregular pulse and lower extremity weakness?

Dysrhythmias

Potassium exerts a direct effect on the excitability of cardiac muscle tissue.
Therefore an increased or low serum level of potassium can alter cardiac function and heart rhythm

Which adverse effect would the nurse monitor when a patient's serum potassium level is 2.8 mEq/L?

Increased phosphate levels

leads to increased concentration of phosphates in the body because of renal damage caused by the sickle cells, thus causing hyperphosphatemia

The nurse would assess for which common electrolyte imbalance while providing care for the patient with sickle cell anemia?

3.1 mEq/L

The normal range for serum potassium is 3.5 to 5.0 mEq/

The nurse reviews several patients' serum potassium results. Which result supports the need to administer a stat does of potassium chloride 20 mEq in 250 mL of normal saline over two hours?

Phosphorus falling to 2.1 mg/dL

Calcium has an inverse relationship with phosphorus in the body. When phosphorus levels fall, calcium rises, and vice versa

Which serum laboratory result would the nurse identify as an adverse effect of administering a patient calcium carbonate for the treatment of osteopenia?

Small fluid losses are significant in older adults as their body water accounts for about 50% of their body weight

Older adults, with less muscle mass and more fat content, have less body water than younger adults. In the older adult, body water content averages 45% to 55% of body weight, leaving them at a higher risk for fluid-related problems than young adults

The nurse, providing care for an older adult patient admitted with pneumonia, closely monitors for fluid and electrolyte imbalances. Which rational supports the nurse's intervention?

Chemotherapy

Phosphate levels greater than 4.4 mg/dL indicate hyperphosphatemia.

A patient with cancer has a serum phosphate level of 5.4 mg/dL.
Which reason would the nurse determine is the probable cause for the patient's electrolyte imbalance?

Hypocalcemia
Hypophosphatemia

Which electrolyte imbalance would prompt the nurse to instruct a patient to consume more dairy products in their diet?

1000 mL of 5% dextrose in water with 20 mEq of KCl

A patient has a prescription to receive D5W with 20 mEq KCl/L at 100 mL/hour. The nurse would select which solution from the IV supply cart?

Sodium 136 mEq/L, potassium 4.5 mEq/L

The normal range for serum sodium is 135 to 145 mEq/L, and the normal range for potassium is 3.5 to 5.0 mEq/L.

The nurse receives a health care provider's prescription to change a patient's IV from D5½ normal saline (NS) with 40 mEq KCl/L to D5NS with 20 mEq KCl/L.
Which serum laboratory value on this same patient supports the rationale for this IV prescription change?

hemodialysis

A patient with chronic kidney disease is experiencing severe hyperphosphatemia.
The nurse notifies the health care provider in anticipation of which ordered treatment?

Home medications include amiloride PO daily
History and treatment of chronic renal disease

Which assessment data would the nurse associate with the patient's serum potassium level of 6.8 mEq/L on admission.

"The additional fluids will increase the loss of critical electrolytes."

The free water will pull electrolytes into the stomach and the NGT will suck the fluids and electrolytes out of the stomach.

The patient with a nasogastric (NGT) on intermittent wall suction asks why they are not able to have something to drink. Which response would the nurse give?

Prolonged QRS
Presence of U wave
ST segment depression

Which electrocardiogram (ECG) changes would the nurse observe when the patient exhibits polyuria; soft, flabby muscles; an irregular pulse; a blood glucose level of 165 mg/dL; and is receiving IV dextrose therapy?

Easy fatigability
Circumoral numbness
Positive Trousseau's sign

Which clinical manifestations would the nurse monitor when assessing a patient with primary hypoparathyroidism?

Ensure availability of IV calcium gluconate at all times.

Which intervention would the nurse add to a patient's plan of care when the recent serum potassium level is 5.1 mEq/L?

Conivaptan

The patient with primary hypoaldosteronism reports weight gain (20 pounds), diarrhea, headache, nausea, vomiting, and the BP is 140/90. The mechanism of action for which medication may be beneficial for this patient?

"I will eat a banana every day."
"I will take my medication with a glass of water."
"I will tell my doctor if I begin to develop constipation.

After receiving information about potassium supplementation for the treatment of hypokalemia from the nurse, which statements indicate patient understanding?

Monitor patient for digitalis toxicity.

Which plan of care change would the nurse implement for the patient who develops cardiac instability secondary to a new onset of hypokalemia?

Shortened QT interval
Shortened ST segment

A patient with malignant lung cancer experiences weakness, lethargy, depressed reflexes, and bone pain. Which changes in the electrocardiogram would lead the nurse to suspect hypercalcemia?

Calcium levels of 15 mg/dL

Calcium levels of more than 10.2 mg/dL indicate hypercalcemia.

Which laboratory results are consistent with a patient's diagnosis of milk-alkali syndrome from an excessive intake of antacids?

Encourage weight-bearing exercises

These exercises will facilitate the movement of extra calcium ions in the blood to the bone.

Which revision to a plan of care would the nurse integrate for a patient with a new diagnosis of hypercalcemia resulting from treatment of hypocalcemia?

IV Calcium Chloride

can be treated by administering IV calcium chloride to antagonize the effects of magnesium on the cardiac muscles.

Which medication would the nurse administer to counter the signs of toxicity when infusing magnesium sulphate IV to a patient with preeclampsia?

Administer furosemide.
Administer bisphosphonates.
Administer isotonic saline infusions

Hypercalcemia is treated by hydrating the patient and promoting urinary excretion of calcium.
Therefore the nurse would administer loop diuretics such as furosemide to promote diuresis and would keep the patient hydrated by administering isotonic saline infusions.

Which interventions would the nurse implement when providing care for a patient with hypercalcemia?

Glucose

The nurse administers regular insulin IV to a patient to manage hyperkalemia.
Which additional IV medication would the nurse administer with the insulin to prevent complications from this treatment?

Anxiety and irritability
A tall, peaked T wave on electrocardiogram (ECG)
Abdominal cramping and diarrhea
Paresthesias and weakness of lower extremities

The nurse would assess for which manifestations when the patient receives a potassium-sparing diuretic?

Hypocalcemia

Chvostek's sign is the contraction of facial muscles in response to a tap over the facial nerve in front of the ear.
Chvostek's sign is a test for hypocalcemia, hypomagnesemia, and hyperphosphatemia when phosphates bind to the calcium.
Calcium and phosphate have an inverse relationship, and calcium and magnesium have similar clinical manifestations.

A patient reports numbness, tingling around the mouth and extremities, difficulty in swallowing, and a contraction of the patient's facial muscles in response to a tap over the facial nerve in front of the ear.
The patient's electrocardiogram (ECG) shows a prolonged QT interval. Which electrolyte imbalance would the nurse relate to these clinical manifestations?

...

...

Which intervention would the nurse plan for a patient with hypercalcemia?

Which interventions would the nurse implement when providing care for a patient with hyperkalemia?

Which intervention with the nurse expect to be prescribed for a patient with hyponatremia?

Which drug therapy might be used to manage symptoms of Hypocalcemia?