Electroyles
Which sign/symptom indicates to the nurse the client is experiencing hypoparathyroidism? 1. A negative Trousseau's sign. 2. A positive Chvostek's sign. 3. Nocturnal muscle cramps. 4. Tented skin turgor.
2. A positive Chvostek's sign. A positive Chvostek's sign indicates that the client is hypocalcemic, which occurs in clients with hypoparathyroidism (not enough PTH to tell the bones to release calcium, therefore not enough calcium, ergo hypocalcemia). Trousseau's would also be positive. Muscle cramps point to hypokalemia. Tented skin tugor is usually seen with dehydration, which points to hypernatremia.
The client diagnosed with a fluid and electrolyte disturbance in the emergency department is exhibiting peaked T waves on the STAT electrocardiogram. Which interventions should the nurse implement? List in order of priority. 1. Assess the client for leg and muscle cramps. 2. Check the serum potassium level. 3. Notify the health-care provider. 4. Arrange for a transfer to the telemetry floor. 5. Administer Kayexalate, a cation resin.
1,2,3,5,4. 1. The nurse should assess to determine if the client is symptomatic of hyperkalemia. 2. A peaked T wave is indicative of hyperkalemia; therefore, the nurse should obtain a potassium level. 3. Hyperkalemia is a life-threatening situation because of the risk of cardiac dysrhythmias; therefore, the nurse should notify the health-care provider. 5. Kayexalate is a medication that will help remove potassium through the gastrointestinal system and should be administered to decrease the potassium level. 4. The client should be monitored continuously for cardiac dysrhythmias, so a transfer to the telemetry unit is warranted.
Match the following functions with the correct electrolyte: A. Bone and Teeth Formation B. Aid in Calcium and Vitamin D Absorption C. Three B's: Bones, Blood (clotting), (strong heart) Beats D. Maintain BP, blood volume, and pH balance E. Maintain Heart and Muscle Contractions F. Maintain Muscle Tone, Contractility, and Controllability 1. Calcium 2. Magnesium 3. Phosphate 4. Potassium 5. Sodium and Chloride
1- C 2- B and F 3- A 4- E 5 - D
The client with chronic alcoholism has chronic pancreatitis and hypomagnesemia. Which data should the nurse assess when administering magnesium sulfate to the client? 1. Deep tendon reflexes. 2. Arterial blood gases. 3. Skin turgor. 4. Capillary refill time.
1. Deep tendon reflexes. If deep tendon reflexes are hypoactive or absent, the nurse should hold the magnesium and notify the health-care provider. The arterial blood gases, skin turgor, nor capillary refill time are not affected by the client's serum magnesium level.
The client diagnosed with ARF (acute renal failure) is experiencing hyperkalemia. Which medication should the nurse prepare to administer to help decrease the potassium level? 1. Erythropoietin. 2. Calcium gluconate. 3. Regular insulin. 4. Osmotic diuretic.
3. Regular insulin. Regular insulin, along with glucose, will drive potassium into the cells, thereby lowering serum potassium levels temporarily. Calcium gluconate helps mitigate effects of hyperkalemia, but doesn't help fix the issue.
The client is diagnosed with an acute exacerbation of Crohn's disease. Which assessment data warrant immediate attention? 1. The client's WBC count is 10 (× 10^3)/mm3 2. The client's serum amylase is 100 units/dL. 3. The client's potassium level is 3.1 mEq/L. 4. The client's blood glucose is 148 mg/dL.
3. The client's potassium level is 3.1 mEq/L. Hypokalemia is an emergent, time-sensitive issue d/t the risk for cardiac arrhythmia. While the WBC count is low, that is not an emergent, time-sensitive level. The glucose and amylase levels are high but not critically.
The telemetry nurse notes a peaked T wave for the client diagnosed with congestive heart failure. Which laboratory data should the nurse first assess? 1. Calcium 2. Sodium. 3. Magnesium 4. Potassium.
4. Potassium. One of the hallmark signs of hyperkalemia is tented or peaked t-waves.
You are caring for a patient admitted with a diagnosis of acute kidney injury. When you review your patient's most recent laboratory reports, you note that the patient's magnesium levels are high. You should prioritize assessment for which of the following health problems? A) Diminished deep tendon reflexes B) Tachycardia C) Cool, clammy skin D) Acute flank pain
A) Diminished deep tendon reflexes Remember that mag does the opposite of the prefix, so hypermag = decreased DTRs
You are doing discharge teaching with a patient who has hypophosphatemia during his time in hospital. The patient has a diet ordered that is high in phosphate. What foods would you teach this patient to include in his diet? SATA. A) Milk B) Beef C) Poultry D) Green vegetables E) Liver
A, C, E With mild hypophosphatemia, foods such as milk and milk products, organ meats, nuts, fish, poultry, and whole grains should be encouraged.
Which of the following are functions of sodium? SATA A. Maintain BP B. Maintain Blood Clotting C. Maintain Blood Volume D. Maintain Heart Contractions E. Maintain pH Balance
A, C, E. B. is calcium D. is potassium
Which patient is at most risk for hypomagnesemia? A. A 55 year old chronic alcoholic B. A 57 year old with hyperthroidism C. A patient reporting overuse of anatacids and laxatives D. A 25 year old suffering from hypoglycemia
A. A 55 year old chronic alcoholic Patients who suffer from alcoholism have an increased secretion of magnesium
Which patient is at a potential risk for Digoxin toxicity? A. A patient with Cushing's syndrome taking Laxis 20 mg IV twice a day B. A patient with a calcium level of 8.9 C. A patient with a potassium level of 3.8 D. A patient presenting with painful muscle spasms and positive Trousseau's sign
A. A patient with Cushing's syndrome taking Laxis 20 mg IV twice a day Digoxin toxicity goes hand-in-hand with hypokalemia (simplified, they compete for the same receptors, so without potassium there isn't as much competition for the receptors and too much digoxin can bind and take effect) Hypokalemia goes hand-in-hand with option A, because a) cushings can cause hypokalemia, and b) lasix can cause hypokalemia, because it is a potassium-wasting diuretic
Magnesium is absorbed by what system of the body? A. Gastrointestinal B. Hepatic C. Lymphatic D. Renal
A. Gastrointestinal
A patient with nasogastric suctioning is experiencing diarrhea. The patient is ordered a morning dose of Lasix 20mg IV. Patient's potassium level is 3.0. What is your next nursing intervention? A. Hold the dose of Lasix and notify the doctor for further orders B. Administered the Lasix and notify the doctor for further orders C. Turn off the nasogastric suctioning and administered a laxative D. No intervention is need the potassium level is within normal range
A. Hold the dose of Lasix and notify the doctor for further orders Lasix (furosemide) is a potassium-wasting diuretic. They are hypokalemic- don't need to waste any more potassium! You might or might not need to turn off the NG tube, but it wouldn't be priority over holding the dose of lasix and you sure wouldn't give a laxative to a hypokalemic patient w/ diarrhea!
On admission, a patient blood alcohol limit is greater than 400 mg/dL. The patient reports drinking a 12 pack of beer on a daily basis. Which of the following conditions is this patient MOST at risk for? A. Hypomagnesemia B. Hypermagnesemia C. Hyponatremia D. Hypernatremia
A. Hypomagnesemia Alcoholism is the leading cause of hypomagnesemia
A patient has a sodium level of 130. What is this condition called? A. Hyponatremia B. Hypernatremia C. Normal Sodium Level D. Hypercalcemia
A. Hyponatremia
A patient's calcium level is 6.9. Which of the following is a nursing priority? A. Initiate seizure precautions B. Educate patient about foods rich in calcium C. Administer Calcitonin D. Administer Vitamin D supplements as ordered
A. Initiate seizure precautions Initiating seizure precautions are priority because this is a critically low calcium level and the patient is at risk for seizures. Siezures are an effect of things going up/ crazy/ wild, which is the effect of hypocalcemia. Remember, calcium does the opposite of the prefix! Next, you would probably begin calcium gluconate or some other calcium supplement. You would educate the patient about calcium rich foods and administer vitamin D supplements as ordered once they are out of critical risk. Calcitonin is for HYPERcalcemia.
A patient has a potassium level of 9.0. Which nursing intervention/s is priority? A. Prepare the patient for dialysis and place the patient on a cardiac monitor - this is far above critical range hyperkalemia. B. Administer Spironolactone C. Administer kayexalate D. Administer Potassium 40 mEq IVPB - this is far below potassium critical range hypokalemia
A. Prepare the patient for dialysis and place the patient on a cardiac monitor - this is far above critical range hyperkalemia. Spironolactone is potassium-sparing diuretic- they don't need any potassium spared! Kayexalate is given for hyperkalemia, but it has a delayed onset. This level of K is so high that the patient will probably die before kayexalate could have time to work. This is far above critical range (critical is anything below 2.5 or above 7).
Pumping up a blood pressure cuff to 20 mmHg above systolic pressure and letting it sit for 2-3 minutes can lead to a positive or negative result for which sign of hypocalcemia? A. Trousseau's Sign B. Chvostek's Sign C. Homan's Sign D. Goodell's Sign
A. Trousseau's Sign
Weight-bearing exercise is extremely important with which electrolyte imbalances? A. calcemias B. kalemias C. magnesemias D. natremias
A. calcemias, especially hypercalcemia
Match the following major s/s to the correct electrolyte imbalance: A. positive T&C, tetany, and circumoral paresthesia B. inability to swallow safely and hyperactive DTRs C. tachycardia then bradycardia then asystole D. Seizures, Coma E. depressed EKG signs (flat T waves, prominent u waves) F. very depressed DTRs and profound muscle weakness G. bone pain and lack of coordination, risk for fractures H. red beefy tongue and edema - hyper/hypo Calcium and opposite Phosphate - hyper/hypo Magnesium - hyper/hypo Potassium - hyper/hypo Sodium
A. hypocalcemia B. hypomagnesemia C. hyperkalemia (can also be hypermag) D. hyponatremia E. hypokalemia F. hypermagnesemia (muscle weakness also found in hyperkalemia and hypercalcemia) G. hypercalcemia H. hypernatremia
A patient with a potassium level of 2.1 has been taking Lasix (furosemide) daily. What medication will the patient most likely be switched to? A. spironolactone (Aldactone) B. None the patient will likely stay on the Lasix C. hydrochlorothiazide (Microzide) D. Demadex (torsemide)
A. spironolactone (Aldactone) It's a potassium-sparing diuretic
You are the surgical nurse caring for a 65-year-old female patient who is postoperative day 1 following a thyroidectomy. During your shift assessment, the patient complains of tingling in her lips and fingers. She tells you that she has an intermittent spasm in her wrist and hand and she exhibits increased muscle tone. What electrolyte imbalance should you first suspect? A) Hypophosphatemia B) Hypocalcemia C) Hypermagnesemia D) Hyperkalemia
B) Hypocalcemia Tetany- or intermittent spasms- are a sign of both hypocalcemia and hypomagnesemia. Circumoral paresthesia - tingling in lips- as well as in fingers- is a prominent signs of hypocalcemia, as is increased muscle tone. Remember that calcium and magnesium do the opposite of the prefix- so hypo- will create these excited s/s.
A patient's potassium level is 3.0. Which foods would you encourage the patient to consume? A. Cheese, collard greens, and fish B. Avocados, strawberries, and potatoes C. Tofu, oatmeal, and peas D. Peanuts, bread, and corn
B. Avocados, strawberries, and potatoes · P: potatoes and pork · O: oranges · T: tomatoes · A: avocados · S: strawberries · S: spinach · I: fish · U: mushrooms · M: muskmelons (cantaloupe) - Also: raisins, bananas, carrots, and salt substitutes
An EKG shows a shortened QT interval. Which lab value below would be indicative of this change? A. Calcium level of 8.0 B. Calcium level of 12.0 C. Calcium level of 8.7 D Calcium level of 9.2
B. Calcium level of 12.0 Shortened QT intervals mean things are too quiet, which is the effect of hypercalcemia. Remember, calcium does the opposite of the prefix! Prolonged QT intervals are the effects of things going up/ crazy/ wild.
Stimulation of the facial nerve via the masseter muscle causes twitching of the nose/lips (sometimes referred to as a smile) in hypocalcemia is known as? A. Trousseau's Sign B. Chvostek's Sign C. Homan's Sign D. Goodell's Sign
B. Chvostek's Sign
The nurse caring for a patient post colon resection is assessing the patient on the second postoperative day. The nasogastric tube (NG) remains patent and continues at low intermittent wall suction. The IV is patent and infusing at 125 mL/hr. The patient reports pain at the incision site rated at a 3 on a 0-to-10 rating scale. During your initial shift assessment, the patient complains of cramps in her legs and a tingling sensation in her feet. Your assessment indicates decreased deep tendon reflexes (DTRs) and you suspect the patient has hypokalemia. What other sign or symptom would you expect this patient to exhibit? A) Diarrhea B) Dilute urine C) Increased muscle tone D) Joint pain
B. Dilute urine Remember that s/s of hypokalemia are the same as the prefix, except for urine output. Polyuria is present with hypokalemia, which will cause diluted urine because of the large quantity.
A patient has a potassium level of 2.0. What would you expect to be ordered for this patient?* A. Potassium 30 meq IV push B. Infusion of Potassium intravenously C. An oral supplement of potassium D. Intramuscular injection of Potassium
B. Infusion of Potassium intravenously Never push or inject potassium Oral is used for moderate hypokalemia, but less than 2.5 is considered critical and IV would be used.
A patient's magnesium level is 0.9. The doctor orders Magnesium Sulfate IV. Which nursing intervention takes PRIORITY? A. Assessing for hypertension B. Monitoring deep tendon reflexes C. Monitoring potassium levels D. Monitoring skin turgor
B. Monitoring deep tendon reflexes
A home care client reports weakness and leg cramps. Per order, the nurse draws blood and requests a potassium level. What is the rationale for this request? A. The nurse is concerned that the client's diet has caused sodium loss. B. The nurse recognizes these symptoms of hypokalemia. C. The client is actively seeking increased attention. D. The client had bananas and orange juice for breakfast.
B. The nurse recognizes these symptoms of hypokalemia
You are called to your patient's room by a family member who voices concern about the patient's status. On assessment, you find the patient tachypneic, lethargic, weak, and exhibiting a diminished cognitive ability. You also find 3+ pitting edema. What electrolyte imbalance are you likely to find in lab reports? A) Hypocalcemia B) Hyponatremia C) Hyperchloremia D) Hypophosphatemia
C) Hyperchloremia These s/s are consistent with a cause of hypernatremia- which goes hand-in-hand with hyperchloremia.
A patient with hypovolemic hyponatremia is started on IV fluids. Which of the following fluids do you expect the patient to be started on? A. 0.45% Saline B. 3% Saline C. D5W D. 0.33% Saline
B: 3% Saline Patients with hypovolemic hyponatremia are started on a hypertonic solution (the circulatory system is dehydrated & and the cells are swollen...so a hypertonic solution will shrink the cells and increase fluid volume) and 3% Saline is the only hypertonic solution. The other options are either hypotonic or isotonic-that-becomes-hypotonic.
Which two electrolytes have an inverse relationship?
Calcium and Phosphate - always opposites
A patient is being discharged after being hospitalized with a Magnesium level of 0.7. After diet teaching with this patient, which statement by the patient warrants you to re-educate the patient? A. "I love eating salads with kale and spinach". B. "I'm shocked mackerel contains magnesium". C. "I can't believe I have to give up dark chocolate". D. "Tonight I'm cooking fried potatoes with a side dish of peas".
C. "I can't believe I have to give up dark chocolate". Chocolate is high in magnesium, as are green leafy vegetables, potatoes, and oily fish like sardines and mackerel.
You have completed diet teaching with a patient who has hypernatremia. Which statement by the patient causes concern? A. "I will buy fresh vegetables and fruits." B. "I will avoid eating canned foods." C. "I'm glad I can still eat sandwiches with bologna." D. "I will avoid cooking with butter."
C. "I'm glad I can still eat sandwiches with bologna." Processed meat has lots of sodium!
Which patient below is considered critically hypernatremic? A. A patient with a sodium level of 155 B. A patient with a sodium level of 145 C. A patient with a sodium level of 160 D. A patient with a sodium level of 136
C. A patient with a sodium level of 160 Critical ranges are above 160 or less than 125.
A patient has a calcium level of 12.5. Which medication will most likely be ordered for this patient? A. Calcium Chloride B. 10% Calcium Gluconate C. Calcitonin D. Hydrochlorothiazide
C. Calcitonin Hydrochlorothiazide can cause hypercalcemia by decreasing the amount of calcium excreted. Both calciums might be given for hypocalcemia. Calcium gluconate might also be given for hyperkalemia and hypermagnesemia, because it helps mitigate the effects of those two electrolytes on the heart.
A patient is recovering from parathyroidectomy surgery. Morning labs values are back. Which of the following lab values would correlate as a complication from this type of surgery? A. Calcium 8.7 B. Calcium 12.5 C. Calcium 6.9 D. Calcium 9.2
C. Calcium 6.9 Hypoparathyroidism would cause hypocalcemia, because the less PTH the less calcium is pulled out of bones.
Calcium gluconate is given with which of the following fluids? A. NS B. LR C. D5 D. SW
C. D5 (D5W) Calcium gluconate is only given with D5W.
A patient's calcium level is 11.2. Which option below could be the cause? A. None, 11.2 is a normal calcium level B. Crohn's Disease C. Hydrochlorothiazide D. Hypoparathyroidism
C. Hydrochlorothiazide Thiazide diuretics can cause decreased excretion of calcium, therefore causing increased calcium levels. 9-11, or 8.5-10.5, are regular ranges. 11.2 is above normal range. Crohn's causes hypocalcemia. Hypoparathyroidism would cause hypocalcemia, because the less PTH the less calcium is pulled out of bones.
A patient's magnesium level is 3.0. The cater associate brings the patient a dinner tray. Which item on the tray would you remove to ensure the patient does not eat? A. Macaroni B. Tomatoes C. Kale D. Onions
C. Kale
A patient is admitted to the ER. The patient receives dialysis on Tuesdays and Thursdays of every week, and presents with a palpable AV shunt (thrill present) in the left upper arm. The patient is extremely lethargic and family members are present to help answer questions. While collecting the patient's medication history the daughter states her mother has been taking "a lot" of Maalox antacid lately due to upset stomach. You note this to be a significant finding. Which of the following lab values correlates with this finding? A. Magnesium level of 1.0 B. Magnesium level of 2.4 C. Magnesium level of 3.6 D. Magnesium level of 1.4
C. Magnesium level of 3.6 Maalox is an aluminum-magnesium antacid. Large quantities can lead to hypermagnesemia.
After obtaining an EKG on a patient you notice that ST depression is present along with an inverted T wave and prominent U wave. What lab value would be the cause of this finding? A. Magnesium level of 2.2 B. Potassium level of 5.6 C. Potassium level of 2.2 D. Phoshorus level of 2.0
C. Potassium level of 2.2
A patient is presenting with an orthostatic blood pressure of 80/40 when she stands up, thready and weak pulse of 58, and shallow respirations. In addition, the patient has been having frequent episodes of vomiting and nausea and is taking hydrochlorothiazide. Which of the following findings would explain the patient's condition? A. Magnesium level of 1.0 B. Calcium level of 7.8 C. Potassium level of 2.4 D. Sodium level of 124
C. Potassium level of 2.4 Potassium generally does the same as the prefix, especially with hypokalcemia. Additionally, hydrochlorothiazide is a potassium-wasting diuretic, so that is a large clue. Magnesium and Calcium do the opposite of the prefix- so hypo- would not cause hypotension, bradycardia, and respiratory depression, hyper- would. Additionally, hydrochlorothiazide is a risk factor for hypercalcemia. Severe hyponatremia causes hypovolemic shock-like symptoms- which would include tachycardia, not bradycardia
A patient with Cushing's Syndrome has been experiencing an infection and has a fever of 102'F. On assessment, you find the patient to be confused, restless, has dry mucous membranes, and flushed skin. Which finding below correlates with the presentation of this patient? A. Sodium level of 144 B. Sodium level of 115 C. Sodium level of 170 D. Sodium level of 135
C. Sodium level of 170 Remember: s/s of dehydration point to hypernatremia *think "they look overheated and dehydrated" to yourself. The overheated part isn't accurate, but the symptoms are similar other than increased temperature. Hypernatremia can present with a low-grade fever, but not typical
Which arrhythmia is a patient who has a Mg+ level of 0.8 most likely to experience? A. Heart block B. Bradycardia C. Torsades de pointes D. Normal sinus rhythm
C. Torsades de pointes Remember that magnesium does the opposite of the sign!
Which of the following is indicative of an EKG change in the case of hypokalemia? SATA A. Widened QRS complex and prolonged PR interval B. Prolonged ST interval and Widened T-wave C. Visible to prominent U-waves D. Tall T-waves and depressed ST segment E. ST depression and inverted T-wave
C. Visible to prominent U-waves E. ST depression and inverted T-wave Remember, with kalemias, especially hypokalemia, s/s go the same way as the prefix.
Monitoring DTRs are extremely important with which electrolyte imbalances? A. calcemias B. kalemias C. magnesemias D. natremias
C. magnesemias
A patient with nasogastric suctioning is experiencing diarrhea. The patient is ordered a morning dose of Lasix 20mg IV. Patient's potassium level is 3.0. You held the dose of furosemide (Lasix) and notified the HCP. Which of the following would you expect him to order? A. Kayexalate (potassium sulfate) B. Calcium gluconate C. spironolactone (Aldactone) D. hydrochlorathiazide (Microzide)
C. spironolactone (Aldactone) spironolactone (Aldactone) is a potassium-sparing diuretic. Kayexalate is used for decreasing potassium levels Calcium gluconate is used to help mitigate cardiac affects of hyperkalcemia hydrochlorothiazide is also a potassium-wasting diuretic, similar to furosemide (a potassium-wasting loop diuretic)
You are caring for a patient who is being treated in the oncology unit with a diagnosis of lung cancer with bone metastases. During your assessment, you note the patient complains of a new onset of weakness with abdominal pain. You should recognize that this patient may be experiencing what electrolyte imbalance? A) Hypernatremia B) Hypomagnesemia C) Hypokalemia D) Hypercalcemia
D) Hypercalcemia The "bone might clue you into calcium- especially as it would lead to breakdown of bone tissue which would increase serum calcium levels. Anorexia, nausea, vomiting, and constipation are common symptoms of hypercalcemia. Abdominal and bone pain may also be present. Primary manifestations of hypernatremia are neurologic and would not include abdominal pain and dehydration. Tetany is the most characteristic manifestation of hypomagnesemia (and hypocalcemia) and this scenario does not mention tetany. The patient's presentation is inconsistent with hypokalemia.
You are caring for a patient with a secondary diagnosis of hypermagnesemia. What assessment finding would be most consistent with this diagnosis? A) Hypertension B) Kussmaul respirations C) Increased DTRs D) Shallow respirations
D) Shallow respirations Remember: magnesium and calcium do the opposite of the prefix!
A patient is being discharged home after hospitalization with hypocalcemia. Which statement by the patient indicates she understood the dietary instructions? A. "I will avoid sardines. B. "I'll avoid salt and Vitamin-D supplements." C. "I will tell my husband to only purchase skim milk." D. "I will be sure to eat lots of cheese, tofu and spinach."
D. "I will be sure to eat lots of cheese, tofu and spinach." Sardines are high in calcium, as are non-fat-free dairy products, tofu, and spinach. Vitamin D is necessary for calcium absorption.
A patient has a Magnesium level of 1.0. Which of the following is NOT a sign or symptom of this condition? A. Tall T-wave and depressed ST segment B. Torsades de pointes C. Dysphagia (difficulty swallowing) D. Absent deep tendon reflexes
D. Absent deep tendon reflexes
A patient's most recent laboratory results show a slight decrease in potassium. The physician has opted to forego drug therapy but has suggested increasing the patient's dietary intake of potassium. Which of the following would be a good source of potassium? A) Apples B) Asparagus C) Chicken D) Bananas
D. Bananas
A patient with a sodium level of 178 is ordered to be started on 0.45% Saline. What is the most IMPORTANT nursing intervention for this patient? A. Maintain patent IV B. Give rapidly to ensure fluids levels are shifted properly C. Clarify doctor's order because 0.45% saline is contraindicated in hypernatremia D. Give slowly and watch for signs and symptoms of cerebral edema
D. Give slowly and watch for signs and symptoms of cerebral edema The most important intervention is to give slowly and watch for S/S of cerebral edema because a hypotonic solution can cause rapid swelling of the cell (remember: hypo makes things swell like a hippo. Hypo Hippo). Maintaining a patent IV is correct but not the most important option in this scenario. Hypovolemic fluid (like 1/2 NS) is contraindicated in hyponatremic patients, because it would further diluate the blood and therefore increase hyponatremia.
A patient's lab work shows that they have a high parathyroid hormone level. Which condition is the patient at risk for? A. Hyperkalemia B. Hypocalcemia C. Hypokalemia D. Hypercalcemia
D. Hypercalcemia Hyperparathyroidism would cause hypercalcemia, because the more PTH the more calcium is pulled out of bones.
A patient with a magnesium level of 3.6 would exhibit which of the signs and symptoms EXCEPT? A. Hypotension B. Profound Lethargy C. Respiratory failure D. Hyperreflexia of the deep tendons
D. Hyperreflexia of the deep tendons Hyperreflexia is an effect of things going up/ crazy/ wild, which is the effect of hypomagnesemia. Remember, magnesium does the opposite of the prefix!
Which patient below is at risk for experiencing Hypovolemic Hyponatremia? A. Patient with congestive heart failure B. Patient with cirrhosis of the liver C. Patient on IV saline at 250 cc/hr D. Patient with nasogastric tube suction experiencing diarrhea
D. Patient with nasogastric tube suction experiencing diarrhea
A patient has a calcium level of 7.2. What sign below is indicative of this lab value? A. None this is a normal calcium level B. Shortened ST segment C. Hypoactive bowel sounds D. Prolonged QT interval on the EKG
D. Prolonged QT interval on the EKG Prolonged QT intervals are the effects of things going up/ crazy/ wild, which is the effect of hypocalcemia. Remember, calcium does the opposite of the prefix! Shortened QT intervals mean things are too quiet, which is the effect of hypercalcemia. Likewise, hypoactive bowel sounds would be hypercalcemia- things are too quiet.
Which of the following is not a cause of hypocalcemia? A. Low parathyroid hormone B. Crohn's Disease C. Acute Pancreatitis D. Thiazide Diuretics
D. Thiazide Diuretics Loop diuretics can cause hypocalcemia
You are taking a patient's blood pressure manually. As you pump up the cuff to 20-above the systolic pressure for a few minutes you notice that the patient develop a carpal spasm. Which of the following is true? A. The patient is having a normal nervous response to an inflating blood pressure cuff that is inflated above the systolic pressure B. This is known as Trousseau's Sign and is present in patients with HYPERcalcemia C. This is known as Chvostek's Sign D. This is known as Trousseau's Sign and is present in patients with hypocalcemia
D. This is known as Trousseau's Sign and is present in patients with hypocalcemia
A client age 80 years, who takes diuretics for management of hypertension, informs the nurse that she takes laxatives daily to promote bowel movements. The nurse assesses the client for possible symptoms of: A. hypocalcemia. B. hyperkalemia. C. hypermagnesemia. D. hypokalemia.
D. hypokalemia The frequent use of laxatives and diuretics promotes the excretion of potassium and magnesium from the body, increasing the risk for fluid and electrolyte deficits.
Swallow precautions / dysphagia risk is a priority intervention which which of the following imbalances? A. hypernatremia B. hyponatremia C. hypermagnesemia D. hypomagnesemia
D. hypomagnesemia This is because the muscles become so tense and taut that enough smooth muscle relaxation to swallow can become impossible. This is a symptom of things being too crazy/ "buck wild". Remember, magnesium does the opposite of the prefix!
Which of the following is not a symptom of hyperkalemia? A. Muscle weakness B. Decreased blood pressure C. Muscle twitches/cramps and increased DTRs D. Weak and slow heart rate E. Oliguria
E. Oliguria Remember, with hyperkalemia, s/s go with the prefix except for 4 things: urine output, BP, HR, and the muscles are weak
Which of the following electrolytes are intracellular and which are extracellular? - Calcium - Chloride - Magnesium - Phosphate - Potassium - Sodium
Extra: calcium, sodium, and chloride Intra: potassium, magnesium, and phosphate
Which two electrolytes are best friends but not twins?
Magnesium and Calcium
Which two electrolytes are essential for normal cardiac contractions?
Potassium and Magnesium
Which two electrolytes are siamese twins?
Sodium and Chloride
