A) Constipation: Elevated potassium levels (hyperkalemia) typically affect neuromuscular and cardiac function rather than gastrointestinal motility. Constipation is more commonly associated with conditions like hypokalemia or electrolyte imbalances affecting the gastrointestinal system.

B) Polyuria: Polyuria, or excessive urination, is not directly caused by hyperkalemia. It can occur due to conditions like diabetes mellitus or diabetes insipidus, or as a side effect of certain medications like diuretics. Hyperkalemia does not typically lead to increased urine output and may even lead to oliguria if severe renal impairment occurs.

C) EKG with a U wave: The presence of a U wave on an electrocardiogram (EKG) is typically associated with hypokalemia, not hyperkalemia. U waves are seen when potassium levels are low, reflecting delayed repolarization of the ventricles. In hyperkalemia, EKG changes more commonly include peaked T waves, prolonged PR interval, and widened QRS complexes.

D) Paresthesias of the extremities: Hyperkalemia can cause paresthesias, which are sensations of tingling or numbness, particularly in the extremities. This occurs due to the effect of elevated potassium levels on nerve and muscle function. As potassium is essential for maintaining normal neuromuscular function, deviations from normal levels can disrupt action potentials and lead to sensory disturbances like paresthesias.

A) Hyperactive bowel sounds: Hypercalcemia typically leads to decreased gastrointestinal motility, not increased. Clients with elevated calcium levels may experience constipation, abdominal pain, or ileus due to the relaxing effect of calcium on smooth muscle. Therefore, hyperactive bowel sounds are not a common finding in hypercalcemia.

B) Increased blood clots: Hypercalcemia can promote a hypercoagulable state, increasing the risk of thromboembolic events. This occurs because high calcium levels can enhance platelet aggregation and increase the coagulability of blood. Therefore, a client with elevated serum calcium may have an increased risk of developing blood clots.

C) Hyperactive deep tendon reflexes: Hypercalcemia generally leads to reduced neuromuscular excitability, which may manifest as decreased or absent deep tendon reflexes, muscle weakness, and lethargy. Hyperactive reflexes are more commonly associated with hypocalcemia, which causes increased neuromuscular excitability.

D) Positive Chvostek’s sign: Chvostek's sign is a clinical indicator of hypocalcemia, not hypercalcemia. It involves twitching of the facial muscles in response to tapping the facial nerve and is due to increased neuromuscular excitability caused by low calcium levels. Hypercalcemia, conversely, does not typically present with a positive Chvostek’s sign.

A) Speech Therapist: A speech therapist typically works with clients who have communication or swallowing disorders. While they may be involved in assessing and managing difficulties with swallowing, they are not the primary professionals for addressing issues related to hand function or fine motor skills, which are crucial for self-feeding in clients with rheumatoid arthritis.

B) Registered Dietician: A registered dietician is responsible for assessing and planning nutritional needs, which may include recommending dietary modifications for overall health and well-being. However, they do not specifically address the mechanical or functional aspects of eating, such as difficulties due to pain and hand deformities in rheumatoid arthritis.

C) Physical Therapist: Physical therapists focus on improving gross motor function, mobility, and physical strength. While they may help with general mobility and exercise plans to reduce pain and improve joint function, they are not specialists in the fine motor skills and adaptive strategies needed for activities of daily living, such as self-feeding.

D) Occupational Therapist: Occupational therapists specialize in helping clients regain and improve their ability to perform daily activities, particularly those involving fine motor skills. They are well-suited to address issues like pain management, joint protection techniques, and the use of adaptive equipment for self-feeding in clients with rheumatoid arthritis. They work on enhancing the client’s functional independence despite physical limitations.

A) Speech Therapist: A speech therapist is the appropriate professional for assessing and managing dysphagia, especially in clients who have experienced a stroke. They specialize in evaluating swallowing function, determining the safest consistencies of food and liquids, and providing strategies or exercises to improve swallowing ability. They play a critical role in deciding the safest method of feeding, whether it involves modified diets or alternative feeding methods.

B) Respiratory Therapist: Respiratory therapists focus on assessing and managing respiratory conditions. While they may become involved if there are concerns about aspiration leading to respiratory complications, they do not directly manage dysphagia or feeding issues.

C) Physical Therapist: Physical therapists work primarily on improving gross motor skills, mobility, and physical function. They do not specialize in swallowing disorders or feeding methods, so they are not the primary professionals to consult for issues related to dysphagia.

D) Occupational Therapist: Occupational therapists can assist clients with fine motor skills and daily living activities, which may include feeding. However, they do not specialize in assessing or treating swallowing disorders. Their role would be more focused on helping clients with the practical aspects of self-feeding once safe swallowing methods are established by a speech therapist.

A) D5W: Dextrose 5% in water (D5W) is not used with blood transfusions because it can cause hemolysis of the red blood cells due to its hypotonic nature. It can also potentially cause clumping and clotting.

B) 0.3% NS: This is a hypotonic saline solution, which can lead to hemolysis of red blood cells when used as a diluent for blood products. It is not appropriate for use in blood transfusions.

C) Lactated Ringers: Although lactated Ringer's solution is often used for fluid resuscitation, it contains calcium, which can cause clotting in the blood product. Therefore, it is not suitable for use with blood transfusions.

D) 0.9% NS: Normal saline (0.9% sodium chloride) is isotonic and the only solution recommended for use with blood transfusions. It does not cause hemolysis of red blood cells, does not alter the composition of the blood product, and helps to maintain the patency of the IV line. It is the standard diluent used in blood transfusions to ensure the safe administration of blood products.

A) Dysphagia: While dysphagia (difficulty swallowing) can occur in individuals with long-term alcohol use, especially if there is coexisting neurological damage or esophageal disorders, it is not specifically associated with vomiting and diarrhea in the context of this scenario. The primary concern here involves electrolyte imbalances.

B) Hypoactive deep tendon reflexes (DTR): Hypoactive DTRs are typically associated with hypermagnesemia rather than hypomagnesemia. In this case, the client's condition is more likely to lead to electrolyte deficiencies, including hypomagnesemia, due to vomiting, diarrhea, and poor nutritional intake.

C) Hypomagnesemia: Chronic alcohol use often results in nutritional deficiencies, and vomiting and diarrhea can further exacerbate this by depleting electrolytes. Hypomagnesemia is a common finding in long-term alcoholics due to poor dietary intake, gastrointestinal losses, and renal losses. This can lead to symptoms such as muscle weakness, tremors, and altered mental status. Hypomagnesemia is particularly concerning because it can affect cardiovascular stability and neuromuscular function.

D) Positive Chvostek sign: A positive Chvostek sign is indicative of hypocalcemia, which can occur secondary to hypomagnesemia. However, it is not as directly associated with chronic alcoholism as hypomagnesemia itself. The positive Chvostek sign involves a facial muscle spasm in response to tapping the facial nerve and indicates neuromuscular irritability due to low calcium levels. While related, the primary electrolyte imbalance expected here is hypomagnesemia.

A) Blood pressure 178/90 mm Hg: Elevated blood pressure is more commonly associated with fluid overload or hypertension rather than dehydration. In dehydration, one would expect to see a decrease in blood pressure, particularly orthostatic hypotension, due to a reduction in blood volume.

B) Edema: Edema indicates fluid retention in the tissues, which is a sign of fluid overload rather than dehydration. Dehydration typically results in reduced extracellular fluid volume, leading to symptoms like dry mucous membranes and poor skin turgor, rather than swelling.

C) Bounding bilateral pulses: Bounding pulses are usually seen in conditions of increased cardiac output or fluid overload, where there is an excess of fluid volume. In contrast, dehydration often leads to weak and thready pulses due to decreased circulatory volume.

D) Increased urine specific gravity: Increased urine specific gravity is a direct indicator of dehydration. It occurs because the kidneys concentrate urine to conserve water, leading to a higher concentration of solutes in the urine. This is a reliable clinical marker of reduced hydration status, reflecting the body's attempt to maintain fluid balance by conserving water.

A) Cooked carrots: While cooked carrots do contain some potassium, they are not as rich in potassium as other foods. They are a good source of vitamins and nutrients, but not the most effective option for replenishing potassium levels.

B) Cheddar cheese: Cheese generally contains minimal potassium compared to other foods. It is a good source of calcium and protein, but it is not a significant source of potassium. Individuals on loop diuretics like furosemide, which can cause potassium loss, need to consume foods higher in potassium.

C) Baked potato: Baked potatoes are an excellent source of potassium. A medium-sized baked potato with the skin can provide a significant amount of potassium, which is essential for maintaining normal heart function and muscle contraction. This makes it an ideal food choice for clients on diuretics like furosemide, which can deplete potassium levels.

D) 2% milk: While milk contains potassium, it is not as high in potassium as other foods, like fruits and vegetables. Although it can contribute to daily potassium intake, it is not the most potent source for clients needing to increase their potassium levels due to diuretic use.

A) The first 2 min: While it is essential to monitor the client closely during the first few minutes of a PRBC infusion, a two-minute observation period is insufficient to detect most acute transfusion reactions. Many reactions, such as fever, chills, and allergic responses, can take longer to manifest.

B) The final 15 min: Monitoring during the final 15 minutes is important to ensure the infusion is completed without complications. However, the most critical time for monitoring is at the beginning of the infusion, as acute reactions are more likely to occur early on.

C) The first 15 min: The first 15 minutes of a PRBC transfusion are crucial because most acute transfusion reactions, such as allergic reactions, febrile non-hemolytic reactions, and hemolytic reactions, occur within this time frame. The nurse should remain at the bedside to promptly identify and manage any adverse reactions, ensuring the client's safety.

D) The final 2 min: Monitoring during the final two minutes of the infusion is also important, but it is not the critical time frame for detecting most transfusion reactions. Observing the client closely during the initial phase of the transfusion is essential to address any immediate complications.

A) Extreme thirst: While extreme thirst can be associated with electrolyte imbalances, particularly in conditions of dehydration or hypernatremia (elevated sodium levels), a sodium level of 116 mEq/L indicates hyponatremia (low sodium levels). Extreme thirst is less typical for hyponatremia.

B) Paresthesias: Paresthesias, or abnormal sensations like tingling or numbness, are more commonly associated with conditions of low calcium or potassium levels rather than sodium. In hyponatremia, neurological symptoms can occur, but they typically include lethargy or confusion rather than specific paresthesias.

C) Lethargy: Lethargy is a common symptom of severe hyponatremia. Low sodium levels can lead to cerebral edema and neurological disturbances, resulting in symptoms such as lethargy, confusion, and even seizures. This is a direct consequence of the altered osmotic balance affecting brain function.

D) Blood clots: Hyponatremia is not typically associated with an increased risk of blood clots. Blood clots are more related to conditions affecting coagulation factors, which are not directly influenced by sodium levels.