A nurse administers an incorrect dose of medication to a client. The nurse recognizes the error immediately and completes an incident report. Which of the following facts related to the incident should the nurse document in the client's medical record?

A. Correct. The nurse should initiate continuous cardiac monitoring because a magnesium level of 2.7 mEq/L indicates hypermagnesemia, which can cause cardiac dysrhythmias, hypotension, and bradycardia.

B. Incorrect. The nurse should not administer potassium chloride to a client who has hypermagnesemia because it can worsen the condition by increasing the intracellular magnesium level and decreasing the serum calcium level.

C. Incorrect. The nurse should not provide a diet rich in legumes, nuts, and green vegetables to a client who has hypermagnesemia because these foods are high in magnesium and can increase the serum magnesium level.

D. Incorrect. The nurse should not monitor the client for tetany because tetany is a sign of hypomagnesemia, not hypermagnesemia. Hypomagnesemia can cause neuromuscular excitability, muscle spasms, and positive Chvostek's and Trousseau's signs.

Cardiovascular abnormalities are a serious risk in clients with bulimia nervosa due to electrolyte imbalances, especially hypokalemia, which can lead to arrhythmias, weakened heart muscles, and potential heart failure. Hyponatremia (low sodium levels) can occur due to excessive vomiting, which leads to the loss of fluids and electrolytes, including sodium. Incorrect responses: Group 1: Hypoglycemia: Bulimia nervosa primarily causes electrolyte imbalances and acid-base disturbances due to vomiting, not significant alterations in blood sugar levels. Metabolic Acidosis: Vomiting leads to the loss of gastric acid, causing metabolic alkalosis. Hypotension: Hypotension could occur if the client experiences significant dehydration from vomiting. Hypotension would be a consequence of severe dehydration rather than a primary risk at this stage. Hyperglycemia: Hyperglycemia is not typically associated with bulimia nervosa or vomiting. It would be more relevant in conditions like diabetes. Group 2: Hyperkalemia: Hyperkalemia (high potassium) is unlikely in bulimia nervosa, where frequent vomiting usually leads to hypokalemia due to the loss of potassium in gastric secretions. Metabolic Acidosis: As mentioned before, vomiting leads to metabolic alkalosis, not acidosis, because of the loss of hydrochloric acid. Hypochloremia: Hypochloremia (low chloride levels) can occur with vomiting due to the loss of stomach acid, which contains chloride. While it is a possible outcome, metabolic alkalosis better captures the overall acid-base disturbance in the client.