A nurse in a community clinic is collecting data from a client who reports frequent vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect? (Select all that apply.)

(Select All that Apply.)

Bradycardia

Pale Yellow Urine

Poor Skin Turgor

Hypotension

Flat Neck Veins

Answer and Explanation

Correct Answer : C,D,E

A. Bradycardia: Vomiting and diarrhea usually lead to tachycardia (increased heart rate) as the body compensates for hypovolemia, not bradycardia (slow heart rate).

B. Pale Yellow Urine: Dehydration often causes the urine to become concentrated and dark yellow, not pale yellow.

C. Poor Skin Turgor: Poor skin turgor is a classic sign of dehydration caused by fluid loss.

D. Hypotension: Loss of fluid volume can result in hypotension due to reduced blood circulation.

E. Flat Neck Veins: Dehydration causes reduced venous return, leading to flat neck veins, particularly when lying down.

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Correct Answer is B

Explanation

A. Increased salivation: Increased salivation is not typically associated with hypernatremia.

B. Decreased level of consciousness: Hypernatremia can cause cellular dehydration, which can lead to neurological symptoms such as confusion, irritability, and decreased level of consciousness.

C. Hypertension: Although hypernatremia can cause fluid retention and contribute to increased blood pressure, the primary concern is neurological changes due to the effect of sodium on cell function.

D. Cool, clammy skin: Cool, clammy skin is more often seen with hypovolemic shock or other conditions like sepsis or hypothermia, not hypernatremia.

A. Lactulose B. Acetylcysteine C. Sodium polystyrene (Kayexalate) D. Triamterene

Correct Answer is C

Explanation

A. Lactulose: Lactulose is used to treat hepatic encephalopathy by reducing ammonia levels, not for hyperkalemia.

B. Acetylcysteine: Acetylcysteine is used for acetaminophen overdose or as a mucolytic agent, not for hyperkalemia.

C. Sodium polystyrene (Kayexalate): Kayexalate is used to treat hyperkalemia by exchanging sodium for potassium in the intestines, promoting the elimination of potassium through the stool. This is the correct treatment for a potassium level of 6.8 mEq/L, which is dangerously high.

D. Triamterene: Triamterene is a potassium-sparing diuretic and would worsen hyperkalemia, not treat it.

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A nurse in a community clinic is collecting data from a client who reports frequent vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who has a sodium level of 155 mEq/L (136-145 mEq/L). Which of the following manifestations should the nurse expect?

Correct Answer is B

Explanation

A nurse is reviewing the medical record of a client and identifies a serum potassium 6.8 mEq/L (3.5-5 mEq/L). Which of the following medications should the nurse expect to administer?

Correct Answer is C

Explanation

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