A nurse is assessing a client who has hypocalcemia. Which of the following manifestations should the nurse expect?

Muscle twitching

Bounding pulse

Hypertension

Decreased bowel sounds

Answer and Explanation

The Correct Answer is A

A) Muscle twitching:
Muscle twitching, also known as tetany, is a common manifestation of hypocalcemia. Low calcium levels increase neuromuscular excitability, leading to symptoms such as muscle cramps, spasms, and twitching. This is a key clinical sign that helps in diagnosing hypocalcemia.
B) Bounding pulse:
A bounding pulse is not typically associated with hypocalcemia. Instead, it is more often seen in conditions such as fluid overload or hyperdynamic circulatory states, where there is increased cardiac output or vascular volume.
C) Hypertension:
Hypertension is not a common manifestation of hypocalcemia. Hypocalcemia is more likely to cause hypotension due to its effect on cardiac contractility and vascular tone, rather than causing high blood pressure.
D) Decreased bowel sounds:
Decreased bowel sounds are not commonly associated with hypocalcemia. Hypocalcemia affects neuromuscular function, but it typically causes increased gastrointestinal motility rather than decreased motility, which would lead to hyperactive bowel sounds rather than decreased ones.

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Correct Answer is C

Explanation

A) Hispanic ethnicity: While ethnicity can influence the prevalence and risk of hypertension, Hispanic ethnicity alone is not a direct risk factor for hypertension. Other factors such as lifestyle, diet, and genetic predispositions play more significant roles in the development of hypertension.

B) Cholesterol 190 mg/dL: Although elevated cholesterol levels can contribute to cardiovascular disease, a cholesterol level of 190 mg/dL is considered borderline high but not a primary risk factor for hypertension. The risk for hypertension is more directly related to factors like blood pressure levels and weight.

C) BMI of 28: A Body Mass Index (BMI) of 28 falls into the overweight category, which is a known risk factor for developing hypertension. Excess body weight can increase blood pressure by increasing the workload on the heart and contributing to insulin resistance, which can further elevate blood pressure.

D) History of atrial fibrillation: While atrial fibrillation is a significant cardiac condition and can be associated with other cardiovascular risks, it is not a direct risk factor for the development of hypertension. The primary risk factors for hypertension include factors like obesity, diet, and physical inactivity.

A. Teach the client to void over a urine strainer. B. Administer oxybutynin to the client twice per day. C. Encourage frequent ambulation for the client. D. Check the client's urine for ketones three times per day. E. Instruct the client to drink 3 L of fluid per day.

Correct Answer is ["A","C","E"]

Explanation

A) Teach the client to void over a urine strainer: After lithotripsy, clients are often advised to void over a strainer to catch any small stone fragments that may pass. This helps in monitoring the passage of stone fragments and ensures that any remaining stones can be analyzed for further management.

B) Administer oxybutynin to the client twice per day: Oxybutynin is an anticholinergic medication used to treat bladder spasms. It is not routinely used after lithotripsy unless specifically prescribed for bladder spasms, which are not a common postoperative concern for this procedure.

C) Encourage frequent ambulation for the client: Frequent ambulation is beneficial after lithotripsy as it helps promote overall recovery, reduces the risk of complications like deep vein thrombosis, and can facilitate the passage of stone fragments. Encouraging movement is an essential aspect of postoperative care.

D) Check the client's urine for ketones three times per day: Monitoring for ketones is not typically required following lithotripsy unless there is a specific concern about diabetic ketoacidosis or another condition that warrants ketone monitoring. It is not a standard intervention for postoperative care after lithotripsy.

E) Instruct the client to drink 3 L of fluid per day: Increasing fluid intake is crucial after lithotripsy to help flush out any remaining stone fragments and to prevent new stone formation. Drinking 3 liters of fluid per day is generally recommended to maintain adequate hydration and support the urinary system.

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A nurse is assessing a client who has hypocalcemia. Which of the following manifestations should the nurse expect?

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