A nurse is assessing a client who reports numbness and tingling of their toes and exhibits a positive Trousseau's sign. Which of the following electrolyte imbalances should the nurse suspect?
Hyponatremia
Hypocalcemia
Hyperkalemia
Hypermagnesemia
The Correct Answer is B
A. Hyponatremia: While hyponatremia can cause neurological symptoms, such as confusion and seizures, it is not typically associated with a positive Trousseau's sign. Trousseau's sign is more specifically related to calcium imbalances.
B. Hypocalcemia: A positive Trousseau's sign (a spasm of the hand and wrist when a blood pressure cuff is inflated) is a classic sign of hypocalcemia, which is low calcium levels in the blood. Numbness and tingling of the toes (paresthesia) are also common symptoms of hypocalcemia.
C. Hyperkalemia: Hyperkalemia typically causes muscle weakness, fatigue, and potential cardiac arrhythmias, but it does not directly cause a positive Trousseau's sign or numbness and tingling in the extremities.
D. Hypermagnesemia: Hypermagnesemia (high magnesium levels) typically causes symptoms such as muscle weakness, respiratory depression, and hypotension. It is not associated with a positive Trousseau's sign.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Place a mask on the client during the procedure: A mask should be placed on the client to reduce the risk of infection during the dressing change. Peritoneal dialysis involves accessing the peritoneal cavity, and maintaining a sterile environment is crucial to prevent contamination.
B. Cleanse the catheter site using a side-to-side motion: The catheter site should be cleansed using a circular motion starting from the site of insertion and moving outward. This helps avoid introducing bacteria into the insertion site. Side-to-side motion may push bacteria into the area.
C. Tape down the corners of the dressing: While securing the dressing is important, taping the corners may not provide the optimal seal and could risk introducing contaminants. The dressing should be secured properly, but not necessarily with just tape at the corners.
D. Secure an occlusive dressing over the gauze pads: An occlusive dressing over gauze pads is not ideal for peritoneal dialysis catheters. A sterile, breathable dressing is recommended to allow for proper airflow and prevent moisture accumulation, which can promote infection.
Correct Answer is B
Explanation
A. Administer digoxin by IV bolus: Digoxin slows conduction through the AV node and can worsen a complete heart block. It is contraindicated in this condition and may lead to further bradycardia or cardiac arrest.
B. Prepare the client for temporary pacing:Third-degree (complete) heart block results in electrical dissociation between atria and ventricles, leading to dangerously low heart rates and inadequate perfusion. The definitive treatment is temporary pacing to stabilize the cardiac rhythm until permanent pacing can be arranged.
C. Instruct the client to perform the Valsalva maneuver: This maneuver is used to terminate supraventricular tachycardias by stimulating the vagus nerve. It is not indicated in bradyarrhythmias like third-degree heart block and could further lower the heart rate.
D. Perform carotid sinus massage: This is another vagal maneuver used to treat tachycardias, not bradycardias. Performing it in a client with third-degree heart block could dangerously reduce the heart rate further and is therefore inappropriate.
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