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

Answer and Explanation

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.

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Correct Answer is A

Explanation

A. Place a towel over the area to be percussed: A towel should be placed over the area to be percussed to protect the skin and to reduce discomfort. This is a standard procedure to ensure that the percussion is effective and comfortable for the client.

B. Ask the client to take shallow, rapid breaths: Shallow, rapid breaths should be avoided during chest percussion. The client should take deep, slow breaths to help mobilize secretions and allow for effective lung expansion. Rapid breathing could increase respiratory distress.

C. Percuss over each area for 10 min: Percussion should not be performed for 10 minutes over each area, it is done for 1-2 minutes over each lung field to help loosen mucus and improve drainage. Prolonged percussion could be harmful and unnecessary.

D. Maintain client positioning for 45 min: Typically, positioning is maintained for short periods (usually 10-15 minutes) depending on the area being targeted for percussion. Prolonged positioning may lead to discomfort or other complications.

A. "I don't have to worry about a rejection for at least 6 months after the transplant. B. "My weight should be monitored daily after the transplant C. "I shouldn't expect urine production for the first 12 hours." D. "I should expect a low-grade fever for the first few days after the transplant."

Correct Answer is B

Explanation

A. Administer digoxin by IV bolus: Digoxin is contraindicated in heart block, as it can worsen the condition. In third-degree heart block, it could further disrupt the electrical signals between the atria and ventricles.

B. Prepare the client for temporary pacing: Third-degree heart block leads to a slow and ineffective heart rate. Temporary pacing is needed to restore the heart’s normal rhythm and improve cardiac output.

C. Instruct the client to perform the Valsalva maneuver: The Valsalva maneuver is used for certain arrhythmias, but not for third-degree heart block. It could slow the heart rate further and worsen the block.

D. Perform carotid sinus massage: Carotid sinus massage is used for arrhythmias like atrial fibrillation or supraventricular tachycardia. In heart block, it could decrease the heart rate even more, making the condition worse.

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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?

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