A nurse is assessing a client with a sodium level of 116 mEq/L (135-145 mEq/L). Which finding should the nurse expect for this client to have?

Extreme thirst

Paresthesias

Lethargy

Blood clots

Answer and Explanation

The Correct Answer is C

A) Extreme thirst: While extreme thirst can be associated with electrolyte imbalances, particularly in conditions of dehydration or hypernatremia (elevated sodium levels), a sodium level of 116 mEq/L indicates hyponatremia (low sodium levels). Extreme thirst is less typical for hyponatremia.

B) Paresthesias: Paresthesias, or abnormal sensations like tingling or numbness, are more commonly associated with conditions of low calcium or potassium levels rather than sodium. In hyponatremia, neurological symptoms can occur, but they typically include lethargy or confusion rather than specific paresthesias.

C) Lethargy: Lethargy is a common symptom of severe hyponatremia. Low sodium levels can lead to cerebral edema and neurological disturbances, resulting in symptoms such as lethargy, confusion, and even seizures. This is a direct consequence of the altered osmotic balance affecting brain function.

D) Blood clots: Hyponatremia is not typically associated with an increased risk of blood clots. Blood clots are more related to conditions affecting coagulation factors, which are not directly influenced by sodium levels.

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Correct Answer is C

Explanation

A) Dysphagia: While dysphagia (difficulty swallowing) can occur in individuals with long-term alcohol use, especially if there is coexisting neurological damage or esophageal disorders, it is not specifically associated with vomiting and diarrhea in the context of this scenario. The primary concern here involves electrolyte imbalances.

B) Hypoactive deep tendon reflexes (DTR): Hypoactive DTRs are typically associated with hypermagnesemia rather than hypomagnesemia. In this case, the client's condition is more likely to lead to electrolyte deficiencies, including hypomagnesemia, due to vomiting, diarrhea, and poor nutritional intake.

C) Hypomagnesemia: Chronic alcohol use often results in nutritional deficiencies, and vomiting and diarrhea can further exacerbate this by depleting electrolytes. Hypomagnesemia is a common finding in long-term alcoholics due to poor dietary intake, gastrointestinal losses, and renal losses. This can lead to symptoms such as muscle weakness, tremors, and altered mental status. Hypomagnesemia is particularly concerning because it can affect cardiovascular stability and neuromuscular function.

D) Positive Chvostek sign: A positive Chvostek sign is indicative of hypocalcemia, which can occur secondary to hypomagnesemia. However, it is not as directly associated with chronic alcoholism as hypomagnesemia itself. The positive Chvostek sign involves a facial muscle spasm in response to tapping the facial nerve and indicates neuromuscular irritability due to low calcium levels. While related, the primary electrolyte imbalance expected here is hypomagnesemia.

A. Speech Therapist B. Registered Dietician C. Physical Therapist D. Occupational Therapist

Correct Answer is D

Explanation

A) Speech Therapist: A speech therapist typically works with clients who have communication or swallowing disorders. While they may be involved in assessing and managing difficulties with swallowing, they are not the primary professionals for addressing issues related to hand function or fine motor skills, which are crucial for self-feeding in clients with rheumatoid arthritis.

B) Registered Dietician: A registered dietician is responsible for assessing and planning nutritional needs, which may include recommending dietary modifications for overall health and well-being. However, they do not specifically address the mechanical or functional aspects of eating, such as difficulties due to pain and hand deformities in rheumatoid arthritis.

C) Physical Therapist: Physical therapists focus on improving gross motor function, mobility, and physical strength. While they may help with general mobility and exercise plans to reduce pain and improve joint function, they are not specialists in the fine motor skills and adaptive strategies needed for activities of daily living, such as self-feeding.

D) Occupational Therapist: Occupational therapists specialize in helping clients regain and improve their ability to perform daily activities, particularly those involving fine motor skills. They are well-suited to address issues like pain management, joint protection techniques, and the use of adaptive equipment for self-feeding in clients with rheumatoid arthritis. They work on enhancing the client’s functional independence despite physical limitations.

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﻿A nurse is assessing a client with a sodium level of 116 mEq/L (135-145 mEq/L). Which finding should the nurse expect for this client to have?

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Explanation

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