A nurse is caring for a client who has a postoperative ileus and an NG tube that has drained 2,500 mL in the past 6 hr. Which of the following electrolyte imbalances should the nurse monitor the client for?

Decreased calcium level

Decreased potassium level

Elevated sodium level

Elevated magnesium level

Answer and Explanation

The Correct Answer is B

A.   Postoperative ileus and NG tube drainage are not typically associated with decreased calcium levels.
B.   The nurse should monitor for electrolyte imbalances, particularly a decreased potassium level. This is because the gastrointestinal tract, especially the stomach, contains a high concentration of potassium, and substantial losses can occur with ongoing gastric suctioning.
C.   NG tube drainage does not typically result in elevated sodium levels.
D.   NG tube drainage does not typically result in elevated magnesium levels.

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Correct Answer is D

Explanation

A. Respiratory acidosis would typically involve an elevated PaCO2, which is not seen in this case.
B. Metabolic alkalosis is characterized by an elevated bicarbonate level, which is not present in this scenario.
C. Respiratory alkalosis would present with a low PaCO2 and an elevated pH, which is not the case here.
D. The low bicarbonate level (HCO3) 18mEq/L (normal range of 22-26 mEq/L), and low pH 7.30 (normal range of 7.35-7.45), indicate metabolic acidosis. suggesting acidemia. The PaCO2 is also low at 28 mm Hg, indicating a respiratory compensation for the metabolic acidosis.

A. Place the client on seizure precautions. B. Have the client breath into a paper bag. C. Encourage the client to breath slowly, D. Plan to administer sodium bicarbonate to the client

Correct Answer is A

Explanation

A. Placing the client on seizure precautions is important as metabolic alkalosis can cause neurological symptoms, such as confusion and increased risk for seizures due to electrolyte imbalances (e.g., low calcium levels). Therefore, seizure precautions are warranted.
B. Breathing into a paper bag is used in respiratory alkalosis to increase CO2 levels, but it is not appropriate in metabolic alkalosis, where the issue is not primarily related to CO2 imbalance.
C. Encouraging the client to breathe slowly is generally more appropriate for respiratory alkalosis, not metabolic alkalosis. Slow breathing would not directly address the underlying issue of metabolic alkalosis.
D. Administering sodium bicarbonate would worsen metabolic alkalosis, as it would further increase the alkalotic state. Sodium bicarbonate is used in metabolic acidosis, not alkalosis.

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A nurse is caring for a client who has a postoperative ileus and an NG tube that has drained 2,500 mL in the past 6 hr. Which of the following electrolyte imbalances should the nurse monitor the client for?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has the following arterial blood gas results: HCO3-, 18 mEq, PaCO, 28 mm Hg and pH 7.30. The nurse recognizes the client is experiencing which of the following acid base imbalances?

Correct Answer is D

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