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
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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Related Questions
Correct Answer is D
Explanation
A. Placing the child on a low-sodium diet is not a priority action for managing Addison's disease. Sodium restriction may be necessary in some cases, but it's not the primary intervention.
B. Monitoring the child for fluid volume excess is not directly related to managing Addison's disease. Addison's disease often leads to hypovolemia due to decreased aldosterone secretion.
C. Discussing manifestations of hyperglycemia may not be directly relevant to Addison's disease, which primarily affects cortisol and aldosterone levels, not glucose metabolism.
D. Teaching the parents about cortical replacement therapy is crucial. Addison's disease results from adrenal insufficiency, and cortical replacement therapy, typically with glucocorticoids and mineralocorticoids, is the mainstay of treatment.
Correct Answer is A
Explanation
A. 0.45% sodium chloride, also known as half-normal saline, is a hypotonic solution with a lower concentration of sodium than normal serum levels. It can help to lower the sodium levels in a client with hypernatremia by diluting the excess sodium in the body.
B. Dextrose 10% in water is hypertonic and not appropriate for a client with hypernatremia, as it could exacerbate the imbalance.
C. Lactated Ringer's is isotonic and contains sodium in a similar concentration to serum levels, hence it could further increase the sodium levels.
D. Dextrose 5% in 0.9% sodium chloride (also known as D5NS) is a hypertonic solution that contains both dextrose and sodium. It would not be appropriate for a client with hypernatremia, as it could exacerbate the condition.
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