A nurse is caring for a client who is a long-term alcoholic. The client presents to the emergency department with vomiting and diarrhea for several days. Which findings would the nurse expect to find in this client?

dysphagia

hypoactive deep tendon reflexes (DTR)

hypomagnesemia

positive Chvostek sign hypertension

Answer and Explanation

The Correct Answer is C

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.

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Correct Answer is C

Explanation

A) The client's daily calorie intake: While daily calorie intake is important for understanding a client's nutritional needs and managing their diet, it is not required for calculating BMI. BMI calculation focuses on weight and height rather than caloric intake.

B) The client's waist circumference: Waist circumference is useful for assessing abdominal fat distribution and risk of obesity-related conditions, but it is not needed for calculating BMI. BMI calculation requires height and weight, not waist measurements.

C) The client's height: To calculate BMI, the client's height is essential. BMI is determined by dividing weight in kilograms by the square of height in meters (kg/m²). Accurate height measurement is crucial for this calculation.

D) The client's skinfold thickness: Skinfold thickness measurements are used to estimate body fat percentage but are not required for calculating BMI. BMI relies solely on weight and height, not body fat estimates.

A. They must also take a vitamin D supplement. B. Reduce sodium intake. C. Decrease the amount of fiber in your diet. D. Take the medication with orange juice to increase absorption.

Correct Answer is A

Explanation

A) They must also take a vitamin D supplement: Calcium absorption is highly dependent on vitamin D, which facilitates the absorption of calcium in the intestines. Taking a vitamin D supplement alongside calcium ensures effective utilization of calcium, improving bone health and preventing deficiencies.

B) Reduce sodium intake: While reducing sodium intake can benefit overall health and reduce fluid retention, it is not directly related to the absorption of calcium supplements. The focus should be on ensuring adequate vitamin D levels for proper calcium absorption.

C) Decrease the amount of fiber in your diet: High fiber diets do not necessarily hinder calcium absorption to a significant extent. In fact, maintaining a balanced diet with adequate fiber is important for overall health. Fiber does not need to be reduced specifically for better calcium absorption.

D) Take the medication with orange juice to increase absorption: Orange juice is high in vitamin C, which does not significantly impact calcium absorption. Calcium supplements are best taken with vitamin D or with meals to enhance absorption, rather than with orange juice alone.

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A nurse is caring for a client who is a long-term alcoholic. The client presents to the emergency department with vomiting and diarrhea for several days. Which findings would the nurse expect to find in this client?

Nursing Test Bank

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A nurse is caring for a client who is a long-term alcoholic. The client presents to the emergency department with vomiting and diarrhea for several days. Which findings would the nurse expect to find in this client?