A nurse is caring for a client who is taking lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances?
Hypomagnesemia
Hypocalcemia
Hyponatremia
Hypokalemia
The Correct Answer is C
Choice A Reason:
Hypomagnesemia is incorrect. Lithium therapy itself is not a direct cause of hypomagnesemia. While exercise can affect magnesium levels to some extent, it's not a primary electrolyte imbalance that is typically associated with lithium use or considered a significant concern specifically due to lithium.
Choice B Reason:
Hypocalcemia is incorrect. Similarly, lithium therapy is not a direct cause of hypocalcemia. Exercise can affect calcium metabolism, but it's not a primary electrolyte imbalance typically associated with lithium use or considered a significant concern specifically due to lithium.
When a client taking lithium begins a new exercise program, the nurse should primarily assess for the risk of:
Choice C Reason:
Hyponatremia is correct. Lithium can affect the body's regulation of sodium, and excessive sweating due to increased exercise can lead to sodium loss. This combination can potentially contribute to the development of hyponatremia (low sodium levels). Therefore, when a client on lithium starts a new exercise regimen that may induce sweating, monitoring for signs of hyponatremia becomes crucial. Symptoms of hyponatremia can include confusion, headaches, nausea, and in severe cases, seizures or coma.
Choice D Reason:
Hypokalemia is incorrect. Lithium itself does not commonly cause hypokalemia. Exercise can lead to potassium loss through sweating, but hypokalemia is not the primary electrolyte imbalance typically associated with lithium use or considered a significant concern specifically due to lithium.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C"]
Explanation
Choice A Reason:
Absence of deep-tendon reflexes is correct. The absence or decrease in deep-tendon reflexes can be a sign of magnesium toxicity. Magnesium sulfate, when given in excessive amounts or in the case of accumulation due to impaired renal function, can lead to muscle weakness, hyporeflexia, and in severe cases, loss of deep-tendon reflexes. Discontinuation of magnesium sulfate and administration of calcium gluconate is warranted in severe cases of magnesium toxicity to counteract its effects.
Choice B Reason:
Report of chills is incorrect. Chills are non-specific symptoms and are not typically associated specifically with magnesium toxicity. They are less indicative of a need for calcium gluconate administration in the context of magnesium sulfate infusion.
Choice C Reason:
Decreased level of consciousness is correct. Severe magnesium toxicity can affect the central nervous system, leading to symptoms like confusion, drowsiness, and eventually decreased level of consciousness. In these cases, discontinuation of magnesium sulfate and administration of calcium gluconate is crucial to counteract the effects of excessive magnesium.
Choice D Reason:
Systolic blood pressure of 130 mm Hg is incorrect. A systolic blood pressure of 130 mm Hg, by itself, is not an indicator of magnesium toxicity that necessitates the administration of calcium gluconate. Blood pressure within this range is not typically a cause for concern related to magnesium sulfate administration.
Choice EReason:
Urine output of 80 mL in 4 hours is incorrect. While decreased urine output might indicate potential renal issues or compromised kidney function, it's not a specific indication for the administration of calcium gluconate in the context of magnesium sulfate infusion. It can signal the need for further assessment but is not a direct sign of magnesium toxicity requiring calcium gluconate administration.

Correct Answer is B
Explanation
Choice A Reason:
Oral is incorrect. Epoetin alfa is not typically administered orally because it would be broken down by digestive enzymes and not absorbed effectively from the gastrointestinal tract.
Choice B Reason:
Intravenous is correct. Epoetin alfa is a medication used to stimulate red blood cell production and is commonly administered intravenously. This route allows for rapid and efficient absorption of the medication into the bloodstream, enabling it to exert its effects effectively.
Choice C Reason:
Inhalation is incorrect. Inhalation is not a route used for epoetin alfa. This medication is intended for systemic effects rather than local effects in the respiratory system.
Choice D Reason:
Transdermal is incorrect. Transdermal administration involves absorption through the skin and is not suitable for epoetin alfa, which needs rapid and direct access to the bloodstream for its action on red blood cell production.

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