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
Hyponatremia
Hypocalcemia
Hypokalemia
The Correct Answer is B
A. Hypomagnesemia:
Correct Answer: This electrolyte imbalance is the one the nurse should assess the client for.
Explanation: Lithium is primarily excreted by the kidneys, and its excretion can be influenced by factors that affect renal function, including electrolyte imbalances. Hypomagnesemia (low magnesium levels) can potentially reduce the excretion of lithium, leading to increased lithium levels in the blood. This can increase the risk of lithium toxicity, which can be dangerous. Therefore, monitoring magnesium levels is important in clients taking lithium.
B. Hyponatremia:
Incorrect Explanation: While hyponatremia (low sodium levels) is a potential concern, it is not as directly linked to lithium interaction as hypomagnesemia.
Explanation: Lithium can cause diabetes insipidus, which leads to excessive urination and subsequent loss of water and electrolytes, including sodium. However, hyponatremia is not the immediate electrolyte imbalance that arises due to the interaction with lithium.
C. Hypocalcemia:
Incorrect Explanation: Hypocalcemia (low calcium levels) is not a primary concern in the context of lithium use.
Explanation: Lithium does not have a direct interaction with calcium levels. Hypocalcemia is typically not a result of lithium use or its interaction with other factors.
D. Hypokalemia:
Incorrect Explanation: While electrolyte imbalances like hypokalemia (low potassium levels) can have health implications, it is not the primary electrolyte imbalance to be concerned about with lithium use.
Explanation: Hypokalemia is not a direct consequence of lithium interaction. Monitoring potassium levels is important for overall health, but it's not the primary electrolyte imbalance associated with lithium use and its potential interactions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Replace the infusion with 0.9% sodium chloride:
Incorrect Explanation: While replacing the infusion with a different solution might be considered later, it's not the immediate next step.
Explanation: The primary concern during an anaphylactic reaction is ensuring the client's airway, breathing, and circulation. Addressing the medication infusion should come after stabilizing the client's condition.
B. Give diphenhydramine IM:
Incorrect Explanation: Administering diphenhydramine (an antihistamine) can be beneficial, but it's not the initial priority.
Explanation: Diphenhydramine can help mitigate allergic symptoms, but it's not the first-line treatment for severe anaphylaxis.
C. Elevate the client's legs and feet:
Incorrect Explanation: Elevating the legs and feet is not the appropriate action for managing anaphylaxis.
Explanation: During anaphylaxis, maintaining the airway, ensuring proper circulation, and administering appropriate medications take precedence over elevating the legs.
D. Administer epinephrine IM:
Correct Answer: Administering epinephrine (adrenaline) IM is the appropriate next step in managing anaphylaxis.
Explanation: Epinephrine is the first-line treatment for severe anaphylactic reactions. It helps counteract the symptoms of anaphylaxis by constricting blood vessels, improving circulation, and opening airways. Epinephrine should be administered promptly and followed by seeking emergency medical care.
Correct Answer is D
Explanation
A. Decrease in protein:
This choice is incorrect. Albumin is a protein found in the blood, and when a client is receiving an infusion of albumin, it is likely to increase, not decrease, the overall protein level in the bloodstream. Albumin infusions are often given to help increase plasma oncotic pressure and improve fluid retention in conditions like shock.
B. Oxygen saturation 96%:
This choice is incorrect. Oxygen saturation of 96% is within the normal range and reflects adequate oxygenation. It doesn't directly relate to the administration of albumin in shock.
C. PaCO2 30 mm Hg:
This choice is incorrect. The partial pressure of carbon dioxide (PaCO2) of 30 mm Hg reflects a respiratory value and doesn't directly relate to the administration of albumin or the management of shock. It's important for assessing acid-base balance, but it's not a specific finding related to the albumin infusion.
D. Increase in BP:
This is the correct choice. Albumin is a colloid solution that helps increase the oncotic pressure within blood vessels, which can contribute to an increase in blood volume. When blood volume increases, it can lead to an increase in blood pressure, which is a desired effect in the management of shock. Increasing blood pressure helps improve perfusion to vital organs and tissues, which is essential in shock situations.
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