A nurse is caring for an endurance athlete admitted for altered mental status. The client drank large amounts of water during a recent long-distance running event. The client is confused, complaining of a headache, and has a full bounding pulse. The nurse develops the plan of care based on the expectation that the client's lab work will demonstrate which of the following abnormalities?
Serum potassium 5.0 mEq/L
Serum osmolality 294 mmol/kg
Serum sodium of 127 mEq/L
Serum hemoglobin 15.7 grams/dL
The Correct Answer is C
A. Serum potassium 5.0 mEq/L: This is within the normal range for serum potassium (3.5-5.0 mEq/L). While potassium levels are important, they are not the primary concern with symptoms of confusion and a bounding pulse due to excessive water intake.
B. Serum osmolality 294 mmol/kg: This value is within the normal range for serum osmolality (275-295 mmol/kg). Elevated or normal osmolality would not be expected in a case of water intoxication, which dilutes serum electrolytes.
C. Serum sodium of 127 mEq/L: A serum sodium level of 127 mEq/L indicates hyponatremia, a condition often caused by excessive water intake that dilutes the sodium in the bloodstream. Symptoms such as confusion, headache, and a full bounding pulse are consistent with hyponatremia, making this the expected abnormality.
D. Serum hemoglobin 15.7 grams/dL: This is within the normal range for hemoglobin (12-16 grams/dL for women and 13.8-17.2 grams/dL for men). Hemoglobin levels would not be expected to change significantly due to water intoxication.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Poorly controlled pain, moves all extremities, reports continued nausea: Poorly controlled pain and nausea are not ideal for discharge, as they indicate the patient might need further monitoring and management.
B. 2-hour total urinary output of 30 mL, pulse oximetry 94% on 3L oxygen, turning from side to side: Low urinary output and low oxygen saturation indicate potential complications that require further assessment and treatment.
C. Afebrile, adventitious breath sounds, responds to painful stimuli: Responding to painful stimuli and adventitious breath sounds suggest the patient may still be experiencing complications and is not ready for discharge.
D. SaO2 of 95%, vital signs stable for last 30 minutes, active gag reflex: This response indicates stable oxygen saturation, stable vital signs, and an active gag reflex, suggesting the patient is ready for discharge from the PACU.
Correct Answer is B
Explanation
A. Weakness in upper extremities: Spinal anesthesia generally affects the lower body, so weakness in the upper extremities is not typically related to this type of anesthesia.
B. Headache: This is the correct choice. A headache is a common post-operative complaint related to spinal anesthesia, often caused by a spinal fluid leak, leading to a post-dural puncture headache.
C. Increased respiratory rate: Spinal anesthesia typically does not affect respiratory rate significantly; it mainly impacts sensation and motor function below the level of anesthesia.
D. Blurred vision: This is not a common issue directly related to spinal anesthesia. Visual disturbances are not typical post-operative complaints associated with spinal anesthesia.
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