A nurse is caring for four clients who have drainage tubes. The nurse should identify the client who has which of the following tubes as being at risk for hypokalemia?

A nephrostomy tube to a drainage bag

An NG tube to suction

An indwelling urinary catheter to gravity drainage

A chest tube to water-seal drainage

Answer and Explanation

The Correct Answer is B

A. A nephrostomy tube to a drainage bag:
A nephrostomy tube drains urine from the kidney to a drainage bag. While it's essential for urinary drainage, it doesn't lead to significant potassium loss, as potassium is primarily excreted through the urine.

B. An NG tube to suction:
An NG tube (Nasogastric tube) is inserted through the nose into the stomach. When connected to suction, it can remove stomach contents, including gastric acid and potassium. Excessive suctioning can lead to significant potassium loss, potentially causing hypokalemia.

C. An indwelling urinary catheter to gravity drainage:
An indwelling urinary catheter drains urine from the bladder into a drainage bag by gravity. While potassium can be found in urine, the drainage through a catheter does not cause significant potassium loss unless there are underlying kidney issues, which are not specified in this scenario.

D. A chest tube to water-seal drainage:
A chest tube removes air or fluid from the pleural space around the lungs. While chest tubes are vital for lung expansion, they don't result in significant potassium loss as they are not connected to body fluids rich in potassium, like gastric acid or urine.

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Correct Answer is B

Explanation

A. Troponin:
Troponin is a protein found in the heart muscle. Elevated levels of troponin in the blood indicate damage to the heart, often due to a heart attack or other cardiac issues. This marker is crucial in diagnosing heart-related problems.

B. Albumin:
Albumin is a protein produced by the liver and is essential for maintaining blood volume and regulating fluid balance. It also helps transport various substances in the blood. Low levels of albumin are indicative of malnutrition, liver disease, or kidney disorders.

C. D-dimer:
D-dimer is a substance in the blood that is released when a blood clot breaks up. Elevated levels of D-dimer can indicate the presence of an abnormal blood clot, but it is not specific to malnutrition. It is often used in diagnosing conditions like deep vein thrombosis (DVT) or pulmonary embolism (PE).

D. Creatinine:
Creatinine is a waste product produced by the muscles and excreted by the kidneys. Creatinine levels in the blood can indicate how well the kidneys are functioning. Elevated levels can suggest kidney damage or other kidney-related issues but are not directly related to malnutrition.

A. Prior to percussing the abdomen B. Prior to inspecting the abdomen C. After checking for kidney tenderness D. After palpating the abdomen

Correct Answer is A

Explanation

A. Prior to percussing the abdomen:Auscultation should be performed before percussing or palpating the abdomen. Percussion and palpation can alter bowel activity, potentially leading to inaccurate assessment of bowel sounds.

B. Prior to inspecting the abdomen:Inspection should always be performed before auscultation when assessing the abdomen. This allows the nurse to observe any visible abnormalities, such as distention or skin changes, without altering bowel activity. Auscultation should follow inspection.

C. After checking for kidney tenderness:Checking for kidney tenderness (e.g., costovertebral angle tenderness) involves percussing the back and is not part of the sequence of a standard abdominal exam. It does not precede auscultation.

D. After palpating the abdomen:
Palpation can stimulate or alter bowel sounds, potentially leading to an inaccurate assessment. Therefore, auscultation should always occur before palpation.

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A nurse is caring for four clients who have drainage tubes. The nurse should identify the client who has which of the following tubes as being at risk for hypokalemia?

Nursing Test Bank

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