A nurse is providing care for a client who has hypervolemia, ketoacidosis, and metabolic acidosis. Which of the following lab values should the nurse be concerned about?

Serum potassium levels

Serum calcium levels

Serum sodium levels

Blood urea nitrogen (BUN)

Answer and Explanation

The Correct Answer is A

The correct answer is a) Serum potassium levels.

Choice A reason:

Serum potassium levels are crucial to monitor in clients with hypervolemia, ketoacidosis, and metabolic acidosis. Potassium imbalances are common in these conditions due to shifts between intracellular and extracellular compartments. In diabetic ketoacidosis (DKA), for example, insulin deficiency and acidosis cause potassium to move out of cells, leading to hyperkalemia. However, once treatment with insulin begins, potassium shifts back into cells, which can cause hypokalemia. Both hyperkalemia and hypokalemia can have serious cardiac implications, making it essential to monitor and manage potassium levels closely.

Choice B reason:

Serum calcium levels are important for overall health, but they are not the primary concern in the context of hypervolemia, ketoacidosis, and metabolic acidosis. While calcium imbalances can occur, they are less common and less immediately life-threatening compared to potassium imbalances. Monitoring calcium is still necessary, but it does not require the same level of immediate intervention.

Choice C reason:

Serum sodium levels are also important to monitor, especially in conditions like hypervolemia where fluid balance is disrupted. However, sodium imbalances are typically managed through fluid management and do not pose the same immediate risk as potassium imbalances in the context of ketoacidosis and metabolic acidosis. Hyponatremia or hypernatremia can cause neurological symptoms, but these are generally less acute compared to the cardiac risks associated with potassium imbalances.

Choice D reason:

Blood urea nitrogen (BUN) levels provide information about kidney function and hydration status. Elevated BUN can indicate dehydration or renal impairment, which are relevant in the context of hypervolemia and ketoacidosis. However, BUN levels do not require the same level of immediate intervention as potassium levels. Monitoring BUN is important for overall management but is not the primary concern in acute settings.

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Correct Answer is B

Explanation

Choice A reason: Increased Serum Sodium

Increased serum sodium, or hypernatremia, is not consistent with SIADH. SIADH typically results in hyponatremia, which is a low level of sodium in the blood due to excessive water retention. The excess antidiuretic hormone (ADH) causes the kidneys to retain water, diluting the sodium in the bloodstream. Therefore, increased serum sodium is not a characteristic finding in SIADH.

Choice B reason: Decreased Serum Osmolality

Decreased serum osmolality is a hallmark of SIADH3. Serum osmolality measures the concentration of solutes in the blood. In SIADH, the excessive release of ADH leads to water retention, diluting the blood and lowering serum osmolality. This is a key diagnostic feature of SIADH and helps differentiate it from other conditions.

Choice C reason: Decreased Urinary Sodium

Decreased urinary sodium is not typically seen in SIADH. In fact, patients with SIADH usually have increased urinary sodium levels. This is because the kidneys excrete more sodium in an attempt to balance the excess water retained due to high ADH levels. Therefore, decreased urinary sodium is not consistent with SIADH.

Choice D reason: Decreased Urine Osmolality

Decreased urine osmolality is also not consistent with SIADH. In SIADH, urine osmolality is typically increased because the kidneys concentrate the urine due to the action of ADH. The high levels of ADH cause the kidneys to reabsorb water, resulting in more concentrated urine. Thus, decreased urine osmolality is not a characteristic finding in SIADH.

A. A client admitted for hip fracture surgery. B. A client who is awaiting cataract surgery. C. A client who is receiving an antibiotic for a urinary tract infection. D. A client who is being evaluated for a breast lump.

Correct Answer is C

Explanation

Choice A reason:

A client admitted for hip fracture surgery is at risk for various complications, but not specifically for hyperosmolar hyperglycemic syndrome (HHS). HHS is more commonly triggered by infections, severe dehydration, or other acute illnesses. While surgery can be a stressor, it is not as directly linked to HHS as infections are.

Choice B reason:

A client who is awaiting cataract surgery is not typically at high risk for developing HHS. Cataract surgery is generally a planned and controlled procedure that does not usually involve the acute stressors or infections that can precipitate HHS.

Choice C reason:

A client who is receiving an antibiotic for a urinary tract infection is at a higher risk for developing HHS. Infections are a common precipitating factor for HHS because they can cause significant stress on the body, leading to elevated blood glucose levels. The body’s response to infection can exacerbate hyperglycemia, especially in individuals with type 2 diabetes.

Choice D reason:

A client who is being evaluated for a breast lump is not typically at high risk for HHS. While the evaluation process can be stressful, it does not usually involve the acute physiological stressors or infections that are more directly linked to the development of HHS.

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A nurse is providing care for a client who has hypervolemia, ketoacidosis, and metabolic acidosis. Which of the following lab values should the nurse be concerned about?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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