A nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which of the following abnormalities on the client's EKG should the nurse interpret as a sign of hypokalemia?

Answer: D

Rationale:

A. "Drink 400 ml every hour until bowel movements are clear": The standard recommendation for PEG is to drink a specific volume, usually 240 ml every 10 to 15 minutes, rather than 400 ml every hour. The goal is to ensure the bowel is adequately cleansed, and this rate is typically more effective in achieving that.

B. "Expect bowel movements to begin 3 hr following completion of solution": Bowel movements often start within an hour or two after starting the PEG solution rather than waiting for 3 hours after finishing it. The timing can vary, but the onset is generally sooner.

C. "To prevent dehydration, drink an additional liter of fluid during preparation time": While it is important to stay hydrated, the specific recommendation for additional fluid intake beyond the PEG solution can vary. Typically, the instructions focus on the volume of PEG solution to drink rather than specifying a set amount of additional fluid.

D. "Abdominal bloating might occur": Abdominal bloating is a common side effect of bowel cleansing preparations like PEG. It can occur due to the large volume of fluid ingested and the rapid movement of the bowel contents, making it a relevant point to include in the instructions.

A. A room with another nonsurgical client: Placing a client with active tuberculosis in a room with another nonsurgical client is not appropriate because it increases the risk of transmission to other patients. Tuberculosis is highly contagious, and isolation precautions are necessary to prevent the spread of the disease.
B. A room in the ICU: While isolation precautions are necessary for a client with active tuberculosis, placing the client in the intensive care unit (ICU) may not be necessary unless the client requires critical care. However, the priority is to provide a room that meets the requirements for airborne infection isolation, which may not necessarily be in the ICU.
C. A room with air exhaust directly to the outdoor environment: This is the correct choice. A room with air exhaust directly to the outdoor environment is essential for a client with active tuberculosis. Airborne infection isolation rooms (AIIRs) have negative air pressure and special ventilation systems that prevent the circulation of air from the room to other areas of the healthcare facility, reducing the risk of transmission to healthcare workers and other patients.
D. A room that is within view of the nursing station: While it may be convenient for the nursing staff to have the client's room within view of the nursing station for monitoring purposes, the priority for a client with active tuberculosis is to ensure that they are placed in a room with appropriate airborne infection isolation precautions, including proper ventilation, to minimize the risk of transmission to others.