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?
Inverted P wave
Wide ORS
Elevated ST segment
Abnormally prominent U wave
The Correct Answer is D
A. Inverted P wave: An inverted P wave may indicate atrial depolarization abnormalities but is not typically associated with hypokalemia. It can be seen in conditions such as atrial enlargement or atrial ischemia. However, in hypokalemia, the P wave may become flattened or have a decreased amplitude, but it is less likely to be inverted.
B. Wide QRS: A wide QRS complex may indicate conduction abnormalities or bundle branch blocks, but it is not specifically associated with hypokalemia. Wide QRS complexes are more commonly seen in conditions such as bundle branch blocks or electrolyte imbalances like hyperkalemia. Hypokalemia tends to cause a prolongation of the QT interval rather than widening of the QRS complex.
C. Elevated ST segment: An elevated ST segment is typically associated with myocardial injury or infarction, not hypokalemia. It can be indicative of conditions such as myocardial ischemia or pericarditis. In hypokalemia, ST segment changes are more likely to be flattened or depressed rather than elevated.
D. Abnormally prominent U wave: An abnormally prominent U wave is a classic EKG finding in hypokalemia. Hypokalemia prolongs the repolarization phase of the cardiac action potential, leading to the appearance of U waves following the T wave. These U waves can become more pronounced as potassium levels decrease. Therefore, an abnormally prominent U wave is a significant indicator of hypokalemia on an EKG, especially in a patient with prolonged vomiting, which can lead to potassium depletion. Thus, it is the most pertinent abnormality to interpret in this context.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. CD4 T cell count 180 cells/mm3: In a client with HIV, monitoring the CD4 T cell count is crucial for assessing immune function and determining the progression of the disease. A CD4 T cell count of less than 200 cells/mm3 indicates severe immunosuppression and an increased risk of opportunistic infections, making it the priority laboratory value to monitor in this client.
B. Platelets 150,000/mm3: While platelet count is important for assessing clotting function, it is not the priority laboratory value in a client with HIV. Thrombocytopenia can occur in HIV but is often secondary to other factors such as medication side effects or opportunistic infections. However, a platelet count within the normal range of 150,000/mm3 is reassuring and does not require immediate intervention.
C. WBC 5000 mm3: White blood cell (WBC) count is essential for assessing overall immune function, but it is not the priority laboratory value in a client with HIV. A WBC count of 5000 mm3 is within the normal range and does not require urgent attention.
D. Positive Western blot test: While a positive Western blot test confirms HIV infection, it does not provide information about the client's current immune status or the need for immediate intervention. Confirmatory tests such as Western blot are important for diagnosis, but they do not provide ongoing monitoring of disease progression or immune function.
Correct Answer is ["B","D","E"]
Explanation
A. Fine hand tremors and pill rolling: These symptoms are more indicative of parkinsonism, which is another extrapyramidal side effect of antipsychotic medications but not specifically tardive dyskinesia.
B. Facial grimacing and eye blinking: Facial grimacing and eye blinking are classic signs of tardive dyskinesia. These involuntary movements of the face are often seen in patients who have been on antipsychotic medications for an extended period.
C. Urinary retention and constipation: Urinary retention and constipation are not typically associated with tardive dyskinesia. These symptoms may be related to other medication side effects or unrelated conditions.
D. Involuntary pelvic rocking and hip thrusting movements: These movements are characteristic of tardive dyskinesia. Involuntary pelvic rocking and hip thrusting can occur as part of the abnormal involuntary movements seen in tardive dyskinesia.
E. Tongue thrusting and lip smacking: Tongue thrusting and lip smacking are classic signs of tardive dyskinesia, particularly involving the orofacial region. These movements can be distressing for patients and may interfere with speech and eating.
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