A nurse is reviewing the laboratory results of a client who has bulimia nervosa. The nurse should notify the provider of which of the following results?
Potassium 3.2 mEq/L
WBC 5,200/mm3
Hgb 14 g/dL
Magnesium 1.6 mEq/L
The Correct Answer is A
Low potassium levels, known as hypokalemia, can be a significant concern in individuals with bulimia nervosa due to the frequent purging behaviors associated with the condition. Purging, such as self-induced vomiting or misuse of laxatives or diuretics, can lead to excessive loss of potassium from the body. Hypokalemia can have serious consequences, including cardiac arrhythmias, muscle weakness, fatigue, and even life-threatening complications.
The normal range for potassium is typically around 3.5-5.0 mEq/L. With a potassium level of 3.2 mEq/L falling below the normal range, it indicates a low potassium level and requires prompt attention.
The other laboratory results mentioned in the question are within normal ranges:
● A WBC (white blood cell) count of 5,200/mm3 falls within the normal range (typically between 4,500 and 11,000/mm3) and indicates a normal white blood cell count.
● An Hgb (hemoglobin) level of 14 g/dL falls within the normal range (typically between 12 and 16 g/dL) and indicates a normal hemoglobin level.
● A magnesium level of 1.6 mEq/L, although slightly low, is still within the normal range (typically between 1.5 and 2.5 mEq/L). The nurse should monitor it closely and assess for symptoms associated with hypomagnesemia. If the client's symptoms or other clinical indications suggest a significant magnesium imbalance, the healthcare provider should be notified.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Check for gastric residual: Gastric residual refers to the volume of formula or contents in the stomach before the next feeding. Checking for gastric residual helps determine if the client is tolerating the feeding properly. If the gastric residual is high, it may indicate delayed gastric emptying or intolerance to the feeding, which can lead to cramping and abdominal distention. The nurse can assess the gastric residual volume and consult with the healthcare provider to determine the appropriate course of action.
Apply low intermittent suction: Applying low intermittent suction is not typically indicated for a client receiving a continuous enteral tube feeding. Suction is more commonly used for clients who have an aspiration risk or need intermittent gastric decompression. In the given scenario, the client is experiencing cramping and abdominal distention, which may require a different approach.
Request a higher-fat formula: Requesting a higher-fat formula may not be the appropriate action at this time. High-fat formulas can contribute to gastrointestinal issues such as increased risk of diarrhea or malabsorption. It is important to assess the client's tolerance to the current formula before considering changes.
Increase the rate of the feeding: Increasing the rate of the feeding may worsen the client's symptoms. Rapid administration of enteral feedings can overwhelm the gastrointestinal system and lead to complications such as cramping, distention, and diarrhea. It is generally recommended to start at a low rate and gradually increase it based on the client's tolerance.
Correct Answer is C
Explanation
The nurse should plan to change the IV tubing for the TPN solution every 72 hours. This is necessary to maintain the sterility of the system and minimize the risk of infection. TPN solutions are prone to bacterial growth, and changing the tubing regularly helps prevent contamination.
Removing TPN from the refrigerator 5 minutes before infusing it is not necessary. TPN solutions are typically stored in the refrigerator to maintain their stability and prevent spoilage. It should be brought to room temperature over a longer period of time, usually 30-60 minutes, before administration.
Discarding the remaining TPN solution that is still infusing after 24 hours is unnecessary. TPN solutions can typically be infused for up to 24 hours without compromising their safety and efficacy. However, it is important to monitor the solution closely for any signs of contamination or degradation, and if any concerns arise, the nurse should consult with the healthcare provider.
Changing the dressing around the IV site weekly is not specific to TPN administration. Dressing changes for peripheral IV sites are typically performed according to facility protocols and the condition of the site, but they are not necessarily done on a weekly basis. The frequency of dressing changes depends on factors such as the type of dressing used, the patient's condition, and any signs of infection or dislodgement.
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