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A nurse is reviewing the laboratory values for a client who has heart failure and is taking bumetanide for diuresis. For which of the following results should the nurse notify the provider?

A.

Potassium 2.3 mEq/L (3.5-5)

B.

Magnesium 14 mEq/L (1.3-2.1)

C.

Carcum to mg/dL (9.9-10.5)

D.

Sodium 136 mEq/L (136-145)

Answer and Explanation

The Correct Answer is A

A. Potassium 2.3 mEq/L (3.5-5.0): This is a severely low potassium level (hypokalemia), which can cause dangerous arrhythmias, especially in a client with heart failure. Bumetanide is a loop diuretic, which can deplete potassium levels.

B. Magnesium 1.4 mEq/L (1.3-2.1): Although the magnesium level is on the lower end of normal, it is not a critical value, and the primary concern here is the potassium level.

C. Calcium 10 mg/dL (9.9-10.5): This is a normal calcium level, so there is no need to notify the provider based on this result.

D. Sodium 136 mEq/L (136-145): This is a normal sodium level, so it would not warrant notifying the provider. The critical concern is the hypokalemia.


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Related Questions

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"C"},"D":{"answers":"B"},"E":{"answers":"A"}}

Explanation

. Obtain an x-ray of the right hip:

  • Anticipated: After a fall, especially in an elderly client with a history of dizziness, it's important to rule out a hip fracture, a common and serious injury in this population.

2. Administer iron supplement

  • Anticipated: Maintaining adequate iron supplementation is important to address the client's chronic iron-deficiency anemia. This helps to support red blood cell production.

3. Administer spironolactone

  • Contraindicated: Administering spironolactone is contraindicated because the client’s potassium level is elevated at 5.8 mmol/L, indicating hyperkalemia. Spironolactone, a potassium-sparing diuretic, could further exacerbate this condition.

4. Administer supplemental oxygen PRN

  • Nonessential: Administering supplemental oxygen is nonessential at this time because the client’s oxygen saturation is 94% on room air, which is within the normal range.

5. Administer an IV fluid bolus

  • Anticipated: Administering an IV fluid bolus is anticipated due to the client’s signs of dehydration (e.g., tenting skin, dry skin, low blood pressure) and recent history of nausea and diarrhea.

Correct Answer is B

Explanation

A. "I’ll be sure to eat foods with lots of vitamin K." This statement shows misunderstanding, as vitamin K counteracts the effects of warfarin. The client should maintain a consistent intake of vitamin K, not increase it.

B. "I’ll use my electric razor for shaving." Using an electric razor reduces the risk of cuts, which could lead to bleeding, a common concern for clients on warfarin.

C. "It's okay to have a few glasses of wine every day." Alcohol can interfere with the metabolism of warfarin and increase the risk of bleeding. This is not a safe practice.

D. "I'll take aspirin for my headaches." Aspirin is an anticoagulant and can increase the risk of bleeding when taken with warfarin, so this statement indicates a lack of understanding.

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