A nurse is reviewing the medical record of a client who has a potassium level of 3.0 mEq/L. Which of the following findings should the nurse recognize as a potential causative factor?

Client has an NG tube to gastric suction.

Client has a history of alcohol abuse disorder.

Client reports drinking 3.5 to 4 L of water each day.

Client is currently prescribed spironolactone.

Answer and Explanation

The Correct Answer is A

The correct answer is choice A. Client has an NG tube to gastric suction.

Choice A rationale:

Having an NG tube to gastric suction can lead to hypokalemia because the suctioning process removes potassium from the stomach contents, leading to a decrease in serum potassium levels.

Choice B rationale:

While a history of alcohol abuse disorder can lead to various electrolyte imbalances, it is not the most direct cause of hypokalemia compared to gastric suction.

Choice C rationale:

Drinking 3.5 to 4 liters of water each day can lead to dilutional hyponatremia but is less likely to cause hypokalemia directly.

Choice D rationale:

Spironolactone is a potassium-sparing diuretic, which means it helps retain potassium in the body. Therefore, it is not a causative factor for hypokalemia.

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Correct Answer is A

Explanation

Choice A rationale:

Fluid volume overload is an excess of fluid in the intravascular and/or interstitial spaces. One of the hallmark signs of fluid volume overload is distended neck veins, which indicates increased venous pressure due to the accumulation of fluid. The neck veins become more visible and prominent, especially when the patient is in a semi-Fowler's position.

Choice B rationale:

Poor skin turgor is a sign of dehydration, not fluid volume overload. It is characterized by the skin's inability to return to its normal position after being gently pinched. In fluid volume overload, the skin may become edematous and puffy, but it does not exhibit poor turgor.

Choice C rationale:

Concentrated hemoglobin and hematocrit levels are seen in conditions of dehydration or hemoconcentration, not in fluid volume overload. In fluid volume overload, there is excess fluid, which may lead to dilutional effects, resulting in decreased concentration of blood components.

Choice D rationale:

Decreased urine output is associated with fluid volume deficit (dehydration) rather than fluid volume overload. In fluid volume overload, there is often an increase in urine output as the body tries to eliminate the excess fluid.

A. 1000 milliliters. B. 600 milliliters. C. 1200 milliliters. D. 750 milliliters.

Correct Answer is B

Explanation

The correct answer is B. 600 milliliters.

Choice A rationale:

A 24-hour urine output of 1000 milliliters is within the normal range for an adult, indicating adequate kidney function and hydration.

Choice B rationale:

A 24-hour urine output of 600 milliliters is below the normal range (typically 800-2000 milliliters), which may indicate oliguria (reduced urine output) and could be a sign of renal impairment or dehydration. This warrants notifying the healthcare provider.

Choice C rationale:

A 24-hour urine output of 1200 milliliters is also within the normal range, suggesting normal kidney function and hydration status.

Choice D rationale:

A 24-hour urine output of 750 milliliters is slightly below the normal range but may not be immediately concerning unless accompanied by other symptoms. However, it is still important to monitor and possibly notify the healthcare provider if it persists.

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