After receiving the change of shift report, the nurse reviews the electronic health record for each client. What client should the nurse see first?

The client with a serum phosphorus of 4.5 mg/dL that requires assistance with planning their meals

The client with a serum magnesium of 1.1 mEq/L who has tremors and hyperactive deep tendon reflexes

The client with a serum potassium of 5.3 mEq/L and is scheduled for hemodialysis in three hours

The client with a serum sodium of 145 mEq/L who is complaining of a dry mouth and wants a glass of water

Answer and Explanation

The Correct Answer is B

A. The client with a serum phosphorus of 4.5 mg/dL that requires assistance with planning their meals: A serum phosphorus level of 4.5 mg/dL is within the normal range, and assistance with meal planning is a lower priority compared to the other situations.
B. The client with a serum magnesium of 1.1 mEq/L who has tremors and hyperactive deep tendon reflexes: This client has hypomagnesemia, which can lead to severe complications like seizures or cardiac arrhythmias. Immediate attention is necessary due to the symptoms and the critically low magnesium level.
C. The client with a serum potassium of 5.3 mEq/L and is scheduled for hemodialysis in three hours: This potassium level is slightly elevated, but the scheduled hemodialysis suggests the issue will be addressed soon.
D. The client with a serum sodium of 145 mEq/L who is complaining of a dry mouth and wants a glass of water: A serum sodium of 145 mEq/L is on the high end of normal; the client's dry mouth is concerning but not as urgent as the issues presented by the hypomagnesemia.

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Correct Answer is C

Explanation

A. Crush the medication and administer it through the tube: Crushing sustained-release medications can disrupt their intended release mechanism, leading to potential overdose or ineffective treatment.
B. Provide the medication orally for the client to swallow: This option is not suitable since the client has a gastrostomy tube, and oral administration is not appropriate.
C. Ask the healthcare provider to prescribe the medication as an elixir for tube administration: This is the correct approach, as an elixir form of the medication would be appropriate for administration through the gastrostomy tube without altering its release properties.
D. Dissolve the medication in water and administer it through the tube: Dissolving sustained-release tablets can compromise their intended release mechanism, which may lead to complications.

A. Absence of the client's gag reflex B. The client has a respiratory rate of eight (8) C. Loss of sensation at the 5th lumbar space D. The blood pressure is within 20% of the client's baseline

Correct Answer is B

Explanation

A. Absence of the client's gag reflex: This finding is not typically related to spinal anesthesia complications. The gag reflex is more pertinent to general anesthesia and its effects on the brainstem.
B. The client has a respiratory rate of eight (8): This is the correct choice. A low respiratory rate (bradypnea) could indicate significant complications from spinal anesthesia, such as respiratory depression, especially if the anesthesia affects the muscles involved in respiration.
C. Loss of sensation at the 5th lumbar space: This could be a normal effect of spinal anesthesia if the level of anesthesia was intended to cover this area, but it does not necessarily indicate a complication.
D. The blood pressure is within 20% of the client's baseline: A slight change in blood pressure within this range is generally not considered a severe complication of spinal anesthesia. Significant hypotension or instability would be more concerning.

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After receiving the change of shift report, the nurse reviews the electronic health record for each client. What client should the nurse see first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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