An older adult nursing home resident who has always been alert and oriented is now showing signs of dehydration and has become confused. Which electrolyte imbalance is most likely involved?

Hypercalcemia

Hypomagnesemia

Hyponatremia

Hypernatremia

Answer and Explanation

The Correct Answer is C

A. Hypercalcemia: Hypercalcemia may cause confusion but is less likely associated with dehydration.

B. Hypomagnesemia: This can cause neuromuscular symptoms but is less commonly linked to confusion in dehydration.

C. Hyponatremia: Low sodium levels disrupt brain cell function, leading to confusion and neurological symptoms, which are common in dehydrated older adults.

D. Hypernatremia: While dehydration may cause hypernatremia, it is less likely to present with confusion in this context compared to hyponatremia.

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Correct Answer is B

Explanation

A. Increased salivation: Increased salivation is not typically associated with hypernatremia.

B. Decreased level of consciousness: Hypernatremia can cause cellular dehydration, which can lead to neurological symptoms such as confusion, irritability, and decreased level of consciousness.

C. Hypertension: Although hypernatremia can cause fluid retention and contribute to increased blood pressure, the primary concern is neurological changes due to the effect of sodium on cell function.

D. Cool, clammy skin: Cool, clammy skin is more often seen with hypovolemic shock or other conditions like sepsis or hypothermia, not hypernatremia.

A. Sodium polystyrene sulfonate (Kayexolate) B. Lactulose C. Acetylcysteine D. Potassium iodide

Correct Answer is A

Explanation

A. Sodium polystyrene sulfonate (Kayexalate): This medication is used to treat hyperkalemia (high potassium levels) by exchanging sodium ions for potassium ions in the intestines, which helps lower potassium levels. The client’s potassium level is dangerously high at 6.2 mEq/L, so this is the most appropriate treatment.

B. Lactulose: Lactulose is used to treat hyperammonemia in liver failure or constipation. It has no role in managing elevated potassium levels.

C. Acetylcysteine: Acetylcysteine is used to treat acetaminophen overdose or as a mucolytic. It is not indicated for hyperkalemia.

D. Potassium iodide: Potassium iodide is used to protect the thyroid from radiation exposure or to treat certain types of thyroid conditions, not for hyperkalemia.

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An older adult nursing home resident who has always been alert and oriented is now showing signs of dehydration and has become confused. Which electrolyte imbalance is most likely involved?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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