As the nurse assesses a client’s laboratory values, the following are noted: Sodium 140 mEq/L, Magnesium 0.8 mEq/L, Chloride 107 mEq/L, Potassium 3.6 mEq/L. What electrolyte imbalance is indicated?

Choice A reason: Weight gain is associated with hypothyroidism, not hyperthyroidism. Hyperthyroidism increases metabolic rate, leading to weight loss due to increased calorie expenditure. The thyroid hormones accelerate metabolism, causing catabolism, which contrasts with the client’s likely symptom of weight loss, not gain, in hyperthyroidism.

Choice B reason: Bradycardia, or slow heart rate, occurs in hypothyroidism due to decreased metabolic rate. Hyperthyroidism causes tachycardia, as elevated thyroid hormones increase sympathetic activity, raising heart rate and cardiac output. The client’s symptoms would likely include a rapid heart rate, not bradycardia, in this condition.

Choice C reason: Heat intolerance is a classic symptom of hyperthyroidism due to increased metabolic rate from elevated thyroid hormones. This causes excessive heat production, leading to sweating and discomfort in warm environments. The symptom aligns with the hypermetabolic state, making it the most likely to be reported.

Choice D reason: Constipation is associated with hypothyroidism, where decreased metabolism slows gastrointestinal motility. Hyperthyroidism increases motility, often causing diarrhea. The client with hyperthyroidism is unlikely to report constipation, as their condition accelerates digestive processes, contrasting with the slowed motility seen in hypothyroidism.

Choice A reason: Urinary retention, the inability to empty the bladder, is unlikely with diuretics, which increase urine output. Diuretics reduce fluid volume by enhancing renal excretion, not causing retention. This concern is irrelevant, as the client’s increased output suggests effective diuresis, not bladder dysfunction or obstruction.

Choice B reason: Decreased fluid volume risk is a primary concern with diuretics, which increase urine output, potentially causing dehydration or electrolyte imbalances (e.g., hypokalemia). Education on fluid intake, monitoring weight, and recognizing dehydration symptoms is critical to prevent hypovolemia, ensuring safe diuretic use and maintaining physiological stability.

Choice C reason: Altered skin integrity may occur secondary to dehydration (dry skin) but is not the primary concern with diuretics. The main risk is fluid volume loss, which can lead to systemic complications like hypotension. Education should focus on fluid balance rather than skin, which is a secondary issue.

Choice D reason: Altered urinary elimination, such as incontinence, is not the primary concern, as diuretics increase output, not disrupt elimination patterns. While frequent urination may occur, the critical issue is fluid volume loss, which poses greater risks like dehydration or electrolyte imbalances, necessitating education on fluid management.