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Labs

LAB	Result	Normal Range
Potassium	2.8 mEq/L	3.5-5.3mEq/L
Sodium	133 mEq/L	135-145 mEqL
Chloride	90 mEq/L	97-107 mEqL
Glucose	200 mg/dL	70mg/dL to 110mg/dL
Magnesium	2.5 mg/dL	1.6-2.2 mg/dL

Calcium

8.0 mg/dL

8.2-10.2 mg/dL:

The nurse observes the rhythm below for a client on the telemetry unit. Which laboratory value result would the nurse suspect contributed to the development of this dysrhythmia?

Sodium

Magnesium

Calcium

Potassium

Answer and Explanation

The Correct Answer is B

A.   Sodium is crucial for maintaining normal cellular function, especially for nerve impulses and muscle contractions. However, sodium imbalances typically affect the general function of the heart, and sodium abnormalities are not commonly associated with torsades de pointes, which is a type of polymorphic ventricular tachycardia.
B.   Magnesium plays a critical role in the electrical stability of the heart and helps regulate potassium and calcium channels, which are involved in the cardiac action potential. Hypomagnesemia (low magnesium) is a well-known risk factor for torsades de pointes, a specific type of polymorphic ventricular tachycardia that is associated with QT interval prolongation. In this case, the magnesium level is 2.5 mg/dL, which is above the normal range (1.6-2.2 mg/dL), suggesting hypermagnesemia.
C.   Calcium is vital for proper muscle function, including the heart muscle, and is essential for electrical conduction. Hypocalcemia (low calcium) can lead to QT interval prolongation, which in turn increases the risk for arrhythmias such as torsades de pointes. However, in this case, the calcium level is 8.0 mg/dL, which is only slightly below the normal range (8.2-10.2 mg/dL), making calcium a less likely primary contributor to torsades de pointes in this situation.
D.   Potassium plays a crucial role in regulating the resting membrane potential and action potentials in cardiac cells. Hypokalemia (low potassium) can lead to QT prolongation and increase the risk of arrhythmias, including torsades de pointes. However, in this case, the potassium level is 2.8 mEq/L, which is low (normal range: 3.5-5.3 mEq/L), and hypokalemia is more commonly associated with arrhythmias such as torsades de pointes than hyperkalemia (high potassium).

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Correct Answer is ["13.8"]

Explanation

The patient weighs 121 lbs, which is approximately 55 kg (121 ÷ 2.2).

The prescribed dose is 1 mg/kg, so the patient requires 55 mg of furosemide. The medication is supplied at a concentration of 40 mg per 10 mL.

To find out how many mL of furosemide to administer, set up a proportion: 40 mg is to 10 mL as 55 mg is to X mL.

Therefore, the nurse should administer 13.8 mL of furosemide, rounding to the nearest tenth.

A. Consume 2500mL of fluids per day during the summer months B. Maintain daily sodium intake of no more than 2gm per day C. Notify the health care provider if weight increases by 5 Ibs. in one week D. If shortness of breath occurs with minimal activity, notify the provider E. Take furosemide anytime when feeling bloated or short of breath

Correct Answer is ["B","C","D"]

Explanation

A. Fluid intake may need to be regulated in heart failure patients, consuming 2500mL of fluids per day may be too high for some patients, depending on their condition and whether they are on fluid restriction. Fluid management should be individualized, and the provider should specify the amount based on the patient's condition.
B. A low-sodium diet is essential for heart failure patients to help reduce fluid retention, decrease blood pressure, and lessen the burden on the heart. The American Heart Association recommends a sodium intake of no more than 2,000-2,300 mg per day for heart failure patients.
C. Rapid weight gain is a sign of fluid retention, which can indicate worsening heart failure. A gain of 2-3 pounds in a single day or 5 pounds in a week should prompt the client to contact their healthcare provider for further evaluation.
D. Shortness of breath with minimal activity can be a sign of worsening heart failure or fluid overload. This symptom should be reported immediately to a healthcare provider for further evaluation and possible adjustments to treatment.
E. Furosemide (a diuretic) is often prescribed to reduce fluid retention but it should not be taken without proper guidance or as a response to symptoms without consulting the healthcare provider. Taking diuretics at the wrong time or in excessive amounts can lead to dehydration and electrolyte imbalances, which could worsen the condition.

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			Male: 14- 17.3 g/dL
Hematocrit	26%	24%	Female: 36%-48% Male: 42%-52%
Platelets	35,000mm3	20,000mm3	150,000- 450,000mm3
RBC	4.5 mm3	3mm3	Female: 4.01-5.51 million/mm3 Male: 4.51-

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Naxlex Comprehensive Predictor Exams

A patient is ordered 1 mg/kg of furosemide IV push. The patient weights 121 Ibs. The medication is supplied 40 mg/10 mL. How many mL should the nurse administer? (round to the nearest tenth)

Correct Answer is ["13.8"]

Explanation

The nurse is providing discharge instructions for the client diagnosed with heart failure. Which information should the nurse provide to assist the client to limit complications and prevent future hospitalizations? (SELECT ALL THAT APPLY).

Correct Answer is ["B","C","D"]

Explanation

The nurse has provided teaching to a client who had an implantable cardioverter/defibrillator inserted. Which statement by the client indicates the need for further instruction?

The nurse is caring for a client who received a transfusion of Fresh Frozen Plasma (FFP) for an acute GI bleed related to accidental wantarin overdose. Which laboratory result would indicate the need for an additional unit of Fresh Frozen Plasma (FFP) to correct the problem caused by the overdose?

The nurse notes that the client's rhythm strip indicates a PR-interval of 0.28 seconds. What is the nurse's analysis of this problem?

The nurse would assess the client diagnosed with disseminated intravascular coagulation (DIC) for which manifestation of the disorder?

The client with heart failure exhibits bibasilar crackles, dyspnea and a respiratory rate of 26/min. The physician prescribes furosemide 40 mg IV. Which parameter would the nurse use to best evaluate if the client is responding to this medication?

The nurse administers atropine 0.5 mg IV to a client. Which action should be performed after the client has received this medication?

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