The nurse is aware that the most important electrolyte to monitor in a patient with cirrhosis is:
Chloride
Calcium
Sodium
Potassium
The Correct Answer is C
Choice A reason: Chloride levels are less critical in cirrhosis compared to sodium. Chloride imbalances may occur secondary to diuretic use or acid-base disturbances, but they do not directly drive major complications like ascites or edema. Monitoring is less urgent, as chloride fluctuations are typically managed indirectly through fluid and electrolyte balance.
Choice B reason: Calcium levels are not the primary concern in cirrhosis. Hypocalcemia may occur due to malnutrition or vitamin D deficiency from liver dysfunction, but it is less immediate than sodium imbalances. Calcium affects bone health and muscle function but does not directly impact acute cirrhosis complications like ascites.
Choice C reason: Sodium is critical to monitor in cirrhosis due to its role in fluid balance. Hyponatremia, common in advanced cirrhosis, results from impaired water excretion and portal hypertension, contributing to ascites and edema. Dilutional hyponatremia can worsen encephalopathy or indicate decompensation, requiring urgent management to stabilize the patient.
Choice D reason: Potassium monitoring is important, especially with diuretic use in cirrhosis, as hypokalemia or hyperkalemia can occur. However, sodium imbalances more directly influence fluid retention and ascites, making it a higher priority. Potassium affects cardiac and muscle function but is secondary to sodium in acute cirrhosis management.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: A blood pH of 7.45 is normal or slightly alkalotic, not indicative of DKA, which causes metabolic acidosis due to ketone accumulation. DKA typically presents with a pH below 7.35, reflecting acid-base imbalance from ketoacid production, making this finding inconsistent with DKA.
Choice B reason: A serum bicarbonate of 12 mEq/L indicates metabolic acidosis, a hallmark of DKA. Ketoacids produced from fat metabolism in uncontrolled hyperglycemia consume bicarbonate, lowering its levels, confirming DKA’s acid-base disturbance and making this the most indicative laboratory finding.
Choice C reason: A blood glucose of 200 mg/dL is elevated but not specific to DKA, which typically involves glucose levels above 250 mg/dL, often much higher. This level could indicate hyperglycemia but does not confirm the severe metabolic acidosis characteristic of DKA.
Choice D reason: Serum potassium of 5.5 mEq/L suggests hyperkalemia, common in DKA due to acidosis shifting potassium extracellularly. However, it is less specific than low bicarbonate, as hyperkalemia can occur in other conditions, and bicarbonate directly reflects DKA’s acidotic state.
Correct Answer is C
Explanation
Choice A reason: Applying lotion between toes is discouraged in diabetes, as moisture in interdigital spaces promotes fungal infections, exacerbated by poor wound healing and neuropathy. Dry skin should be managed with lotion on other foot areas, making this statement incorrect for proper foot care.
Choice B reason: Wearing sandals increases injury risk in diabetic patients with neuropathy, as open footwear exposes feet to trauma and infections. Protective, closed-toe shoes are recommended to prevent cuts or ulcers, which heal poorly in diabetes, indicating this statement reflects misunderstanding.
Choice C reason: Daily foot inspections for sores and bruises are critical in type 1 diabetes to detect early injuries, as neuropathy reduces sensation and poor glycemic control impairs healing. Early identification prevents infections or ulcers, making this statement correct and reflective of proper foot care practices.
Choice D reason: Soaking feet in warm, soapy water is not recommended, as prolonged soaking can macerate skin, increasing infection risk in diabetic patients with impaired healing. Brief washing and thorough drying are preferred, making this statement incorrect for safe diabetic foot care practices.
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