The nurse is caring for a client who is being treated on the oncology unit with a diagnosis of lung cancer with bone metastases. The client reports a new onset of weakness with abdominal pain and further assessment suggests that the client likely has a fluid volume deficit. The nurse should recognize that this client may be experiencing which electrolyte imbalance?
Hypomagnesemia
Hyperphosphatemia
Hypokalemia
Hypercalcemia
The Correct Answer is D
A. Hypomagnesemia: While hypomagnesemia can cause weakness and other symptoms, it is less commonly associated with fluid volume deficit compared to other imbalances in this context.
B. Hyperphosphatemia: Hyperphosphatemia is typically associated with renal failure or specific conditions, but it does not directly correlate with fluid volume deficit or the symptoms described.
C. Hypokalemia: Hypokalemia can cause weakness and abdominal pain, but it is less likely to be directly associated with the type of symptoms presented in this oncology context.
D. Hypercalcemia: This is the correct choice. Hypercalcemia, often associated with bone metastases, can lead to weakness, abdominal pain, and dehydration, as well as contribute to fluid volume deficit through increased urinary calcium excretion and renal effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Respiratory rate 24/min: A respiratory rate of 24/min indicates tachypnea, which can be a sign of ongoing fluid volume excess or other complications. This does not show effective treatment.
B. Blood pressure 138/86 mm Hg: While this blood pressure is within the higher range of normal, it does not specifically indicate effective treatment of fluid volume excess. Blood pressure alone is not a reliable indicator of fluid status.
C. Total urinary output 700 mL in 24 hours: A urinary output of 700 mL in 24 hours is below the normal range (typically 800-2000 mL per day) and suggests that the fluid volume excess has not been effectively treated. Adequate urinary output is a key indicator of effective fluid management.
D. Weight loss of 4 lb in 24 hours: A weight loss of 4 lb in 24 hours is a clear indicator that the client has lost excess fluid, which is the desired outcome in treating fluid volume excess. This demonstrates that the treatment has been effective in reducing fluid retention
Correct Answer is C
Explanation
A. Client's serum pH is 7.41: This is within the normal range for blood pH (7.35-7.45) and does not specifically indicate a potassium deficit.
B. Client has a stage 2 sacral wound: This is related to skin integrity and does not directly impact potassium levels.
C. Client requires continuous nasogastric suction: Continuous nasogastric suction can lead to the loss of potassium as it removes gastric contents, which may include electrolytes.
D. Client has a history of adrenal insufficiency: While adrenal insufficiency can affect electrolyte balance, continuous nasogastric suction is a more immediate risk for potassium deficit.
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