The nurse is caring for client who has had partial removal the parathyroid gland. The client reports numbness and tingling of the hands and fingers. Which lab value would the nurse expect to see?
Chloride 112
Calcium 7.5
Potassium 4.0
Calcium 12.1
The Correct Answer is B
A) Chloride 112:
Chloride levels are typically not directly associated with numbness or tingling of the hands and fingers. Elevated chloride levels (greater than 108 mEq/L) may indicate metabolic acidosis, but they would not directly explain the symptoms seen in this client following parathyroidectomy. Therefore, this value is unlikely to be relevant in this scenario.
B) Calcium 7.5:
After the partial removal of the parathyroid glands, the client may experience hypocalcemia, or low calcium levels, due to the reduced production of parathyroid hormone (PTH). PTH helps regulate calcium levels in the blood. When the parathyroid glands are removed or damaged, there may be insufficient PTH to maintain normal calcium levels, leading to hypocalcemia. Symptoms of hypocalcemia include numbness and tingling, especially in the hands and fingers. A calcium level of 7.5 mg/dL is below the normal range (8.5–10.5 mg/dL), indicating hypocalcemia, which is consistent with the patient's symptoms.
C) Potassium 4.0:
A potassium level of 4.0 mEq/L is within the normal range (3.5–5.0 mEq/L) and does not typically cause numbness or tingling. Although potassium imbalances can cause neuromuscular symptoms, they would not be the most likely cause of the symptoms in this case, especially in relation to parathyroidectomy.
D) Calcium 12.1:
A calcium level of 12.1 mg/dL is elevated and would suggest hypercalcemia. Hypercalcemia can cause symptoms like fatigue, confusion, and weakness, but it does not typically cause numbness and tingling in the hands and fingers. Elevated calcium levels are more likely to occur in conditions such as hyperparathyroidism or malignancy, not typically following parathyroid gland removal. Therefore, this is not the expected lab result in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Provide a dedicated area for the nurse to prepare medications:
Having a dedicated, quiet area for preparing medications is crucial for reducing the risk of medication errors. A designated space minimizes distractions, ensures proper organization, and allows the nurse to focus on the task at hand, which can help prevent mistakes. It also supports a more organized environment where medications can be checked for accuracy, labels can be read carefully, and correct dosages can be administered. This is the best practice to reduce medication errors.
B) Wait to document medications given to clients until the end of a shift:
Delaying the documentation of medications until the end of a shift increases the risk of forgetting to document or making errors. Medications should be documented immediately after administration to ensure accuracy and prevent omissions. Immediate documentation also provides real-time updates on the client's medication history and avoids any discrepancies between what was actually administered and what is recorded.
C) Remove medications from automatic dispensing systems before they are reviewed by pharmacists:
Removing medications from automatic dispensing systems before they are reviewed by pharmacists increases the risk of errors. Medications should be reviewed by the pharmacist to ensure proper drug selection, dosage, and appropriateness for the patient's condition. Pharmacists play an essential role in medication safety, and bypassing their review increases the likelihood of incorrect medication administration, potentially leading to harmful consequences.
D) Prepare medications for multiple clients at the same time:
Preparing medications for multiple clients simultaneously is risky and can lead to confusion and errors. Nurses should focus on preparing medications for one patient at a time to ensure that the correct medication and dosage are administered to the correct person. This practice reduces the likelihood of mixing up medications or administering the wrong drug or dosage.
Correct Answer is C
Explanation
A) SOAP documentation:
SOAP (Subjective, Objective, Assessment, Plan) documentation is a method used for organizing and documenting client information. It focuses on both subjective and objective data, as well as the assessment and plan. While SOAP helps structure the documentation of patient conditions and interventions, it does not specifically focus on documenting only unexpected findings. It is a more comprehensive approach that includes normal and abnormal findings, not just the unexpected ones.
B) Focus charting (DAR):
Focus charting (DAR) is based on a client-centered approach and uses the components of Data, Action, and Response. It is a way of documenting observations and interventions, particularly in relation to specific patient problems or conditions. Focus charting is more about the care provided, responses to interventions, and client outcomes. While it may include unexpected findings, it doesn’t limit documentation exclusively to abnormal or unexpected events.
C) Charting by exception (CBE):
Charting by exception (CBE) is a documentation method that focuses on recording only the significant deviations from the norm. It emphasizes noting any abnormal or unexpected findings, and everything that is normal is assumed to be within expected limits and not documented. This method reduces the amount of documentation by excluding routine information and only highlighting significant, unexpected findings. Therefore, CBE is the correct answer in this scenario, as it involves documenting only unexpected or abnormal findings related to the client's condition.
D) Problem-oriented medical record (POMR):
POMR is a method of documentation that organizes client care around specific problems or diagnoses. It includes the identification of problems, interventions, and outcomes. While POMR focuses on client problems and plans of care, it does not specifically focus on documenting only unexpected findings. It may include both normal and abnormal findings related to each identified problem.
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