Use Case Study to answer the following questions.

Exhibits

Which of the following assessment findings is most concerning in a patient with hypokalemia?

Flattened T waves on ECG

Muscle cramps

Fatigue

Decreased bowel sounds

Answer and Explanation

The Correct Answer is A

Rationale:

A. This is an early and potentially serious sign of cardiac involvement in hypokalemia. It can lead to life-threatening arrhythmias such as ventricular tachycardia or fibrillation. Continuous cardiac monitoring is essential in patients with low potassium levels.

B. Muscle cramps – Common in hypokalemia due to muscle cell irritability, but not immediately life-threatening like cardiac effects.

C. Fatigue is a general symptom of hypokalemia, but nonspecific and not as critical as ECG changes.

D. Decreased bowel sounds – Reflects reduced smooth muscle activity (hypokalemia can slow GI motility), but this is also less critical than cardiac dysrhythmias.

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Correct Answer is D

Explanation

Rationale:

A. Hemoglobin is important for evaluating oxygen-carrying capacity and detecting anemia, but spironolactone does not directly affect hemoglobin levels. This value is not a priority for monitoring the effects of spironolactone.

B. Cholesterol levels are relevant for assessing cardiovascular risk, but spironolactone does not significantly impact lipid profiles. Therefore, total cholesterol is not the most important lab to monitor for this medication.

C. TSH is used to evaluate thyroid function. Spironolactone does not influence thyroid hormones or TSH levels, so this value is unrelated to the medication’s expected effects or complications.

D. Spironolactone is a potassium-sparing diuretic. It works by antagonizing aldosterone in the distal tubule, leading to retention of potassium. This can result in hyperkalemia, especially in older adults or those with renal impairment. Monitoring serum potassium is essential to prevent life-threatening arrhythmias and other complications.

A. A 7-year-old child who has diabetes insipidus and a urine specific gravity of 1.002 B. A 4-year-old preschooler who has status asthmaticus and a pulse oximetry of 95% C. A 1-year-old infant who has roseola and a temperature of 39°C (102.2°F) D. A 10-year-old child who has sickle cell anemia and a pain rating of 6 on a 0 to 10 scale.

Correct Answer is A

Explanation

Rationale:
A. Diabetes insipidus can lead to profound dehydration due to excessive fluid loss. A urine specific gravity of 1.002 indicates very dilute urine, supporting the concern. This child is at immediate risk for hypovolemic shock, so the nurse should assess them first.
B. A pulse oximetry of 95% is within acceptable range for a child with asthma, suggesting no acute distress at this time.
C. Roseola with a fever of 39°C is expected; while monitoring is needed, it's not the highest priority.
D. Pain of 6/10 in sickle cell anemia is concerning and requires attention, but it is not as emergent as potential fluid imbalance in diabetes insipidus.

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Use Case Study to answer the following questions. Exhibits Which of the following assessment findings is most concerning in a patient with hypokalemia?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Use Case Study to answer the following questions.

Exhibits

Which of the following assessment findings is most concerning in a patient with hypokalemia?