Which client electrocardiography (ECG) change from baseline will alert the nurse to possible development of hypercalcemia?

Choice A reason: Initiating antibiotics is critical but follows cultures to identify the causative organism. Obtaining cultures first ensures accurate treatment, making this incorrect, as it risks altering culture results if antibiotics are given before sampling in the pneumonia client.

Choice B reason: Obtaining blood and sputum cultures first identifies the pneumonia-causing organism, guiding effective antibiotic therapy. This aligns with infection management protocols, making it the correct initial order to implement for the client admitted with pneumonia to ensure accurate treatment.

Choice C reason: Airborne precautions are needed for specific pneumonias (e.g., tuberculosis), but most require droplet precautions. Cultures guide treatment, making this incorrect, as it’s less urgent than obtaining cultures first to confirm the pathogen in the client with pneumonia.

Choice D reason: An indwelling catheter is unnecessary for pneumonia unless urinary retention is present. Obtaining cultures is the priority, making this incorrect, as it’s irrelevant to the immediate management of the client’s infection compared to identifying the causative organism.

Choice A reason: Hypercalcemia shortens the QT interval on ECG due to accelerated cardiac repolarization. This aligns with electrolyte-related cardiac monitoring, making it the correct change the nurse would recognize as indicating possible hypercalcemia in the client’s electrocardiography assessment.

Choice B reason: Inverted T waves suggest ischemia or hypokalemia, not hypercalcemia, which shortens the QT interval. This is incorrect, as it doesn’t align with the nurse’s expected ECG change for hypercalcemia compared to the characteristic shortened QT interval.

Choice C reason: Prominent U waves are associated with hypokalemia, not hypercalcemia, which affects the QT interval. Shortened QT is correct, making this incorrect, as it’s unrelated to the nurse’s monitoring for hypercalcemia’s ECG changes in the client.

Choice D reason: Absent P waves indicate atrial fibrillation, not hypercalcemia, which shortens the QT interval. This is incorrect, as it doesn’t reflect the nurse’s anticipated ECG change for hypercalcemia, unlike the characteristic shortened QT interval in the client’s monitoring.