Which serum electrolyte value alerts the nurse to the possibility of hyperaldosteronism?

Serum sodium, 150 mmol/L; serum potassium, 2.5 mmol/L

Serum sodium, 140 mmol/L; serum potassium, 5.0 mmol/L

Serum sodium, 130 mmol/L; serum potassium, 7.5 mmol/L

Serum sodium, 130 mmol/L; serum potassium, 2.5 mmol/L

Answer and Explanation

The Correct Answer is A

A. Hyperaldosteronism causes sodium retention and potassium excretion, leading to elevated serum sodium levels and low potassium levels. A serum potassium level of 2.5 mmol/L is indicative of hypokalemia, which is a classic finding in hyperaldosteronism.
B. This serum electrolyte pattern (normal sodium and potassium) is not suggestive of hyperaldosteronism.
C. In hyperaldosteronism, the serum sodium is typically elevated, but the potassium level is very low, not elevated as seen in this option.
D. While low potassium is indicative of hyperaldosteronism, the sodium level is abnormally low in this case, which is not typical for this condition. Hyperaldosteronism typically presents with elevated sodium.

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Correct Answer is C

Explanation

A. The head of the bed should be elevated to at least 30-45 degrees to help prevent aspiration and reduce the risk of ventilator-associated pneumonia (VAP). Flat positioning increases the risk of aspiration and subsequent pneumonia.
B. Humidification is important for preventing drying of the respiratory passages but does not directly reduce the risk of VAP.
C. Turning the client every 2 hours (not just 4) is a key practice to prevent VAP by improving lung expansion, promoting drainage, and reducing the risk of ventilator-associated pneumonia.
D. Oral care, including brushing the teeth, should be done more frequently than every 12 hours. The current guidelines recommend brushing the client's teeth every 4-6 hours and using suctioning as needed to prevent oral bacterial buildup that can lead to VAP.

A. Peak flow of more than 40% B. Bradycardia C. Loud and prominent wheezing D. Arterial blood gas is deteriorating

Correct Answer is D

Explanation

A. A peak flow of more than 40% would indicate that the patient's asthma is not in an acute exacerbation. This patient's symptoms, such as confusion and inability to speak, suggest a severe asthma attack, and the peak flow would likely be much lower.
B. Bradycardia is not typically associated with severe asthma exacerbations. Tachycardia is more commonly observed as the body attempts to compensate for hypoxia.
C. Loud and prominent wheezing is usually seen in less severe cases of asthma. In this case, the inability to speak and confusion suggest severe respiratory distress, where wheezing might be diminished or absent due to poor air movement.
D. Deteriorating arterial blood gas (ABG) results, with low oxygen levels (hypoxemia) and elevated carbon dioxide levels (hypercapnia), would be expected in a patient with severe asthma exacerbation. These signs indicate respiratory failure and the need for urgent intervention.

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Which serum electrolyte value alerts the nurse to the possibility of hyperaldosteronism?

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Naxlex Comprehensive Predictor Exams

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