The nurse assessing a client hospitalized with a diagnosis of hypoparathyroidism notes positive Trousseau's and Chvostek's signs. The nurse determines that these findings most indicate which electrolyte imbalance?
Hypernatremia
Hypermagnesemia
Hypocalcemia
Hypokalemia
The Correct Answer is C
Rationale:
A. Hypernatremia, an elevated sodium level, does not cause Trousseau's or Chvostek's signs.
B. Hypermagnesemia, an elevated magnesium level, is not associated with positive Trousseau's and Chvostek's signs.
C. Hypocalcemia, a low calcium level, is commonly associated with positive Trousseau's and Chvostek's signs. Trousseau's sign is a carpopedal spasm induced by inflating a blood pressure cuff, while Chvostek's sign is facial twitching in response to tapping over the facial nerve. Both are indicative of neuromuscular irritability due to low calcium levels.
D. Hypokalemia, a low potassium level, does not cause these specific signs and is associated with different clinical manifestations.
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Correct Answer is C
Explanation
Rationale:
A. An increase in weight is typically a symptom of untreated or poorly managed hypothyroidism, not a therapeutic response.
B. A decrease in body temperature is associated with hypothyroidism, and an improvement in this condition should result in a normalization of temperature, not a decrease.
C. An increase in energy is a therapeutic response to liothyronine, as hypothyroidism often causes fatigue and low energy levels. Treatment with liothyronine should alleviate these symptoms and restore normal energy levels.
D. A decreased heart rate (bradycardia) is a symptom of hypothyroidism, and effective treatment should normalize the heart rate, not lower it further.
Correct Answer is A
Explanation
Rationale:
A. A rapid weight gain, such as a 5 lb increase in one day, is a strong indicator of fluid overload, particularly in clients with end-stage kidney disease. This excess fluid retention can lead to complications like pulmonary edema and congestive heart failure.
B. An oxygen saturation of 93% is slightly low but not a direct indicator of fluid overload; it may be related to other factors like anemia or underlying lung disease.
C. Normal skin turgor, where the skin returns to its previous position after being pinched, does not indicate fluid overload. In fluid overload, you might see pitting edema, where the skin does not return immediately.
D. Flattened neck veins would suggest a lack of fluid, not an overload. In fluid overload, you would expect to see distended neck veins (jugular venous distension).