A nurse assesses a client who is prescribed a medication that inhibits aldosterone secretion and release. For which potential complications should the nurse assess? (Select all that apply.)

Correct Answer: A

Rationale: Step-by-step rationale for why option A is correct: 1. Inhibition of aldosterone secretion leads to decreased sodium reabsorption and increased water excretion. 2. Decreased aldosterone can result in decreased blood volume and BP, leading to decreased urine output. 3. Monitoring urine output is crucial to assess renal function and fluid balance. 4. A urine output of 25 mL/hr is considered inadequate and can indicate renal impairment or dehydration. Summary: Option A is correct as it directly relates to the mechanism of action of inhibiting aldosterone secretion. Options B, C, and D are incorrect as they do not align with the expected complications of aldosterone inhibition.

Correct Answer: C

Rationale: The correct answer is C. The client's high serum potassium level of 7.5 mEq/L can lead to serious cardiovascular complications like arrhythmias. The immediate priority is to lower potassium levels rapidly to prevent cardiac arrest. Administering dextrose 20% and regular insulin IV push helps shift potassium from extracellular to intracellular space, lowering serum levels quickly. Option A (Kayexalate) is not as rapid as insulin therapy. Option B (low-potassium diet) is not immediate. Option D (hemodialysis) is effective but not as quick as insulin therapy for urgent potassium reduction.

Correct Answer: D

Rationale: The correct answer is D: Decrease in glomerular filtration. Sympathetic stimulation constricts renal arterioles, leading to decreased blood flow to the kidneys. This reduction in blood flow decreases the glomerular filtration rate, impacting the kidney's ability to filter blood and produce urine. The constriction of renal arterioles does not directly affect the release of aldosterone (choice A), filtration in the Loop of Henle (choice B), or the reabsorption of sodium (choice C). The primary effect of sympathetic stimulation on renal arterioles is to decrease glomerular filtration by reducing blood flow to the kidneys.

Correct Answer: A

Rationale: The correct answer is A: Client with pancreatitis who has continuous nasogastric suctioning. Pancreatitis can lead to gastrointestinal losses of potassium, and continuous nasogastric suctioning can further exacerbate this potassium loss, putting the client at risk for hypokalemia. The other choices are incorrect because: B: ACE inhibitors can cause hyperkalemia, not hypokalemia. C: Blood transfusions can lead to hyperkalemia due to the potassium content in blood products. D: Uncontrolled diabetes and a serum pH level of 7.33 are not directly associated with hypokalemia.

Correct Answer: C

Rationale: Rationale: Option C is correct because berries, cherries, apples, and peaches are indeed low in potassium compared to other fruits. This response acknowledges the client's love for fruits while providing suitable alternatives to manage potassium levels. By choosing these low-potassium fruits, the client can continue enjoying fruits without exacerbating hyperkalemia. Incorrect options: A: Potatoes and avocados are high in potassium, so they are not suitable substitutes. B: Cooking fruit does not significantly reduce its potassium content. D: This option lacks guidance and does not offer a solution to the client's concern about high potassium levels.

Correct Answer: B

Rationale: The correct answer is B because limiting fluids can lead to dehydration, which can cause confusion and dry mucous membranes. Adjusting the timing of fluids can help maintain hydration without causing frequent nighttime bathroom trips. Choice A is incorrect because hospital readmission is not necessary at this point. Choice C is incorrect as it normalizes confusion post-surgery and dangerous practice of avoiding urination at night. Choice D is incorrect because urine accumulation in the bladder does not directly cause confusion; dehydration is the primary concern.

Correct Answer: B

Rationale: The correct answer is B: Hypocalcemia. Following a thyroidectomy, there is a risk of damaging the parathyroid glands, leading to hypocalcemia. Symptoms such as tingling in lips and fingers, muscle spasms, and increased muscle tone are classic signs of hypocalcemia. The initial concern should be hypocalcemia due to its potential to cause serious complications such as tetany and laryngospasm. Options A, C, and D are incorrect as they do not align with the symptoms described. Hypophosphatemia may present with weakness and respiratory failure, hypermagnesemia with hypotension and respiratory depression, and hyperkalemia with muscle weakness and cardiac arrhythmias.

Correct Answer: B

Rationale: The correct answer is B: Report of headache and stiff neck. This finding indicates a potential complication of epidural anesthesia called a post-dural puncture headache, which can lead to serious consequences like meningitis or subdural hematoma. The nurse should act immediately by notifying the healthcare provider for further evaluation and management. Redness at the catheter insertion site (A) may indicate local inflammation but doesn't require immediate intervention. Temperature elevation (C) could be a sign of infection but isn't as urgent as a headache and stiff neck. Pain rating of 8 (D) is important but doesn't indicate an immediate threat to the client's health like a post-dural puncture headache.

Correct Answer: D

Rationale: To interpret the given ABG results: 1. pH <7.35 indicates acidosis. 2. PaCO2 <35 indicates respiratory alkalosis. 3. HCO3 <22 indicates metabolic acidosis. Therefore, the ABG results show metabolic acidosis (low pH, low HCO3) with compensatory respiratory alkalosis (low PaCO2). This means the body is trying to compensate for the metabolic acidosis by decreasing PaCO2 through hyperventilation. Option D is correct. Options A, B, and C are incorrect as they do not align with the ABG results and the principles of acid-base balance.