The nurse working in the PACU is aware that which of the following procedures may contribute to extracellular losses?

Correct Answer: C

Rationale: In the context of a PACU (Post-Anesthesia Care Unit), the nurse must be knowledgeable about procedures that may lead to extracellular losses. Abdominal surgery, the correct answer, can contribute to extracellular losses due to the potential for fluid shifts, blood loss, and third spacing of fluids during the procedure. This can result in a decrease in circulating blood volume and extracellular fluid. In contrast, options A, B, and D, which involve localized procedures like toenail removal, tooth extraction, and cataract surgery, are less likely to lead to significant extracellular losses as compared to a major abdominal surgery. Educationally, this question highlights the importance of understanding how different surgical procedures can impact fluid and electrolyte balance in patients. It underscores the need for nurses in the PACU to monitor patients for signs of fluid shifts and losses, especially after major surgeries that can significantly affect extracellular fluid volume. This knowledge is crucial for providing safe and effective postoperative care and ensuring optimal patient outcomes.

Correct Answer: D

Rationale: In the context of medical surgical nursing, understanding the importance of potassium in maintaining proper physiological function is crucial. Potassium is an essential electrolyte that plays a key role in nerve transmission, muscle function, and maintaining fluid balance within the body. In the scenario provided where a patient has a slight decrease in potassium levels, dietary interventions can be an effective way to increase potassium levels. Among the options provided, bananas are a good source of potassium. Bananas are rich in potassium, with one medium-sized banana containing approximately 400-450 mg of potassium. Consuming bananas can help replenish potassium levels in the body naturally. As for the other options: - Apples, while a healthy fruit choice, are not particularly high in potassium compared to bananas. - Asparagus is a nutritious vegetable but is not as rich in potassium as bananas. - Carrots are also a healthy vegetable choice but do not contain significant amounts of potassium compared to bananas. In a clinical setting, it is important for nurses to educate patients on appropriate dietary choices to manage electrolyte imbalances. Encouraging patients to consume potassium-rich foods like bananas can be an effective and safe way to address mild hypokalemia without the need for pharmacological interventions, aligning with the principle of holistic patient care and promoting overall health and well-being.

Correct Answer: A

Rationale: In a patient with alcoholism, hypomagnesemia is a common electrolyte imbalance due to poor dietary intake, malabsorption, and increased renal excretion. The correct answer is A) Tremor because low serum magnesium levels can lead to neuromuscular irritability, causing tremors, muscle cramps, and hyperactive deep tendon reflexes. These symptoms are indicative of hypomagnesemia and should alert the nurse to the need for further assessment and intervention. Option B) Pruritus is incorrect because itching is not typically associated with hypomagnesemia. It is more commonly seen in conditions like liver disease or chronic kidney disease. Option C) Edema is incorrect because hypomagnesemia is not directly associated with fluid retention. Edema is more commonly seen in conditions like heart failure or renal disease. Option D) Decreased blood pressure is incorrect because hypomagnesemia is more likely to cause hypertension rather than hypotension. Low magnesium levels can lead to increased vascular tone and vasoconstriction, resulting in elevated blood pressure. Educationally, understanding the manifestations of electrolyte imbalances like hypomagnesemia is crucial for nurses to provide safe and effective care. Recognizing these signs and symptoms allows for timely interventions and prevents potential complications associated with untreated electrolyte abnormalities.

Correct Answer: C

Rationale: In medical-surgical nursing, understanding electrolyte imbalances is crucial for providing safe and effective patient care. In this scenario, a positive Chvostek's sign indicates hypocalcemia. Chvostek's sign is a facial muscle spasm elicited by tapping the facial nerve in front of the ear, which is a classic indicator of hypocalcemia. Option A, hypermagnesemia, is incorrect because high magnesium levels do not typically manifest with Chvostek's sign. Option B, hypomagnesemia, is incorrect as low magnesium levels can lead to neuromuscular symptoms but not specifically Chvostek's sign. Option D, hyperkalemia, does not typically present with Chvostek's sign but rather with cardiac manifestations like peaked T waves on an ECG. Understanding the relationship between electrolyte imbalances and clinical manifestations like Chvostek's sign is essential for nurses to promptly recognize and intervene in such situations. It ensures timely and appropriate treatment to prevent complications and improve patient outcomes.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Elevated U wave. Hypokalemia, a low potassium level in the blood, can lead to various ECG abnormalities. One of these abnormalities is the elevation of the U wave, which is a small waveform following the T wave. This elevation can be seen in patients with hypokalemia and can indicate an increased risk of cardiac arrhythmias. Option A) Shortened P-R interval is not typically associated with hypokalemia but can be seen in conditions like hyperkalemia. Option B) Inverted T wave is commonly seen in patients with ischemia or myocardial infarction, not specifically in hypokalemia. Option C) Depressed U wave is not a common ECG finding in hypokalemia. It is more often associated with conditions like hypomagnesemia. Educationally, understanding ECG abnormalities in relation to electrolyte imbalances is crucial for nurses caring for patients with cardiac issues. Recognizing these changes promptly can lead to timely interventions and improved patient outcomes. It highlights the importance of monitoring electrolyte levels and ECG changes in patients with heart failure or other cardiac conditions.