Mrs. Adams, a 63-year-old retired bookkeeper, comes to the emergency unit with complaints of nausea and vomiting, muscle weakness, and fatigue. Nursing assessment includes a blood pressure of 180/100 mmHg and a slow irregular pulse rate. ECG results show shortened QT intervals. Which of the following electrolytes is most likely elevated?
Explanation
Answer: B - An abnormal increase in serum calcium is causes muscle weakness, fatigue, nausea, vomiting, and dysrhythmias. Elevated serum calcium is manifested by lethargy, hypoactive deep tendon reflexes, and bradycardia. Episodes of pathologic fractures due to bone resorption may be noted in the history. Elevated serum potassium is manifested by muscle weakness that progresses to flaccid paralysis and paresthesias. The client with hyperkalemia may also complain of intestinal colic, cramps, and anxiety. ECG changes, such as tall T waves, prolonged PR intervals and QRS durations, ST depressions, and absent P waves, are usually seen in clients with hyperkalemia. Elevated serum sodium is characterized by dry swollen tongue, sticky mucous membranes, increased thirst, and hyperthermia. Increased serum magnesium is characterized by prolonged PR intervals and QRS, hypotension, drowsiness, depressed respiration, and hypoactive reflexes.
