NURS 380 Exam 1 Study Guide Blueprint Questions With
Complete Solutions
Hypercalcemia Correct Answers Clinical Manifestations
- bradycardia, hypertension, thirst, lethargy, muscle
weakness/soreness, abdominal discomfort, constipation,
decreased deep tendon reflexes, anorexia, nausea, vomiting,
confusion, renal calculi, renal failure
Treatment
- stabilization/reduction of calcium levels, hydration with 0.9%
NaCl, dialysis, IV bisphosphonates, calcitonin, treatment of
malignancy, removal of parathyroid gland
Interventions
- assessment/monitoring of cardiac rhythm and mental status,
encourage early/frequent ambulation, encourage hydration
Hyperchloremia Correct Answers Clinical Manifestations
- deep, rapid respirations, lethargy, tachypnea, decreased
cognitive ability, elevated blood pressure
Treatment
- management of underlying causes, correction of acid-base,
fluid, and electrolyte disturbance, hypotonic IV solutions,
sodium bicarbonate infusion, limiting fluids containing sodium
and chloride
Interventions
- assessment, patient education (avoid foods such as processed
meats, canned veggies, eggs, bananas, cheese, and milk)
Hyperkalemia Correct Answers Clinical Manifestations
- generalized fatigue, muscle cramps, palpitations, paresthesias,
weakness, ECG changes, cardiac arrest
,Treatment
- obtain ECG, serial serum potassium levels, dialysis, dietary
modifications, calcium administration, correction of metabolic
acidosis, IV dextrose and insulin administration, inhaled
albuterol, loop diuretics, kayexalate
Interventions
- assessment, monitoring/reporting lab values, continuous
cardiac monitoring and ECG, administering medications as
ordered, patient education (how to limit foods high in
potassium)
Hypermagnesemia Correct Answers Clinical Manifestations
- hypotension, cardiac dysrhythmias, heart blocks, asystole,
drowsiness, lethargy, muscle weakness, loss of deep tendon
reflexes, paralysis, coma, decreased respiratory rate, respiratory
arrest, increased risk of bleeding
Treatment
- identify/treat cause, cessation of magnesium supplements, loop
diuretics, hydration, supportive care, hemodialysis, calcium
gluconate administration
Interventions
- assessment, monitor vital signs, patient education (diet,
medications)
Hypernatremia Correct Answers Clinical Manifestations
- thirst, signs of dehydration, nonspecific neurological changes
(neuromuscular irritability, agitation, restlessness, lethargy,
coma, seizure), severe- hallucinations, delusions, disorientation
Treatment
- limiting sodium intake, replacing water deficits
Interventions
, - monitor intake/output, ensuring adequate water intake, monitor
daily weight, monitor serum sodium
Hyperphosphatemia Correct Answers Clinical Manifestations
- positive Chvostek or Trousseau sign, soft tissue calcification,
tetany, bone/joint pain, muscle weakness, anorexia, paresthesias,
delirium, convulsions, seizures, coma, hypotension, heart
failure, prolonged QT interval
Treatment
- identify/treat underlying cause, IV hydration, loop diuretics,
correction of hypocalcemia, dialysis, limiting phosphorus-
containing foods, phosphate binders
Interventions
- assessment/monitoring, patient and family education
Hypocalcemia Correct Answers Clinical Manifestations
- excitability of nerves/muscles, smooth muscle spasms,
prolonged QT interval, decreased myocardial contractility,
anxiety, confusion, irritability, positive Trousseau and Chvostek
sign
Treatment
- protection/maintenance of airway, cardiac monitoring, IV
access, IV replacement of calcium, treat other electrolyte
abnormalities, especially magnesium, oral calcium/vitamin D
supplements
Interventions
- assessment, maintain access to emergency equipment, seizure
precautions, maintain quiet environment, patient education,
encourage smoking cessation, encourage limiting caffeine and
alcohol