A client received a first dose of cyanocobalamin (Nascobal) 2 ...

[evelyn o bentley]

A client received a first dose of cyanocobalamin (Nascobal) 2 days ago. The nurse is monitoring the client's electrolytes because of the possibility of which clinical manifestation?
 
  1. A marked decrease in serum osmolality and the risk of cerebral edema.
  2. A marked decrease in calcium and the risk of tetany.
  3. A marked decrease in potassium and the potential for dangerous dysrhythmias.
  4. A decrease in sodium and the potential for renal failure.

Question 2

Mild folate deficiency can be managed with dietary interventions. Which foods would the nurse recommend?
 
  1. Lean meat, cheese, and milk
  2. Bread and pastas, dried beans, and fresh greens
  3. Strawberries, melon, and blueberries
  4. Fresh citrus fruits

[Joc]

Answer to Question 1

Correct Answer: 3
Rationale 1: Cyanocobalamin does not decrease serum osmolality.
Rationale 2: Cyanocobalamin does not affect calcium levels.
Rationale 3: Cyanocobalamin can cause potassium levels to drop, which can lead to marked hypokalemia with the risk of lethal dysrhythmia.
Rationale 4: Cyanocobalamin can cause sodium retention with possible worsening of heart failure.
Global Rationale: Cyanocobalamin can cause potassium levels to drop, which can lead to marked hypokalemia with the risk of lethal dysrhythmia. Cyanocobalamin does not decrease serum osmolality or affect calcium levels. Cyanocobalamin can cause sodium retention with possible worsening of heart failure.

Answer to Question 2

Correct Answer: 2
Rationale 1: Meat and dairy products are not good sources of folic acid.
Rationale 2: Whole grains, dried beans, and fresh green vegetables are good sources of folic acid.
Rationale 3: Berries and melons are not good sources of folic acid.
Rationale 4: Fresh citrus fruits are not good sources of folic acid.
Global Rationale: Whole grains, dried beans, and fresh green vegetables are good sources of folic acid. Meat and dairy products, berries and melons, and fresh fruits are not good sources of folic acid.