Which assessment finding would the nurse expect for a patient ...

[segrsyd]

Which assessment finding would the nurse expect for a patient with the following laboratory values: sodium 145 mEq/L, potassium 4.5 mEq/L, calcium 4.5 mg/dL?
 
  a. Lightheadedness when standing up
  b. Weak quadriceps muscles
  c. Tingling of the extremities and tetany
  d. Decreased deep tendon reflexes

Question 2

A patient had an acute intravascular hemolytic reaction to a blood transfusion. After discontinu-ing the blood transfusion, what is the nurse's next action?
 
  a. Run normal saline through the existing tubing.
  b. Start normal saline at TKO rate using new tubing.
  c. Discontinue the IV catheter.
  d. Return the blood to the blood bank.

[joechoochoy]

Answer to Question 1

ANS: C
This patient has hypocalcemia because the normal calcium range is 8.4 to 10.5 mg/dL. Sodium and potassium values are within their normal ranges: sodium 135 to 145 mEq/L; potassium 3.5 to 5.0 mEq/L. Hypocalcemia causes muscle tetany, positive Trousseau's sign, and tingling of the extremities. Lightheadedness when standing up is a manifestation of ECV deficit or sometimes hypokalemia. Weak quadriceps muscles are associated with potassium imbalances. Decreased deep tendon reflexes are related to hypercalcemia or hypermagnesemia.

Answer to Question 2

ANS: B
The nurse should first attach new tubing and begin running in normal saline at a rate to keep the vein open, in case any sorts of medications need to be delivered through that IV site. The exist-ing tubing should not be used because that would infuse the blood in the tubing into the patient. It is necessary to preserve the IV catheter in place for IV access to treat the patient. After the pa-tient has been assessed and stabilized, the blood can be returned to the blood bank.