Nursing Prioritization Delegation Assignment Q 32

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The nurse just received the client’s morning laboratory results. Which of these results is of most concern?

  

     A. Serum sodium level of 134 mEq/L

     B. Serum potassium level of 5.2 mEq/L

     C. Serum magnesium level of 0.8 mEq/L

     D. Serum calcium level of 10.6 mg/dL

    

    

Correct Answer: C. Serum magnesium level of 0.8 mEq/L

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With a magnesium level this low, the client is at risk for ECG changes and life-threatening ventricular dysrhythmias. Normal serum magnesium levels are between 1.46 and 2.68 mg/dL. Hypomagnesemia can be attributed to chronic disease, alcohol use disorder, gastrointestinal losses, renal losses, and other conditions. Signs and symptoms of hypomagnesemia include anything from mild tremors and generalized weakness to cardiac ischemia and death.

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Option A: Hyponatremia is defined as a serum sodium concentration of less than 135 mEq/L but can vary to some extent depending upon the set values of varied laboratories. Patients with mild-to-moderate hyponatremia (greater than 120 mEq/L) or gradual decrease in sodium (greater than 48 hours) have minimal symptoms.

Option B: Hyperkalemia is defined as a serum or plasma potassium level above the upper limits of normal, usually greater than 5.0 mEq/L to 5.5 mEq/L. While mild hyperkalemia is usually asymptomatic, high levels of potassium may cause life-threatening cardiac arrhythmias, muscle weakness or paralysis.

Option D: Hypercalcemia is defined as serum calcium concentration two standard deviations above the mean values. The normal serum calcium ranges from 8.8 mg/dL-10.8 mg/dL. Primary hyperparathyroidism and malignancy accounts for 90% of the cases of hypercalcemia.

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