BCCL kharkhanda Staff Nurse - 2015
Medical & Surgical Nursing
Easy
Which of the signs and symptoms would be an early indication that the patient's serum potassium level is below usual?
Appeared in: BCCL kharkhanda Staff Nurse - 2015
Explanation
- Muscle weakness is a hallmark early sign of hypokalemia (low potassium), as potassium is crucial for the electrical function of nerve and muscle cells.
- This weakness characteristically starts in the lower extremities (legs) and can progress upwards as potassium levels drop further.
- Low extracellular potassium hyperpolarizes the muscle cell's resting membrane potential, which impairs its ability to depolarize and contract, leading to weakness.
- Other early neuromuscular signs can include fatigue and muscle cramps (myalgia).
Why Other Options Were Wrong
- Option A: This is a classic sign of dehydration (fluid volume deficit) due to water loss, not a direct or specific sign of hypokalemia.
- Option B: Diarrhea is a common cause of potassium loss, leading to hypokalemia, but it is not a symptom of it. Hypokalemia actually slows gastrointestinal motility, causing constipation or ileus.
- Option D: Tingling sensations (paresthesia) are not a typical early sign of hypokalemia. They are more commonly associated with hypocalcemia (low calcium) or even hyperkalemia (high potassium).
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Early signs and symptoms of hypokalemia (low serum potassium) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Nurses must diligently monitor for muscle weakness in patients at risk for hypokalemia, such as those on potassium-wasting diuretics (e.g., furosemide, thiazides), or those with significant gastrointestinal losses from vomiting or diarrhea.
- Early recognition and reporting of muscle weakness can prevent progression to severe, life-threatening complications like cardiac arrhythmias (e.g., ventricular tachycardia) and respiratory muscle paralysis.
- Hypokalemia potentiates the effects of digoxin, increasing the risk of digoxin toxicity. Nurses should be especially vigilant for signs of hypokalemia in patients taking this medication.
How to Approach the Question
- First, identify the key concepts in the question: 'early indication' and 'serum potassium level is below usual' (hypokalemia).
- Recall the primary function of potassium in the body, which is its role in maintaining the resting membrane potential of nerve and muscle cells.
- Analyze how a deficit in potassium would affect these cells. A lack of potassium impairs muscle contraction and nerve impulse transmission.
- Evaluate each option based on this physiological understanding:
- Sticky mucous membrane relates to fluid balance (dehydration), not directly to potassium.
- Diarrhea is a cause of potassium loss, not a symptom of low potassium.
Concept Tested & Keywords
- Concept Tested: Early signs and symptoms of hypokalemia (low serum potassium).
- Stem keywords: signs and symptoms, early indication, serum potassium level, below usual
- Lead-in keywords: Which
- Negative lead-in flag: false
Question ID
QPwdOs-dp2MK639SdHxBh1
Reference Book
E6 Medicine Davidson Principles Practice 24e p. 381-383
E6 Medicine Harrison 22e Part 1 p. 397-399
E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 61-63
Practise the full BCCL kharkhanda Staff Nurse - 2015
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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