Question

upon assessment of a client in renal failure, the nurse observes a mental status change with hyperactive deep tendon reflexes. she inflates the blood pressure cuff to a level above his systolic pressure for 3 minutes and trousseau’s sign is positive. the nurse recognizes this as which electrolyte imbalance?
hypermagnesemia
hypomagnesemia
hypercalcemia
hypocalcemia

Explanation:

1. Recall the signs of electrolyte imbalances:

• Trousseau’s sign (carpopedal spasm after BP cuff inflation) and hyperactive deep tendon reflexes are classic signs of hypocalcemia.
• Hypermagnesemia and hypomagnesemia have different clinical manifestations (e.g., hypomagnesemia may have tremors, but Trousseau’s is not a key sign).
• Hypercalcemia is associated with decreased reflexes, not hyperactive ones.

1. Analyze the options:

• Hypermagnesemia: Usually causes decreased reflexes, so eliminate.
• Hypomagnesemia: While it can have neuromuscular irritability, Trousseau’s sign is more specific to hypocalcemia.
• Hypercalcemia: Causes hyporeflexia, so eliminate.
• Hypocalcemia: Matches the signs (mental status change, hyperactive DTRs, positive Trousseau’s sign), especially in renal failure (where calcium regulation is impaired).

Answer:

D. Hypocalcemia