A client is diagnosed with acute tubular necrosis. The nurse understands that cardiac monitoring would be indicated based on which laboratory findings? Select all that apply:
1. Hyperkalemia
2. Hypercalcemia
3. Hyperphosphatemia
4. Lymphocytosis
5. Leukocytosis
1. Hyperkalemia
2. Hypercalcemia
3. Hyperphosphatemia
Rationale: Hyperkalemia. The kidneys have lost their ability to regulate electrolyte excretion; hyperkalcemia levels can quickly change with acute tubular necrosis and result in cardiac complications. Therefore, it is necessary that the client have EKG monitoring continuously to identify changes in the client's condition. Hypercalcemia. The kidneys have lost their ability to regulate electrolyte excretion; hypercalcemia levels can quickly change with acute tubular necrosis and result in cardiac complications. Therefore, it is necessary that the client have EKG monitoring continuously to identify changes in the client's condition. Hyperphosphatemia. The kidneys have lost their ability to regulate electrolyte excretion; hyperphosphatemia levels can quickly change with acute tubular necrosis and result in cardiac complications. Therefore, it is necessary that the client have EKG monitoring continuously to identify changes in the client's condition. Lymphocytosis. Lymphocytes are not affected in acute tubular necrosis. Leukocytosis. Leukocytosis would only be elevated if the client had an infection. In this case, the client does not.
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