The nurse is caring for a patient who has a serum magnesium level of 0.8 mEq/L. Which is the highest priority goal to include in the patient's plan of care?
a. The patient will maintain urine output of at least 30 mL/hr.
b. The patient will verbalize the importance of sufficient dietary intake of magnesium.
c. The patient's oral mucous membranes will remain free of ulceration and pain.
d. The patient will remain alert and oriented x3 with no confusion or seizure activity.
ANS: D
A patient with low serum magnesium is at risk for neurologic symptoms including confusion, disorientation, and seizures. The highest priority goal for this patient is to avoid neurologic problems that could lead to injury. The other goals are applicable to the patient with low magnesium but are less important.
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