NCLEX-PN® ExaminationPhysiological AdaptationMedium
A client is admitted with acute pancreatitis. The nurse is monitoring for complications. Which of the following findings would indicate a potential complication of hypocalcemia?
- AAbsent bowel sounds
- BMuscle flaccidity
- CDeep tendon reflexes +3
- DPositive Chvostek's sign
Show answer & explanationAnswer & explanation
Correct answer: D. Positive Chvostek's sign
Hypocalcemia is a common complication of acute pancreatitis due to the saponification of fat (calcium binding to fatty acids) in the abdomen. A positive Chvostek's sign (facial twitching when the facial nerve is tapped) is a classic indicator of increased neuromuscular excitability associated with hypocalcemia.
Why the other options are wrong
- A. Absent bowel sounds could indicate paralytic ileus, a general complication of pancreatitis, but not specific to hypocalcemia.
- B. Muscle flaccidity is typically associated with hypercalcemia or hypokalemia, not hypocalcemia, which causes muscle spasms and tetany.
- C. Deep tendon reflexes +3 (hyperreflexia) can be seen with hypocalcemia, but +3 is often considered normal to slightly brisk. Chvostek's sign is a more specific and direct indicator.
Hypocalcemia in Acute Pancreatitis
Hypocalcemia is a significant complication of acute pancreatitis, often due to fat saponification, and manifests with signs of increased neuromuscular excitability.
- Calcium binds with fatty acids released during pancreatic fat necrosis.
- Classic signs include Chvostek's and Trousseau's signs.
- Can lead to tetany, seizures, and cardiac arrhythmias.
Memory trick: Low Calcium, twitching face, a Chvostek's sign in this place!