Nokea
A 3-year-old child diagnosed with congestive heart failure is receiving maintenance doses of digoxin and furosemide (Lasix). She is rubbing her eyes when she is looking at the lights in the room and her heart rate is 65 beats per minute. The nurse expects which laboratory finding?
- A. Hypokalemia
- B. Hypomagnesemia
- C. Hypocalcemia
- D. Hypophosphatemia
Correct Answer: A
Rationale: Hypokalemia is a common side effect of furosemide, a diuretic, and can exacerbate digoxin toxicity, which may present with symptoms such as visual disturbances and bradycardia.
You may also like to solve these questions
List THREE medical management plans for biatrial enlargement.
- A. Loop diuretics (carefully)
- B. Beta-blockers (carefully)
- C. Anticoagulation
- D. All of the above
Correct Answer: D
Rationale: These are standard treatment options aimed at managing heart function, reducing fluid buildup, and preventing complications like clot formation.
The nurse is teaching a client with glomerulonephritis about self-care. Which dietary recommendations should the nurse encourage the client to follow?
- A. Increase intake of high-fiber foods, such as bran cereal
- B. Restrict protein intake by limiting meats and other high-protein foods
- C. Limit oral fluid intake to 500 ml per day
- D. Increase intake of potassium-rich foods such as bananas or cantaloupe
Correct Answer: B
Rationale: Reducing protein intake helps decrease the workload on the kidneys, which is beneficial in glomerulonephritis.
Tall (>25 mm), narrow, and spiked P waves are seen in
- A. Ebstein anomaly
- B. ventricular septal defect
- C. patent ductus arteriosus
- D. severe mitral stenosis
Correct Answer: D
Rationale: Severe mitral stenosis can cause tall, narrow, and spiked P waves due to left atrial enlargement.
An 8-month-old infant has a hypercyanotic spell while blood is being drawn. What is the priority nursing action?
- A. Assess for neurologic defects
- B. Place the child in the knee-chest position
- C. Begin cardiopulmonary resuscitation
- D. Prepare family for imminent death
Correct Answer: B
Rationale: The first action is to place the infant in the knee-chest position. Blow-by oxygen may be indicated. Neurologic defects are unlikely. The child should be assessed for airway, breathing, and circulation. Often, calming the child and administering oxygen and morphine can alleviate the hypercyanotic spell.
After a transurethral resection of the prostate (TURP), a client has bloody urine output with large clots. The nurse implements the postoperative prescription to irrigate the indwelling catheter PRN to maintain the catheter's patency. Which action should the nurse implement?
- A. Clamp the catheter for 30 minutes prior to irrigating with saline
- B. Manually irrigate the catheter with sterile saline as prescribed
- C. Increase the client's oral fluid intake to flush out clots naturally
- D. Remove the catheter and notify the healthcare provider immediately
Correct Answer: A
Rationale: Clamping the catheter before irrigation prevents sudden fluid shifts and ensures that irrigation is performed effectively.