Nokea
A client is prescribed amiloride. The nurse would administer this drug cautiously if the client had a history of which of the following? Select all that apply.
- A. Gout
- B. Asthma
- C. Diabetes
- D. HIV
- E. Hepatic disease
Correct Answer: A,C,E
Rationale: Potassium-sparing diuretics, like amiloride, should be used cautiously in clients with gout, diabetes, and hepatic disease.
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A nurse administers a thiazide diuretic to a client with renal compromise as prescribed by the primary health care provider. Which action by the nurse would be most appropriate if the client's blood urea nitrogen level increases?
- A. Give prescribed magnesium supplements
- B. Withhold the next dose of the drug
- C. Administer the drug in a diluted form
- D. Increase the fluid intake for the client
Correct Answer: B
Rationale: The nurse should withhold the drug or discontinue its use if the blood urea nitrogen (BUN) rises in the client with renal compromise.
A physician has prescribed furosemide to a client with pulmonary edema. The client informs the nurse that he is also taking phenytoin as treatment for seizures. The nurse would assess the client closely for which of the following?
- A. Increased risk of bleeding
- B. Decreased diuretic effectiveness
- C. Increased blood glucose levels
- D. Increased seizure episodes
Correct Answer: B
Rationale: The nurse should monitor for decreased diuretic effectiveness in the client as the effect of the interaction between furosemide and hydantoins.
A nurse is reviewing the medical record of several clients who are prescribed amiloride. The nurse would identify a client with which condition as being at highest risk for developing hyperkalemia? Select all that apply.
- A. Diabetes
- B. Hypertension
- C. Renal disease
- D. Epilepsy
- E. Asthma
Correct Answer: A,C
Rationale: Hyperkalemia is most likely to occur in clients with an inadequate fluid intake and urine output, those with diabetes or renal disease, the elderly, and those who are severely ill.
A nurse is caring for a client with edema. The physician has prescribed diuretic therapy for the client. Which of the following would be most appropriate for the nurse to do?
- A. Ask the client to decrease fluid intake
- B. Gradually increase the drug dosage
- C. Administer the drug early in the day
- D. Encourage the client to exercise
Correct Answer: C
Rationale: The nurse should administer the drug early in the day to prevent any nighttime sleep disturbance caused by increased urination.
A nurse is preparing to administer spironolactone to a client. When reviewing the client's medical record, the nurse would be alert for the development of hyperkalemia if the client was also receiving which of the following?
- A. Lisinopril (Prinivil)
- B. Metoprolol (Lopressor)
- C. Terazosin (Hytrin)
- D. Diltiazem (Cardizem)
Correct Answer: A
Rationale: Spironolactone when given with ACE inhibitors (lisinopril) can lead to hyperkalemia.