Nokea
A nurse is caring for a client who has fluid volume excess and received furosemide 40 mg via intermittent IV bolus 1 hr ago. Which of the following findings indicates that the medication has been effective?
- A. Increased urinary output
- B. Increased respiratory rate
- C. Decreased blood pressure
- D. Increased pulse
Correct Answer: A
Rationale: The correct answer is A: Increased urinary output. Furosemide is a loop diuretic that promotes diuresis by inhibiting sodium and water reabsorption in the kidneys. Therefore, an increase in urinary output indicates that the medication has been effective in reducing fluid volume excess.
Incorrect Options:
B: Increased respiratory rate - Furosemide does not directly affect respiratory rate.
C: Decreased blood pressure - While furosemide may lead to decreased blood pressure as a side effect, it is not a direct indicator of the medication's effectiveness in this scenario.
D: Increased pulse - Furosemide may cause electrolyte imbalances that could impact pulse rate, but it is not a direct indicator of medication effectiveness in this context.
You may also like to solve these questions
A nurse is planning care for a client who has a new prescription to receive a continuous infusion of total parenteral nutrition (TPN) Which of the following interventions should the nurse implement?
- A. Change the TPN infusion tubing once every 3 days
- B. Check the client's blood glucose level regularly
- C. Insert the peripheral IV catheter for administration
- D. Monitor the client's weight every 3 days
Correct Answer: B
Rationale: The correct answer is B: Check the client's blood glucose level regularly. This is essential as TPN is a high-calorie, nutrient-dense solution that can increase the risk of hyperglycemia. Monitoring blood glucose levels helps the nurse assess the client's response to TPN and adjust the infusion rate accordingly to prevent complications.
Option A is incorrect because changing the TPN infusion tubing once every 3 days is not a priority in this situation. Option C is incorrect as TPN should be administered through a central venous catheter, not a peripheral IV catheter. Option D is incorrect as monitoring the client's weight every 3 days is not as crucial as monitoring blood glucose levels when on TPN.
A nurse is caring for a client who is receiving heparin by continuous IV infusion for treatment of venous thrombosis. Which of the following laboratory values should the nurse monitor for in order to titrate the heparin dose?
- A. Platelet function assay
- B. aPTT
- C. INR
- D. Amylase
Correct Answer: B
Rationale: The correct answer is B: aPTT. Activated Partial Thromboplastin Time (aPTT) is a lab value used to monitor heparin therapy. Heparin works by inhibiting clot formation, so monitoring aPTT ensures the blood is at the appropriate level of anticoagulation. If aPTT is too low, there is a risk of clot formation, and if it is too high, there is a risk of bleeding. Platelet function assay (A) measures platelet function, not heparin effectiveness. INR (C) is used to monitor warfarin therapy, not heparin. Amylase (D) is a pancreatic enzyme, not relevant to heparin monitoring. Monitoring aPTT helps maintain the therapeutic range for heparin dosing.
A nurse is providing teaching to a client who has chronic rheumatoid arthritis and a new prescription for hydroxychloroquine. The nurse should instruct the client to obtain which of the following diagnostic studies routinely?
- A. Eye examination
- B. Chest -ray
- C. Pancreatic enzyme levels
- D. Urinalysis screening
Correct Answer: A
Rationale: The correct answer is A: Eye examination. Hydroxychloroquine can cause retinal toxicity, so regular eye exams are essential to monitor for any ocular changes. This is crucial in preventing irreversible vision damage. Choices B, C, and D are not routinely necessary for monitoring hydroxychloroquine therapy and are not directly related to its potential side effects. A chest x-ray is not typically indicated unless specific symptoms or concerns arise. Pancreatic enzyme levels and urinalysis are not directly impacted by hydroxychloroquine use. Therefore, the most appropriate diagnostic study for this client would be an eye examination to monitor for potential retinal toxicity.
A nurse is preparing to administer ampicillin/sulbactam 15 g via intermittent IV bolus, Available is ampicillin-sulbactam 1.5 g in 0.9% sodium chloride 100 mL to infuse over 30 min. The nurse should set the IV infusion pump to deliver how many mL/h?
- A. 200 mL/h
Correct Answer: A
Rationale: The correct answer is A: 200 mL/h. To calculate the infusion rate, you first need to convert the total dose of ampicillin/sulbactam to mL. The concentration is 1.5 g in 100 mL, so 15 g would be in 1000 mL. The infusion time is 30 min, so you need to convert it to hours (30 min ÷ 60 = 0.5 hours). Next, divide the total volume (1000 mL) by the infusion time (0.5 hours) to get 2000 mL/h. Therefore, the nurse should set the IV pump to deliver 200 mL/h. Other choices are incorrect as they do not follow the correct calculations based on the given information.
A nurse is providing teaching to a client who has a history of diabetes mellitus and a new prescription for hydrochlorothiazide to treat uncontrolled hypertension. Which of the following information should the nurse include in the teaching?
- A. Blood glucose monitoring is likely to be inaccurate while taking hydrochlorothiazide
- B. You might need to decrease your insulin dosage while taking hydrochlorothiazide.
- C. Hydrochlorothiazide therapy can elevate blood glucose levels in clients who have diabetes
- D. Reducing sodium in your die whim taking your control your blood glucose.
Correct Answer: C
Rationale: The correct answer is C: Hydrochlorothiazide therapy can elevate blood glucose levels in clients who have diabetes. Hydrochlorothiazide is a diuretic that can lead to increased blood glucose levels, particularly in individuals with diabetes. This is important for the nurse to include in the teaching to ensure the client is aware of potential effects on their blood glucose levels.
A: Blood glucose monitoring is likely to be inaccurate while taking hydrochlorothiazide - This statement is incorrect as monitoring blood glucose levels is still important while taking hydrochlorothiazide.
B: You might need to decrease your insulin dosage while taking hydrochlorothiazide - This statement is incorrect as hydrochlorothiazide can elevate blood glucose levels, which may necessitate adjustments to insulin dosage.
D: Reducing sodium in your diet will help control your blood glucose - This statement is not directly related to the effects of hydrochlorothiazide on blood glucose levels.
In summary, choice C is the correct