Nokea
A nurse is caring for a client with edema due to congestive heart failure (CHF). The primary health care provider has prescribed indapamide. The client is also receiving digoxin. Which intervention would be most appropriate for the nurse to implement?
- A. Encourage oral fluids at frequent intervals during waking hours
- B. Encourage the client to eat or drink between meals and in the evening
- C. Frequently monitor the client's pulse rate and rhythm
- D. Closely monitor the client for signs of hyperkalemia
Correct Answer: C
Rationale: Clients receiving a diuretic, particularly a loop or thiazide diuretic such as indapamide, and a digitalis glycoside concurrently require frequent monitoring of the pulse rate and rhythm.
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A nurse is caring for a client with increased intraocular pressure who is receiving urea. After administering the drug, the nurse would assess the client for which of the following?
- A. Syncope
- B. Cramping
- C. Photosensitivity
- D. Blurred vision
Correct Answer: A
Rationale: The nurse should observe the client for syncope after administering urea.
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.
A nurse is administering a diuretic that inhibits reabsorption of sodium and chloride ions in the distal and proximal tubules and in the loop of Henle. Which of the following might the nurse be administering? Select all that apply.
- A. Chlorothiazide
- B. Furosemide
- C. Bumetanide
- D. Mannitol
- E. Spironolactone
Correct Answer: B,C
Rationale: Loop diuretics, like furosemide (Lasix) and bumetanide (Bumex), cause diuresis by inhibiting reabsorption of sodium and chloride ions in the distal and proximal tubules and in the loop of Henle.
A client is prescribed a diuretic that is to be taken twice a day. When instructing the client about the schedule for administration, the nurse would suggest that the client take the drug at which times?
- A. In the early morning and at bedtime
- B. After lunch and dinner
- C. At breakfast and midafternoon
- D. Midmorning and before dinner
Correct Answer: C
Rationale: Twice-a-day dosing should be administered early in the morning (e.g., 7 a.m.) and early afternoon (e.g., 2 p.m.) to prevent the drug from interfering with the client's sleep.
The nurse is to administer bumetanide. The nurse reviews the client's medication history for possible interacting drugs. Which of the following, if found, would the nurse identify as having an increased risk for toxicity? Select all that apply.
- A. Lithium
- B. Phenytoin
- C. Gentamicin
- D. Warfarin
- E. Digoxin
Correct Answer: A,C,D,E
Rationale: Loop diuretics, like bumetanide, can increase toxicity of lithium, gentamicin, warfarin, and digoxin.