Nokea
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.
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A nurse is providing care to a client who has an allergy to sulfamethoxazole/trimethoprim. The nurse understands that the client may have cross-sensitivity reactions with which of the following diuretics? Select all that apply.
- A. Chlorothiazide
- B. Furosemide
- C. Chlorthalidone
- D. Metolazone
- E. Spironolactone
Correct Answer: A,C,D
Rationale: A cross-sensitivity reaction may occur with the thiazides (chlorothiazide, chlorthalidone, and metolazone) and sulfonamides (sulfamethoxazole).
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 client who is receiving diuretic therapy comes to the clinic for a follow-up visit. The client states that his mouth is often dry and that he is 'urinating like there is no tomorrow.' Assessment reveals dry mucous membranes and decreased skin turgor. Which nursing diagnosis would the nurse most likely identify?
- A. Risk for Injury
- B. Risk for Deficient Fluid Volume
- C. Impaired Urinary Elimination
- D. Deficient Knowledge
Correct Answer: B
Rationale: Based on the client's report and assessment findings, a nursing diagnosis of Risk for Deficient Fluid Volume would be most appropriate.
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 physician has prescribed bumetanide for a client with high blood pressure who also has renal insufficiency. Which of the following instructions should the nurse include in the teaching plan for this client?
- A. Avoid salt substitutes containing potassium
- B. Avoid over-the-counter drugs for cold symptoms
- C. Always take the drug before meals
- D. Omit the drug dose when feeling dizzy
Correct Answer: B
Rationale: The nurse should instruct the hypertensive client to avoid medications that increase blood pressure, such as OTC drugs for appetite suppression and cold symptoms.