Nokea
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).
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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.
After administering metolazone to a client, the nurse monitors for signs of hypokalemia, including which of the following? Select all that apply.
- A. Diarrhea
- B. Anorexia
- C. Depression
- D. Hypoglycemia
- E. Drowsiness
Correct Answer: B,C,E
Rationale: The following are signs of hypokalemia: anorexia, nausea, vomiting, depression, confusion, cardiac arrhythmias, impaired thought process, and drowsiness.
A nurse may notice a decrease in diuretic effect when furosemide (Lasix) is given with which of the following drugs? Select all that apply.
- A. Phenytoin
- B. Naproxen
- C. Digoxin
- D. Lithium
- E. Ibuprofen
Correct Answer: A,B,E
Rationale: A nurse may notice a decrease in diuretic effect when furosemide (Lasix) is given with hydantoins (phenytoin) and NSAIDs (naproxen and ibuprofen).
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.
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.