A nurse is reviewing the laboratory test results of a client...

A nurse is reviewing the laboratory test results of a client who is receiving diuretic therapy. The nurse determines that the client is at risk for electrolyte imbalance based on which results? Select all that apply.

A. Potassium 4.5 mEq/L
B. Sodium 139 mEq/L
C. Magnesium 2.0 mEq/L
D. Sodium 124 mEq/L
E. Potassium 2.9 mEq/L

Correct Answer: D,E

Rationale: Sodium levels below 132 mEq/L, such as 124 mEq/L, or above 145 mEq/L would indicate an imbalance. Potassium imbalances would occur with levels below 3.0 mEq/L, such as 2.9 mEq/L.

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A nurse is assessing a client after administering a diuretic. Which of the following would lead the nurse to suspect that the client is experiencing a fluid and electrolyte imbalance? Select all that apply.

A. Dry mouth
B. Diaphoresis
C. Muscle cramps
D. Hypertension
E. Tachycardia

Correct Answer: A,C,E

Rationale: Warning signs of a fluid and electrolyte imbalance include dry mouth, thirst, lethargy, weakness, drowsiness, restlessness, muscle pain or cramps, confusion, GI disturbances, hypotension, oliguria, tachycardia, and seizures.

A nurse is caring for a client with increased intracranial pressure caused by cerebral edema. The physician has prescribed mannitol. After administering the drug, the nurse should do which of the following?

A. Monitor blood pressure every 4 hours
B. Check response of pupils to light
C. Monitor client for joint pain
D. Monitor serum uric acid concentrations

Correct Answer: B

Rationale: When caring for a client who has been given mannitol for intracranial pressure, the nurse should perform neurologic assessments such as response of the pupils to light, level of consciousness, or response to a painful stimulus.

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.

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 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.