Nokea
A patient in the neurologic intensive care unit is being treated for cerebral edema. Which class of diuretic is used to reduce intracranial pressure?
- A. Loop diuretics
- B. Osmotic diuretics
- C. Thiazide diuretics
- D. Vasodilators
Correct Answer: B
Rationale: Mannitol, an osmotic diuretic, is commonly used to reduce intracranial pressure and cerebral edema resulting from head trauma.
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When assessing a patient who is receiving a loop diuretic, the nurse looks for the manifestations of potassium deficiency, which would include what symptoms?
- A. Dyspnea
- B. Constipation
- C. Tinnitus
- D. Muscle weakness
- E. Anorexia
- F. Lethargy
Correct Answer: D,E,F
Rationale: Symptoms of hypokalemia include anorexia, nausea, lethargy, muscle weakness, mental confusion, and hypotension. The other symptoms are not associated with hypokalemia.
When a patient is receiving diuretic therapy, which of these assessment measures would best reflect the patient's fluid volume status?
- A. Blood pressure and pulse
- B. Serum potassium and sodium levels
- C. Intake, output, and daily weight
- D. Measurements of abdominal girth and calf circumference
Correct Answer: C
Rationale: Urinary intake and output and daily weights are the best reflections of a patient's fluid volume status.
When monitoring a patient who has diabetes and is receiving a carbonic anhydrase inhibitor for edema, the nurse will monitor for which possible adverse effect?
- A. Metabolic alkalosis
- B. Elevated blood glucose
- C. Hyperkalemia
- D. Hypoglycemia
Correct Answer: B
Rationale: An undesirable effect of carbonic anhydrase inhibitors is that they elevate the blood glucose level and cause glycosuria in diabetic patients. They induce metabolic acidosis, making their effectiveness diminish in 2 to 4 days. In addition, hypokalemia and drowsiness may occur. Hypoglycemia is not an adverse effect.
A patient is being discharged to home on a single daily dose of a diuretic. The nurse instructs the patient to take the dose at which time so it will be least disruptive to the patient's daily routine?
- A. In the morning
- B. At noon
- C. With supper
- D. At bedtime
Correct Answer: A
Rationale: It is better to take the diuretic medication early in the morning to prevent urination during the night. Taking the diuretic at the other times may cause nighttime urination and disrupt sleep.
Furosemide is prescribed for a patient who is about to be discharged, and the nurse provides instructions to the patient about the medication. Which statement by the nurse is correct?
- A. Take this medication in the evening.
- B. Avoid foods high in potassium, such as bananas, oranges, fresh vegetables, and dates.
- C. If you experience weight gain, such as 5 pounds or more per week, be sure to tell your physician during your next routine visit.
- D. Be sure to change positions slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes.
Correct Answer: D
Rationale: Orthostatic hypotension is a possible problem with diuretic therapy. Foods high in potassium should be eaten more often, and the drug needs to be taken in the morning so that the diuretic effects do not interfere with sleep. A weight gain of 5 pounds or more per week must be reported immediately.