Nokea
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.
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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.
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 primary health care provider has prescribed a loop diuretic for a client with hypertension. The client also has diabetes mellitus. The nurse would assess the client for which of the following after administering the drug?
- A. Sudden pain in the joints
- B. Increased blood glucose levels
- C. Occurrence of gout attacks
- D. Sudden increase in weight
Correct Answer: B
Rationale: The nurse should monitor for increased blood glucose levels in the diabetic client receiving a loop diuretic.
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.
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.