Nokea
A physician has prescribed furosemide to a client with pulmonary edema. The client informs the nurse that he is also taking phenytoin as treatment for seizures. The nurse would assess the client closely for which of the following?
- A. Increased risk of bleeding
- B. Decreased diuretic effectiveness
- C. Increased blood glucose levels
- D. Increased seizure episodes
Correct Answer: B
Rationale: The nurse should monitor for decreased diuretic effectiveness in the client as the effect of the interaction between furosemide and hydantoins.
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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 administering a diuretic that inhibits reabsorption of sodium and chloride ions in the distal and proximal tubules and in the loop of Henle. Which of the following might the nurse be administering? Select all that apply.
- A. Chlorothiazide
- B. Furosemide
- C. Bumetanide
- D. Mannitol
- E. Spironolactone
Correct Answer: B,C
Rationale: Loop diuretics, like furosemide (Lasix) and bumetanide (Bumex), cause diuresis by inhibiting reabsorption of sodium and chloride ions in the distal and proximal tubules and in the loop of Henle.
A nurse is preparing to administer spironolactone to a client. The nurse would contact the primary health care provider about the need to change the order if the client has a history of which of the following?
- A. Hyperkalemia
- B. Liver disease
- C. Gout
- D. Diabetes
Correct Answer: A
Rationale: Potassium-sparing diuretics are contraindicated in clients with hyperkalemia.
A nurse is administering acetazolamide to a client. The nurse understands that this drug leads to excretion of which of the following? Select all that apply.
- A. Sodium
- B. Magnesium
- C. Potassium
- D. Bicarbonate
- E. Chloride
Correct Answer: A,C,D
Rationale: Carbonic anhydrase inhibitors, like acetazolamide, result in the excretion of sodium, potassium, bicarbonate, and water.
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.