Nokea
The nurse is preparing to administer furosemide to a client with severe heart failure. What lab study should be of most concern for this client while taking furosemide?
- A. BNP of 100
- B. Sodium level of 135
- C. Hemoglobin of 12
- D. Potassium level of 3.1
Correct Answer: D
Rationale: Severe heart failure usually requires a loop diuretic such as furosemide (Lasix). These drugs increase sodium and therefore water excretion, but they also increase potassium excretion. If a client becomes hypokalemic, digitalis toxicity is more likely. The BNP does not demonstrate a severe heart failure. Sodium level of 135 is within normal range, as is the hemoglobin level.
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A client is brought to the emergency department via rescue squad with suspicion of cardiogenic pulmonary edema. What complication(s) should the nurse monitor for? Select all that apply.
- A. Nausea and vomiting
- B. Pulmonary embolism
- C. Cardiac arrhythmias
- D. Respiratory arrest
- E. Cardiac arrest
Correct Answer: C,D,E
Rationale: Pulmonary edema is fluid accumulation in the lungs, which interferes with gas exchange in the alveoli. It represents an acute emergency and is a frequent complication of left-sided heart failure. Cardiac arrhythmias and cardiac or respiratory arrest are associated complications. Nausea and vomiting are not complications but are symptoms of many disorders. The client is not at increased risk for the development of pulmonary embolism with pulmonary edema.
The student nurse is caring for a client with heart failure. Diuretics have been prescribed. What method might be used with a debilitated client to help the nurse evaluate the client's response to diuretics?
- A. Using mechanical ventilation
- B. Using a urinary catheter
- C. Using a pulmonary artery catheter
- D. Using a biventricular pacemaker
Correct Answer: B
Rationale: To evaluate response to diuretics, a urinary catheter is used. Mechanical ventilation helps maintain a normal breathing pattern. A pulmonary artery catheter helps estimate cardiac output. A biventricular pacemaker is used to sustain life.
A client is taking furosemide for the treatment of heart failure. What food should the nurse suggest that is rich in potassium?
- A. Pasta
- B. Peanut butter
- C. Coffee
- D. Angel food cake
Correct Answer: B
Rationale: Peanut butter is rich in potassium. Pasta, coffee, and angel food cake are low potassium items.
The nurse is caring for a client with heart failure. What procedure should the nurse prepare the client for in order to determine the ejection fraction to measure the efficiency of the heart as a pump?
- A. Echocardiogram
- B. A pulmonary arteriography
- C. A chest radiograph
- D. Electrocardiogram
Correct Answer: A
Rationale: The heart's ejection fraction is measured using an echocardiogram or multiple gated acquisition scan. A pulmonary arteriography is used to confirm cor pulmonale. A chest radiograph can reveal the enlargement of the heart. An electrocardiogram is used to determine the activity of the heart's conduction system.
A client is admitted to the hospital with a diagnosis of heart failure, and the health care provider prescribes a BNP level. What results would indicate to the nurse that the client is in moderate heart failure?
- A. 120 pg/mL
- B. 400 pg/mL
- C. 780 pg/mL
- D. 980 pg/mL
Correct Answer: C
Rationale: The result of 780 pg/mL indicates that the client has moderate heart failure, 120 pg/mL indicates that the client has heart failure present, 400 pg/mL indicates that the client has mild heart failure, and 980 pg/mL indicates that the client is in severe heart failure.