Nokea
The nurse will monitor a patient for signs and symptoms of hyperkalemia if the patient is taking which of these diuretics?
- A. Hydrochlorothiazide
- B. Furosemide
- C. Acetazolamide
- D. Spironolactone
Correct Answer: D
Rationale: Spironolactone (Aldactone) is a potassium-sparing diuretic, and patients taking this drug must be monitored for signs of hyperkalemia. The other drugs do not cause hyperkalemia but instead cause hypokalemia.
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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.
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.
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.
A patient is to receive furosemide (Lasix) via a percutaneous endoscopic gastrostomy (PEG) tube. The order reads, "Give furosemide, 60 mg, per PEG tube once daily. The medication is available in a liquid form, 40 mg/5 mL. Identify how many milliliters the nurse will administer for each dose.
Correct Answer: 7.5 mL
Rationale: 40 mg : 5 mL :: 60 mg : x mL; (40 * x) = (5 * 60); 40x = 300; x = 300/40 = 7.5 mL.
Mannitol has been ordered for a patient with acute renal failure. The nurse will administer this drug using which procedure?
- A. Intravenously, through a filter
- B. By rapid intravenous bolus
- C. By mouth in a single morning dose
- D. Through a gravity intravenous drip with standard tubing
Correct Answer: A
Rationale: Mannitol is administered via intravenous infusion through a filter because of possible crystallization. It is not available in oral form. The other options are incorrect.