Nokea
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.
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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.
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 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.
When reviewing the mechanisms of action of diuretics, the nurse knows that which statement is true about loop diuretics?
- A. They work by inhibiting aldosterone.
- B. They are very potent, having a diuretic effect that lasts at least 6 hours.
- C. They have a rapid onset of action and cause rapid diuresis.
- D. They are not effective when the creatinine clearance decreases below 25 mL/min.
Correct Answer: C
Rationale: The loop diuretics have a rapid onset of action; therefore, they are useful when rapid onset is desired. Their effect lasts for about 2 hours, and a distinct advantage they have over thiazide diuretics is that their diuretic action continues even when creatinine clearance decreases below 25 mL/min.
The nurse is monitoring a patient who is taking a potassium-sparing diuretic. Which of the drugs or drug classes may have an interaction with this type of diuretic?
- A. Lithium
- B. Vancomycin
- C. Potassium supplements
- D. NSAIDs
- E. Antidiabetic drugs
- F. ACE Inhibitors
Correct Answer: A,C,D,F
Rationale: Taking lithium with potassium-sparing diuretics may cause lithium toxicity; taking ACE inhibitors or potassium supplements may lead to hyperkalemia. Taking NSAIDs with potassium-sparing diuretics may cause a decreased diuretic response. There are no interactions with vancomycin or antidiabetic drugs and potassium-sparing diuretics.