Nokea
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.
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A patient is started on a diuretic for antihypertensive therapy. The nurse expects that a drug in which class is likely to be used initially?
- A. Loop diuretics
- B. Osmotic diuretics
- C. Thiazide diuretics
- D. Potassium-sparing diuretics
Correct Answer: C
Rationale: The Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-8) guidelines reaffirmed the role of thiazide diuretics as among the first-line drugs in the treatment of hypertension. The other drug classes are not considered first-line treatments.
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.
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.
When monitoring a patient who is taking hydrochlorothiazide, the nurse notes that which drug is most likely to cause a severe interaction with the diuretic?
- A. Digoxin
- B. Penicillin
- C. Potassium supplements
- D. Aspirin
Correct Answer: A
Rationale: There is an increased risk for digitalis toxicity in the presence of hypokalemia, which may develop with hydrochlorothiazide therapy. Potassium supplements are often prescribed with hydrochlorothiazide therapy to prevent hypokalemia. The other options do not have interactions with hydrochlorothiazide.
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.