Nokea
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.
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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.
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.
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 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.
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.