A client is taking furosemide 40 mg/day for management of early chronic kidney disease (CKD). To assess the therapeutic effect of the medication, what action of the nurse is best?

Obtain daily weights of the client.

Assess for acid-base balance.

Assess the client's serum creatinine.

Auscultate heart sounds.

Answer and Explanation

The Correct Answer is A

Choice A reason: Obtaining daily weights of the client is the best action to assess the therapeutic effect of furosemide in managing early chronic kidney disease. Daily weights provide valuable information about fluid balance and the effectiveness of the diuretic in reducing fluid retention. Consistent weight monitoring helps determine if the medication is achieving its goal of managing fluid overload, which is a common issue in CKD patients.

Choice B reason: Assessing acid-base balance is important in managing CKD, but it is not the primary action to assess the therapeutic effect of furosemide. While diuretics can influence electrolyte levels and acid-base balance, monitoring fluid status through daily weights is more directly related to evaluating the effectiveness of the medication.

Choice C reason: Assessing the client's serum creatinine is crucial for monitoring kidney function and progression of CKD. However, it is not the primary action to determine the therapeutic effect of furosemide. The focus of furosemide therapy is to manage fluid balance, and daily weights provide a more immediate and relevant assessment of this effect.

Choice D reason: Auscultating heart sounds is part of a comprehensive assessment of a CKD patient, but it is not the best action to evaluate the therapeutic effect of furosemide. Heart sounds can provide information about cardiac function and potential complications, but they do not directly measure the effectiveness of fluid management achieved by the diuretic.

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Correct Answer is B

Explanation

Choice A reason: Decreased cardiac arrhythmias are not the primary desired effect of dobutamine in heart failure patients. While dobutamine can have some effects on heart rhythm, its main action is to increase the strength of the heart's contractions.

Choice B reason: Increased myocardial contractility is the correct and desired effect of dobutamine. Dobutamine is a positive inotropic agent, meaning it increases the force of the heart's contractions. This is particularly beneficial in heart failure patients as it helps improve cardiac output and the effectiveness of the heart as a pump, thus alleviating symptoms of heart failure and improving organ perfusion.

Choice C reason: Decreased electrical conductivity in the heart is not an effect of dobutamine. In fact, dobutamine can increase the risk of arrhythmias due to its stimulating effects on the heart. The drug works by enhancing the contractility of the heart muscle rather than altering the electrical conduction system.

Choice D reason: Dilated coronary arteries are not a primary effect of dobutamine. While the drug may have some vasodilatory properties, especially at higher doses, its primary role is to enhance myocardial contractility rather than directly dilate the coronary arteries.

A. You will not need vascular access to perform PD. B. This can be done in the comfort of your home. C. You will have no risk for infection with PD. D. You have some flexibility in when you do the exchanges. E. It takes less time than hemodialysis treatments.

Correct Answer is ["A","B","D","E"]

Explanation

Choice A reason: Not needing vascular access to perform PD is a significant advantage for patients. Peritoneal dialysis uses the peritoneal membrane in the abdomen as a filter to clean the blood, which eliminates the need for vascular access, such as fistulas or catheters required in hemodialysis. This can reduce the risks associated with vascular access, such as infections and complications related to surgical procedures.

Choice B reason: Being able to perform PD in the comfort of one's home is a major benefit. Patients can manage their dialysis treatments at home, which offers more convenience and flexibility compared to traveling to a dialysis center for hemodialysis sessions. This can greatly improve the quality of life and reduce the burden of frequent trips to healthcare facilities.

Choice C reason: Stating that there is no risk for infection with PD is inaccurate. While PD offers many benefits, it does carry a risk of peritonitis, an infection of the peritoneal cavity. Patients must be educated on proper technique and hygiene to minimize this risk. Hence, this statement is not accurate and should not be included as an advantage.

Choice D reason: Having flexibility in when to do the exchanges is another benefit of PD. Patients can schedule their dialysis exchanges at times that best fit their lifestyle and daily routines. This flexibility allows for greater independence and freedom compared to the fixed schedules required for in-center hemodialysis.

Choice E reason: PD can take less time than hemodialysis treatments, especially when considering travel and waiting times associated with in-center hemodialysis. Although the actual dialysis process for PD requires regular exchanges throughout the day or night, it integrates more seamlessly into daily life, making it a time-efficient option for many patients.

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A client is taking furosemide 40 mg/day for management of early chronic kidney disease (CKD). To assess the therapeutic effect of the medication, what action of the nurse is best?

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Naxlex Comprehensive Predictor Exams

A client with acute heart failure is receiving dobutamine. What is the desired effect of this drug in a patient with heart failure?

Correct Answer is B

Explanation

A patient is unsure of the decision to undergo peritoneal dialysis (PD) and wishes to discuss the advantages of this treatment with the nurse. Which statements by the nurse are accurate regarding PD? Select all that apply.

Correct Answer is ["A","B","D","E"]

Explanation

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