A client who is taking furosemide reports experiencing leg cramps, a cough, feeling tired, and palpitations. Which action should the nurse take first?

Apply warm compresses to legs.

Monitor intake and output.

Raise the head of the bed.

Place on cardiac monitoring.

Answer and Explanation

The Correct Answer is D

A. Apply warm compresses to legs:
While leg cramps can be uncomfortable, addressing them with warm compresses does not address the potential underlying issues related to the client's symptoms, especially considering the possibility of more severe conditions.

B. Monitor intake and output:
Monitoring intake and output is important in managing fluid balance, especially with diuretics like furosemide. However, this action does not directly address the immediate concerns raised by symptoms like palpitations and a cough.

C. Raise the head of the bed:
Raising the head of the bed can be helpful if the client is experiencing shortness of breath or orthopnea. However, it does not address the need to evaluate cardiac function, which is crucial given the presence of palpitations and other symptoms.

D. Place on cardiac monitoring:
The client's symptoms—palpitations, cough, fatigue—could indicate significant electrolyte imbalances or cardiac issues, which are common with furosemide use. Cardiac monitoring is the most appropriate initial action to quickly identify and address any cardiac complications.

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Correct Answer is A

Explanation

A. Explore what the client means by the drug "is not working":
The first step in addressing the client's concern is to understand their perception of how the medication is performing. This involves exploring their specific symptoms, any changes they've noticed, and their expectations of the medication. This understanding will help guide further assessment and intervention.

B. Determine if the client is taking the medication before meals:
Carbidopa-levodopa is typically recommended to be taken on an empty stomach to optimize absorption. While this is important for effective medication use, addressing the client's perception of the drug's effectiveness takes priority to identify whether there is an issue with their treatment regimen or if other factors are influencing their response.

C. Evaluate the client for signs of dyskinesia:
Dyskinesia, or involuntary movements, can be a side effect of long-term use of carbidopa-levodopa, but evaluating for these signs should follow the initial exploration of the client's concerns. If the client believes the medication is ineffective, it’s crucial first to clarify what symptoms they are experiencing before assessing for specific side effects.

D. Ask if the client's morning voids are dark colored:
Dark-colored urine is not directly related to the effectiveness of carbidopa-levodopa. This assessment is less relevant compared to understanding the client's overall experience with the medication and symptoms. Addressing the client’s concern about the medication’s effectiveness should be the priority.

A. Double the dose if a dose is missed. B. Reduce caffeine and acidic intake. C. Avoid taking on an empty stomach. D. Consume 2. liters of water daily.

Correct Answer is A

Explanation

A. Double the dose if a dose is missed:
This instruction is incorrect. Clients should not double their dose of allopurinol if they miss a dose. Instead, they should take the missed dose as soon as they remember, unless it is almost time for the next dose. Doubling the dose can lead to overdose and potential side effects.

B. Reduce caffeine and acidic intake:
Reducing caffeine and acidic foods can help manage gout and lower uric acid levels, making this advice appropriate.

C. Avoid taking on an empty stomach:
While allopurinol can be taken with or without food, some clients might find it less irritating if taken with food. This guidance is intended to reduce gastrointestinal discomfort.

D. Consume 2 liters of water daily:
Drinking adequate fluids helps prevent kidney stones and promotes overall kidney health, which is especially important when taking allopurinol. This advice supports effective medication use and overall health.

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A client who is taking furosemide reports experiencing leg cramps, a cough, feeling tired, and palpitations. Which action should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is A

Explanation

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