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 B

Explanation

A. Request a prescription to change the route of administration and use the available heparin:
Low molecular weight heparin (LMWH) and unfractionated heparin (UFH) are not interchangeable. LMWH is usually administered subcutaneously, whereas UFH is administered intravenously for acute situations. Changing the route of administration without a new prescription would not be appropriate.

B. Advise the pharmacy of the need to deliver a vial of heparin to the nursing unit immediately:
Since the prescription is for intravenous heparin and the available syringes are of LMWH (which is not suitable for IV use), it is essential to contact the pharmacy to provide the correct formulation. Immediate action ensures that the client receives the correct medication promptly.

C. Calculate and administer the equivalent dose of the available low molecular weight heparin:
Calculating and administering LMWH instead of UFH is inappropriate because they are different types of heparin with different indications, dosing regimens, and routes of administration. Using LMWH for an IV prescription could result in ineffective treatment or complications.

D. Dilute the available heparin in 250 mL of normal saline solution prior to IV administration:
LMWH should not be diluted or used in place of UFH for IV administration. This action is incorrect because the available medication is not suitable for the prescribed route and dose. The proper medication needs to be obtained from the pharmacy.

A. Avoid prolonged exposure to direct sunlight. B. Stop the oral contraceptive immediately. C. Take the medications at least 12 hours apart. D. Use an additional form of contraception.

Correct Answer is D

Explanation

A) Avoid prolonged exposure to direct sunlight: While erythromycin can increase sensitivity to sunlight, this is not directly related to the interaction between oral contraceptives and erythromycin. The primary concern with erythromycin and oral contraceptives is their interaction rather than sun exposure.

B) Stop the oral contraceptive immediately: There is no need to stop oral contraceptives when taking erythromycin. However, erythromycin can potentially reduce the effectiveness of oral contraceptives, so additional precautions should be taken rather than discontinuing the contraceptive.

C) Take the medications at least 12 hours apart: Timing of administration is not a primary concern for this interaction. The main issue is the potential reduction in contraceptive efficacy rather than timing the doses of the medications.

D) Use an additional form of contraception: Erythromycin can potentially decrease the effectiveness of oral contraceptives due to its effect on liver enzymes and drug metabolism. It is advisable to use an additional form of contraception to prevent unintended pregnancy while taking erythromycin.

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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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