A client with heart failure is scheduled to receive 40 mg of Furosemide IV push. Which data would cause the nurse to question administering this medication?

Serum potassium 3.1 mEq/L (3.5-5.0 mEq/L)

Patient reports abdominal pain

Patient does not have a foley catheter

Blood pressure 132/70

Answer and Explanation

The Correct Answer is A

a. Serum potassium 3.1 mEq/L (3.5-5.0 mEq/L): Furosemide (a loop diuretic) can cause potassium loss (hypokalemia). A potassium level of 3.1 mEq/L is below the normal range, and administering Furosemide could further decrease potassium levels. The nurse should question giving the medication and consider potassium supplementation.

b. Patient reports abdominal pain:Abdominal pain is not directly related to Furosemide administration. While it's essential to assess the cause of pain, it doesn't specifically impact the decision to administer Furosemide.

c. Patient does not have a foley catheter: The absence of a foley catheter is not a contraindication for Furosemide administration. It's unrelated to the medication's safety or effectiveness.

d. Blood pressure 132/70: The blood pressure reading falls within a normal range. Furosemide is commonly used to manage hypertension and fluid overload in heart failure patients. This blood pressure reading does not raise concerns about administering Furosemide.

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Correct Answer is D

Explanation

a. Aortic regurgitation: Aortic regurgitation involves the backflow of blood from the aorta into the left ventricle during diastole due to a dysfunctional aortic valve. While aortic regurgitation can cause symptoms such as dyspnea and chest pain, they are typically associated with exertion rather than occurring at rest or unrelated to activity.

b. Mitral valve prolapse: Mitral valve prolapse is characterized by the abnormal movement of the mitral valve leaflets into the left atrium during systole. While mitral valve prolapse can lead to symptoms such as palpitations, chest discomfort, and dyspnea, these symptoms are usually not unrelated to activity. They are often precipitated or exacerbated by physical exertion or stress.

c. Mitral stenosis: Mitral stenosis involves narrowing of the mitral valve opening, which obstructs blood flow from the left atrium to the left ventricle. Symptoms of mitral stenosis, such as dyspnea and chest discomfort, typically occur with exertion or during periods of increased cardiac demand rather than being unrelated to activity.

d. Aortic stenosis: Aortic stenosis is characterized by narrowing of the aortic valve opening, which obstructs blood flow from the left ventricle to the aorta. This obstruction leads to increased pressure in the left ventricle and can cause symptoms such as dyspnea (due to pulmonary congestion) and chest pain (angina) even at rest. These symptoms are often exacerbated during physical activity but can occur spontaneously as well.

A. Hemolytic anemia B. Endocarditis C. Hypertension D. Elevated PT/INR

Correct Answer is B

Explanation

a. Hemolytic anemia: Hemolytic anemia is more commonly associated with mechanical heart valves rather than tissue valves. Mechanical valves can cause damage to red blood cells as they move through the valve, leading to hemolysis and subsequent anemia. Tissue valves typically do not cause significant hemolysis.

b. Endocarditis: Endocarditis is a known complication associated with prosthetic heart valves, including tissue valves. While tissue valves generally have a lower risk of thrombosis compared to mechanical valves, they are still susceptible to bacterial colonization and subsequent endocarditis. Patients with prosthetic heart valves, regardless of type, are recommended to take antibiotic prophylaxis before certain dental or surgical procedures to reduce the risk of infective endocarditis

c. Hypertension: Hypertension is not specifically associated with tissue valve replacements. While hypertension is a common cardiovascular condition, it is not directly related to the type of prosthetic valve implanted.

d. Elevated PT/INR: Elevated prothrombin time (PT) and international normalized ratio (INR) are more commonly associated with mechanical heart valves rather than tissue valves. Mechanical valves require lifelong anticoagulation therapy with medications such as warfarin to prevent thrombosis. Tissue valves generally do not require long-term anticoagulation therapy, although they may still require short-term anticoagulation immediately after implantation.

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A client with heart failure is scheduled to receive 40 mg of Furosemide IV push. Which data would cause the nurse to question administering this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is B

Explanation

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