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

For a client with mitral stenosis who has developed atrial fibrillation, the primary concern is often controlling the heart rate and preventing complications associated with atrial fibrillation, such as thromboembolism.

a. Hydralazine: Hydralazine is an antihypertensive medication that works by dilating blood vessels to lower blood pressure. However, it is not typically used to manage atrial fibrillation. Therefore, this would not be the anticipated drug for this condition.

b. Lorazepam: Lorazepam is a benzodiazepine medication used primarily for its anxiolytic (anxiety-reducing) and sedative properties. It does not have a direct effect on managing atrial fibrillation or its complications. Therefore, it would not be the anticipated drug for this condition.

c. Enalapril: Enalapril is an angiotensin-converting enzyme (ACE) inhibitor used to manage hypertension and heart failure. While it may be beneficial in some cases of heart failure, it is not typically the first-line choice for managing atrial fibrillation. Therefore, it would not be the anticipated drug for this condition.

d. Digoxin: Digoxin is a medication that increases the strength of the heart's contractions and helps control the heart rate in atrial fibrillation. It is often used in patients with atrial fibrillation, especially when there is concurrent heart failure or atrial fibrillation with rapid ventricular response. Therefore, digoxin would be the anticipated drug for managing atrial fibrillation in this scenario.

A. Monitor urine output B. Assess pulse oximetry C. Check PT/INR D. Infuse 0.9% NS with 20 mEq KCl at 50 ml/hr E. Administer 40 mg furosemide IV now

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

Explanation

a. Monitor urine output: Monitoring urine output is important in clients with heart failure to assess renal perfusion and renal function. Decreased urine output may indicate worsening heart failure or inadequate response to treatment. Therefore, monitoring urine output is appropriate in this situation to assess the client's fluid status and response to therapy.

b. Assess pulse oximetry: Assessing pulse oximetry is essential to evaluate the client's oxygen saturation levels, especially in a client presenting with dyspnea and crackles throughout bilateral lung fields. Decreased oxygen saturation may indicate respiratory compromise or worsening heart failure. Therefore, assessing pulse oximetry is necessary to monitor the client's respiratory status and guide interventions.

c. Check PT/INR: Checking PT/INR (Prothrombin Time/International Normalized Ratio) is not indicated in this situation. PT/INR monitoring is typically performed in clients on anticoagulant therapy such as warfarin to assess coagulation status and therapeutic levels. It is not directly relevant to the client's current presentation of dyspnea, tachycardia, and crackles.

d. Infuse 0.9% NS with 20 mEq KCl at 50 ml/hr: Infusing normal saline (0.9% NS) with potassium chloride (KCl) is not appropriate based solely on the client's presentation of dyspnea, anxiety, tachycardia, and crackles. While fluid and electrolyte balance are important considerations in heart failure management, administering IV fluids and electrolytes should be guided by the client's fluid status, electrolyte levels, and response to treatment.

e. Administer 40 mg furosemide IV now: Administering furosemide IV (intravenous loop diuretic) is appropriate in this situation to manage the client's symptoms of dyspnea and crackles indicative of fluid overload in heart failure. Furosemide helps promote diuresis and reduce fluid volume, thereby alleviating symptoms of congestion and improving respiratory distress.

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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?

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Naxlex Comprehensive Predictor Exams

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Explanation

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

Explanation

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