A nurse is assisting in the care of a male client who has a new prescription for furosemide.

Which of the following client findings should the nurse identify as a contraindication to the administration of furosemide? Select the 3 findings the nurse should identify as a contraindication.

Potassium level

Client verbal report

Blood pressure

Prescription for digoxin

BUN

Answer and Explanation

Correct Answer : A,B,D

A. Potassium level: The potassium level of 3.2 mEq/L is below the normal range and indicates hypokalemia, which furosemide can worsen because it promotes potassium loss. Administering the medication now increases the risk of arrhythmias. Correcting the potassium imbalance is essential before giving a loop diuretic.

B. Client verbal report: The client reports diarrhea, dry mouth, and excessive thirst, which suggest ongoing fluid depletion. Giving furosemide in this state can lead to further intravascular volume loss and increase the risk of hypotension or renal impairment.

C. Blood pressure: The blood pressure of 122/68 mm Hg is stable and does not indicate hypotension or hemodynamic compromise. This value would not independently prevent the administration of furosemide, as diuretics can be safely given when blood pressure is within an acceptable range.

D. Prescription for digoxin: Furosemide-induced potassium loss raises the risk of digoxin toxicity, especially when the potassium level is already low. Hypokalemia sensitizes cardiac tissue to digoxin, increasing the chance of dangerous dysrhythmias. This combination requires correction of electrolytes before administering the diuretic.

E. BUN: The BUN of 19 mg/dL is within normal limits and does not indicate renal dysfunction or dehydration severe enough to contraindicate treatment. It provides no evidence of impaired renal clearance that would complicate furosemide use.

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Correct Answer is D

Explanation

A. "I will increase vitamin C intake by drinking orange juice.": Citrus foods are acidic and can worsen GERD symptoms by increasing esophageal irritation and reflux. Clients should avoid or limit acidic foods to reduce discomfort.

B. "I will sleep flat on my back at night.": Lying flat can promote reflux of stomach contents into the esophagus, worsening GERD symptoms. Elevating the head of the bed or sleeping on the left side is recommended.

C. "I will lie down for 30 minutes after each meal.": Lying down after eating increases the likelihood of acid reflux. Clients should remain upright for at least 2–3 hours post-meal to reduce symptoms.

D. "I will eat six small meals each day.": Eating smaller, more frequent meals helps prevent excessive gastric distention and reduces reflux episodes. This approach is an effective strategy for managing GERD.

A. Perform suctioning. B. Instil saline into the tubing. C. Increase the humidification. D. Check the cuff pressure.

Correct Answer is A

Explanation

A. Perform suctioning.: Restlessness and crackles indicate retained secretions that are obstructing airflow, a common concern in clients with tracheostomies. Suctioning removes mucus and improves ventilation, reducing hypoxia and airway irritation. This intervention directly addresses both the respiratory sounds and the behavioral signs of oxygenation problems.

B. Instill saline into the tubing.: Routine saline instillation is no longer recommended because it can push secretions deeper, cause coughing spasms, and increase infection risk. It does not reliably improve secretion removal and may worsen airway irritation. This option does not address the client's immediate respiratory compromise.

C. Increase the humidification.: Humidification helps prevent thick secretions but does not rapidly correct acute airway obstruction. While useful as a supportive measure, it cannot relieve the crackles heard on auscultation or the associated restlessness. It is not the priority when signs point to retained mucus needing clearance.

D. Check the cuff pressure.: Cuff pressure monitoring protects the tracheal mucosa but does not treat ineffective airway clearance. Abnormal cuff pressure would not cause crackles or sudden restlessness related to secretion buildup. This step can be performed later but does not address the immediate problem.

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A nurse is assisting in the care of a male client who has a new prescription for furosemide. Which of the following client findings should the nurse identify as a contraindication to the administration of furosemide? Select the 3 findings the nurse should identify as a contraindication.

Nursing Test Bank

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A nurse is assisting in the care of a male client who has a new prescription for furosemide. Which of the following client findings should the nurse identify as a contraindication to the administration of furosemide? Select the 3 findings the nurse should identify as a contraindication.

A nurse is assisting in the care of a male client who has a new prescription for furosemide.

Which of the following client findings should the nurse identify as a contraindication to the administration of furosemide? Select the 3 findings the nurse should identify as a contraindication.