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 B

Explanation

A. "I will hold the pen upside-down to select the appropriate dose.": Insulin pens are designed to be held upright with the needle pointing upward when selecting the dose. Holding it upside-down can cause air bubbles to enter the cartridge and result in inaccurate dosing. Correct technique ensures the client receives the intended insulin amount.

B. "I will apply a disposable needle on the cartridge.": Attaching a new disposable needle for each injection is essential to maintain sterility, prevent infection, and ensure accurate dosing. This practice also prevents needle damage and reduces the risk of insulin leakage during administration.

C. "I will aspirate before injecting the insulin.": Aspiration is unnecessary with subcutaneous insulin injections and can cause tissue trauma or discomfort. Current guidelines advise inserting the needle directly into subcutaneous tissue without pulling back to check for blood.

D. "I will shake the pen before injecting the insulin.": Shaking insulin aspart 70/30 can create air bubbles and compromise the insulin mixture. Instead, gently rolling the pen between the palms ensures proper mixing without introducing bubbles, preserving insulin effectiveness.

A. The client reports a sore throat. B. The client's temperature is 38.6° C (101.4° F). C. The client's sputum has streaks of blood. D. The client has inspiratory stridor.

Correct Answer is D

Explanation

A. The client reports a sore throat: Mild sore throat is a common and expected side effect following a bronchoscopy due to airway irritation from the scope. It usually resolves within a day or two and does not require urgent intervention.

B. The client's temperature is 38.6° C (101.4° F): A mild elevation in temperature can occur after bronchoscopy due to airway irritation or minor inflammatory response. While it should be monitored, it is not immediately life-threatening unless it continues to rise or is accompanied by other infection signs.

C. The client's sputum has streaks of blood: Small amounts of blood-tinged sputum are common after bronchoscopy from minor mucosal trauma. It typically resolves quickly and does not indicate severe bleeding unless the volume increases significantly.

D. The client has inspiratory stridor: Inspiratory stridor indicates upper airway obstruction, which can be a life-threatening complication following bronchoscopy. Immediate reporting to the provider is necessary for prompt assessment and intervention to maintain airway patency.

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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.

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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.