A nurse is caring for a client who has cirrhosis of the liver and is receiving spironolactone. Which of the following findings indicates that the client is responding to the treatment?
Increased appetite
Decreased jaundice
Increased energy
Decreased ascites
The Correct Answer is D
A. Increased appetite can be a positive sign but is not a direct indicator of spironolactone’s effectiveness in treating cirrhosis-related complications.
B. Decreased jaundice is a positive sign but is not the primary indicator of spironolactone’s effectiveness. Jaundice is more directly related to liver function.
C. Increased energy can indicate overall improvement but is not specific to the effects of spironolactone.
D. Decreased ascites is a direct indicator that spironolactone is effective. Spironolactone is a diuretic used to reduce fluid accumulation in the abdomen (ascites) associated with liver cirrhosis. A reduction in ascites indicates that the medication is working as intended.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["50"]
Explanation
Step 1: Determine the total volume to be infused. 100 mL
Step 2: Determine the time in minutes over which the infusion will be administered. 30 minutes
Step 3: Calculate the flow rate in mL/min. 100 mL ÷ 30 minutes = 3.33 mL/min
Step 4: Calculate the flow rate in gtt/min using the drop factor. 3.33 mL/min × 15 gtt/mL = 49.95 gtt/min
Step 5: Round to the nearest whole number. 50 gtt/min
The nurse should set the manual IV infusion to deliver 50 gtt/min.
Correct Answer is A
Explanation
A. Keep the solution refrigerated until 1 hr before infusion. This action is correct because total parenteral nutrition (TPN) solutions should be kept refrigerated to maintain their stability and prevent bacterial growth. The solution should be removed from the refrigerator about one hour before infusion to allow it to reach room temperature, which helps to reduce the risk of discomfort and complications during administration.
B. Check the client’s WBC count daily. This action is not typically required specifically for TPN administration. While monitoring the client’s overall health is important, daily WBC counts are not a standard part of TPN management unless there is a specific concern for infection.
C. Change the solution every 36 hr. This action is incorrect because TPN solutions are usually changed every 24 hours to reduce the risk of infection and ensure the client receives the correct nutrient composition.
D. Obtain the client’s weight three times a week. This action is not directly related to the immediate administration of TPN. While monitoring the client’s weight is important to assess nutritional status and fluid balance, it is not a step in the preparation or administration of TPN.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.