A nurse is caring for a client who has heart failure and has started taking a loop diuretic. Which of the following findings indicates the client is experiencing an adverse effect of the medication?

Decreased reflexes

Weight gain of 1.4 kg (3b)

Increased urinary output

Jugular vein distention

Answer and Explanation

The Correct Answer is A

A. Decreased reflexes: Loop diuretics can cause electrolyte imbalances, particularly hypokalemia and hypomagnesemia. Hypokalemia can lead to neuromuscular changes, including decreased reflexes, muscle weakness, and potentially life-threatening cardiac arrhythmias. This is an adverse effect that requires prompt assessment and intervention.

B. Weight gain of 1.4 kg (3 lb): Weight gain in heart failure may indicate fluid retention, but a loop diuretic typically promotes diuresis. A small weight gain of 1.4 kg is not immediately indicative of an adverse effect from the medication itself and may reflect other factors, such as fluid shifts or diet.

C. Increased urinary output: Increased urinary output is the intended therapeutic effect of loop diuretics. It indicates that the medication is working to reduce fluid overload rather than an adverse effect.

D. Jugular vein distention: Jugular vein distention is a sign of fluid overload in heart failure. While it may indicate insufficient therapeutic response, it is not a direct adverse effect of the loop diuretic. Monitoring and adjusting therapy may be necessary, but it is not a medication-related complication.

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Free Nursing Study Resources

Correct Answer is D

Explanation

A. "I wonder if the metal in my knee will show up in airport screenings.": This statement reflects curiosity and does not indicate a lack of understanding of the procedure or its risks.

B. "The physical therapy has not been working, so I will need to have the surgery.": The client is expressing a reason for pursuing surgery, which shows understanding of the indication and is appropriate.

C. "I look forward to being able to bend my knee again when I sit in a chair.": This statement demonstrates realistic expectations for postoperative outcomes, indicating understanding of the procedure’s benefits.

D. "I am thankful there are no serious complications from this type of surgery.": This statement indicates a misunderstanding of informed consent. The client shows a lack of awareness that all surgeries carry potential risks. The nurse should contact the surgeon to ensure the client fully understands possible complications before signing.

A. A brainstorming session with nurses B. A community-wide program C. Role playing with nurses D. Personal discussions with clients

Correct Answer is A

Explanation

A. A brainstorming session with nurses: Brainstorming encourages open discussion and the generation of creative ideas to address a specific problem, such as rising rates of sexually transmitted infections. It allows the team to contribute multiple perspectives and potential interventions that can later be evaluated for feasibility and effectiveness.

B. A community-wide program: Implementing a program is an action step rather than a strategy for generating ideas. It is a solution that may be developed after identifying potential interventions through planning and brainstorming, rather than a method for idea generation itself.

C. Role playing with nurses: Role playing is a teaching and training strategy used to practice communication or counseling skills. While useful for preparing nurses to interact with clients, it does not generate new ideas for addressing a public health concern.

D. Personal discussions with clients: Talking with clients can provide valuable insight into individual behaviors and barriers, but it is not primarily a method for generating a broad range of innovative strategies. It serves more as a source of feedback or data rather than a creative ideation tool.

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A nurse is caring for a client who has heart failure and has started taking a loop diuretic. Which of the following findings indicates the client is experiencing an adverse effect of the medication?

Nursing Test Bank

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