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A nurse is caring for a client who has heart failure and is taking hydrochlorothiazide.
The nurse should monitor the client for which of the following manifestations as an adverse effect of the medication?

Hypermagnesemia.

Hypernatremia.

Hypocalcemia.

Hypokalemia.

Answer and Explanation

The Correct Answer is D

The nurse should monitor the client for hypokalemia as an adverse effect of hydrochlorothiazide.

Hypokalemia refers to a low level of potassium in the blood.

Choice A is wrong because hypermagnesemia is not a commonly reported adverse effect of hydrochlorothiazide.

Choice B is wrong because hypernatremia is not a commonly reported adverse effect of hydrochlorothiazide.

Choice C is wrong because hypocalcemia is not a commonly reported adverse effect of hydrochlorothiazide.

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Correct Answer is C

Explanation

The first intervention for a client with diabetic ketoacidosis and a blood glucose level of 800 mg/dL should be to initiate fluid replacement therapy with 0.9% sodium chloride at a rate of 15 mL/kg/hr.

This will help to replace fluids lost through excessive urination and to dilute the excess sugar in the blood.

Choice A is wrong because subcutaneous insulin injections are not the first intervention for diabetic ketoacidosis.

Insulin therapy is generally given intravenously.

Choice B is wrong because bicarbonate by IV infusion is not the first intervention for diabetic ketoacidosis.

Choice D is wrong because potassium chloride at a rate of 10 mEq/hr is not the first intervention for diabetic ketoacidosis.

Electrolyte replacement may be necessary to replace minerals such as sodium, potassium, and chloride, but this is not the first intervention 2.

A. Assist the client to a left lateral position. B. Implement fluid restrictions. C. Request a dosage increase from the provider. D. Prepare the client for hemodialysis.

Correct Answer is C

Explanation

A. Assist the client to a left lateral position.
- This is generally used for clients at risk of aspiration, and it's not indicated based on the lithium level.
B. Implement fluid restrictions.
- Fluid restrictions are usually implemented when there is a risk of fluid overload or hyponatremia, and not in this case. In fact, dehydration can raise lithium levels to toxic levels, so proper hydration is important.
C. Request a dosage increase from the provider.
- While 0.6 mEq/L is within the therapeutic range, some providers may want to see a level slightly higher for maintenance. So requesting a dosage increase from the provider is the correct action.
D. Prepare the client for hemodialysis.
- Hemodialysis is used to remove lithium from the blood in cases of severe lithium toxicity, which is indicated by levels significantly higher than 1.5 mEq/L. This is not needed when the lithium level is 0.6 mEq/L.

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A nurse is caring for a client who has heart failure and is taking hydrochlorothiazide. The nurse should monitor the client for which of the following manifestations as an adverse effect of the medication?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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A nurse is caring for a client who has heart failure and is taking hydrochlorothiazide.
The nurse should monitor the client for which of the following manifestations as an adverse effect of the medication?