A nurse is caring for an older adult client who has a new prescription for spironolactone. Which of the following laboratory values should the nurse monitor for this client?
Hemoglobin
Total cholesterol
Thyroid stimulating hormone (TSH)
Potassium
The Correct Answer is D
Rationale:
A. Hemoglobin is important for evaluating oxygen-carrying capacity and detecting anemia, but spironolactone does not directly affect hemoglobin levels. This value is not a priority for monitoring the effects of spironolactone.
B. Cholesterol levels are relevant for assessing cardiovascular risk, but spironolactone does not significantly impact lipid profiles. Therefore, total cholesterol is not the most important lab to monitor for this medication.
C. TSH is used to evaluate thyroid function. Spironolactone does not influence thyroid hormones or TSH levels, so this value is unrelated to the medication’s expected effects or complications.
D. Spironolactone is a potassium-sparing diuretic. It works by antagonizing aldosterone in the distal tubule, leading to retention of potassium. This can result in hyperkalemia, especially in older adults or those with renal impairment. Monitoring serum potassium is essential to prevent life-threatening arrhythmias and other complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
Rationale:
A. Applesauce is naturally low in sodium and is appropriate for a low-sodium diet.
B. Pretzels are typically high in sodium and should be avoided or eaten in moderation.
C. Chicken hotdogs are processed meats that contain high levels of sodium and should be avoided.
D. Lemonade is low in sodium and generally acceptable unless other health concerns are present (e.g., diabetes).
E. Tomato juice often contains added salt and is high in sodium unless specifically labeled as low-sodium.
Correct Answer is A
Explanation
Rationale:
A. Calcium gluconate is the antidote for magnesium toxicity; it helps reverse the cardiac and neuromuscular effects of hypermagnesemia.
B. IV fluid restriction is not appropriate; often IV fluids are given to promote magnesium excretion.
C. Potassium chloride is not indicated for hypermagnesemia treatment.
D. Increasing magnesium sulfate would worsen hypermagnesemia and is contraindicated.
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