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 D
Explanation
Rationale:
A. A pH of 7.35 and pCO₂ of 42 mmHg are both within normal limits, indicating no acidosis.
B. A pH of 7.50 and pCO₂ of 28 mmHg indicate respiratory alkalosis, not acidosis.
C. A pH of 7.40 and pCO₂ of 43 mmHg are normal values, not consistent with acidosis.
D. A pH of 7.25 is acidic, and a pCO₂ of 55 mmHg is elevated, indicating respiratory acidosis, which is expected in a client with emphysema due to CO₂ retention.
Correct Answer is D
Explanation
Rationale:
A. Bronchoscopy allows for direct visualization of the airways and may be used for sampling or clearing secretions but does not assess acid-base balance.
B. Pulmonary function tests evaluate lung volume and airflow but are not specific to acid-base status.
C. Pulse oximetry measures oxygen saturation, which reflects oxygenation but not CO₂ levels or pH status.
D. Arterial blood gases (ABGs) are the most accurate test for evaluating acid-base balance, as they provide values for pH, PaCO₂, HCO₃⁻, and PaO₂ — essential indicators in COPD management.
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