A nurse is preparing to administer bumetanide to a client who has heart failure. Which of the following findings indicates effectiveness of the medication?

Bounding radial pulse

Alert and oriented to time, place, and person

Lung sounds clear on auscultation

Bowel sounds present in four quadrants on auscultation

Answer and Explanation

The Correct Answer is C

Rationale:

A. Bounding radial pulse: A bounding radial pulse is not an indication of the effectiveness of bumetanide. It may suggest fluid overload or increased blood pressure, which is contrary to the goal of diuretic therapy in heart failure.

B. Alert and oriented to time, place, and person: While this indicates the client is neurologically stable, it does not specifically reflect the effectiveness of bumetanide, which is focused on reducing fluid overload and improving lung and cardiac function.

C. Lung sounds clear on auscultation: Clear lung sounds indicate that fluid buildup in the lungs, which is common in heart failure, has improved. Bumetanide is a diuretic that reduces fluid overload, and clear lung sounds are a key sign that the medication is effectively treating the client's condition.

D. Bowel sounds present in four quadrants on auscultation: While normal bowel sounds are important, they are not directly related to the effectiveness of bumetanide. Bumetanide’s primary effect is on fluid balance and lung function, not gastrointestinal function.

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Correct Answer is ["C","D","E","G"]

Explanation

Rationale:

A. Blood glucose level: The blood glucose level of 103 mg/dL is within normal limits (74 to 106 mg/dL) and does not require immediate follow-up. While the client has type 2 diabetes mellitus, the blood glucose is not abnormal at this time.

B. Bowel sounds: Bowel sounds are present in all four quadrants and do not require immediate follow-up. This finding is normal and is unrelated to the acute symptoms being assessed for a possible myocardial infarction.

C. Blood pressure: The client’s blood pressure is elevated at 164/80 mm Hg, which requires immediate attention in the context of chest pain and other symptoms that may suggest an acute myocardial infarction (MI).

D. Pain level: The client rates their chest pain as 7 out of 10, which is significant and consistent with potential myocardial ischemia or infarction. The pain’s radiation to the left arm, along with other symptoms like nausea and diaphoresis, suggest an urgent need for intervention.

E. Electrocardiogram findings: The 12-lead ECG shows tachycardia, ST segment elevation, and T wave changes, which are indicative of acute myocardial injury, such as an ST-elevation myocardial infarction (STEMI). This requires immediate intervention to prevent further myocardial damage.

F. Lung sounds: The lung sounds are clear in all lobes, which is reassuring and does not indicate an immediate concern.

G. Troponin T level: The elevated Troponin T level (0.40 ng/mL) is a key biomarker for myocardial injury. The elevation indicates ongoing cardiac damage, which requires immediate follow-up to assess for the extent of the infarction and initiate treatment.

A. Bilateral lung crackles B. 1+ pitting peripheral edema C. Engorged neck veins D. Urine output 25 mL/hr

Correct Answer is D

Explanation

Rationale:

A. Bilateral lung crackles: Bilateral lung crackles are typically a sign of fluid overload or pulmonary edema, not fluid loss. They do not indicate the need for fluid resuscitation in the case of burns.

B. 1+ pitting peripheral edema:1+ pitting edema is mild and does not typically indicate the need for fluid resuscitation. It may occur with minor fluid retention, but it is not a severe indication of dehydration or fluid loss that would require resuscitation.

C. Engorged neck veins: Engorged neck veins suggest fluid overload or venous congestion, often seen in conditions like heart failure, but not in the immediate need for fluid resuscitation for burn patients.

D. Urine output 25 mL/hr: A urine output of 25 mL/hr is below the normal range (30 mL/hr or more) and suggests inadequate renal perfusion. This is a clear indicator that the client may require fluid resuscitation to restore adequate circulation and kidney function.

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A nurse is preparing to administer bumetanide to a client who has heart failure. Which of the following findings indicates effectiveness of the medication?

Nursing Test Bank

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