A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia?
Hydrochlorothiazide
Spironolactone
Furosemide
Metolazone
The Correct Answer is B
A) Hydrochlorothiazide: Hydrochlorothiazide is a thiazide diuretic that promotes sodium and water excretion, leading to decreased blood volume and decreased potassium excretion. While it can cause hypokalemia due to increased potassium excretion, it does not typically lead to hyperkalemia.
B) Spironolactone: Spironolactone is a potassium-sparing diuretic that inhibits aldosterone, leading to decreased sodium reabsorption and increased potassium retention. This mechanism of action can predispose clients to hyperkalemia due to potassium retention. Additionally, spironolactone can cause hyponatremia by promoting the excretion of sodium and water. Therefore, clients receiving spironolactone are at risk for both hyperkalemia and hyponatremia.
C) Furosemide: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the loop of Henle, promoting sodium, chloride, potassium, and water excretion. While it can cause hypokalemia due to increased potassium excretion, it does not typically lead to hyperkalemia.
D) Metolazone: Metolazone is a thiazide-like diuretic that acts similarly to hydrochlorothiazide by promoting sodium and water excretion. Like hydrochlorothiazide, it can cause hypokalemia due to increased potassium excretion but does not typically lead to hyperkalemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) "Would you like to talk about your concerns?": This response acknowledges the client's feelings and offers support and an opportunity to discuss their concerns further. It respects the client's autonomy and allows them to express their thoughts and feelings about the situation.
B) "Why don't you want to tell your partner your diagnosis?": This response may come across as confrontational and judgmental, potentially making the client feel defensive. It does not facilitate open communication or address the client's concerns in a supportive manner.
C) "If I were you, I would tell my partner.": This response imposes the nurse's values and beliefs on the client, which may not be helpful or appropriate. It undermines the client's autonomy and decision-making process.
D) "Most people find it helpful to talk to their partner.": While this statement may be true for some individuals, it assumes that the client's situation is the same as others and does not take into account the client's unique circumstances and preferences. It does not encourage open dialogue or address the client's concerns directly.
Correct Answer is A
Explanation
A) Headache:
Clients with obstructive sleep apnea often experience morning headaches due to the intermittent hypoxia and hypercapnia that occur during episodes of apnea. These headaches are typically described as dull and diffuse and may improve throughout the day.
B) Nausea:
While gastrointestinal symptoms such as nausea can occur in some individuals with sleep apnea, it is not a typical or specific finding associated with this condition. Nausea may result from other causes, such as medication side effects or underlying gastrointestinal issues, rather than directly from obstructive sleep apnea.
C) Hypotension:
Obstructive sleep apnea is more commonly associated with hypertension rather than hypotension. The recurrent episodes of hypoxemia and sympathetic nervous system activation during apneic episodes can lead to systemic hypertension over time.
D) Constipation:
Constipation is not a typical finding associated with obstructive sleep apnea. While sleep apnea may contribute to fatigue and alterations in gastrointestinal motility in some individuals, constipation is not a direct consequence of this sleep disorder.
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