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 D
Explanation
A) Pulling the client up from under the arms: This action can increase shearing force on the client's skin, especially if done abruptly or without proper assistance. Pulling the client up by the arms can create friction and shear between the skin and underlying tissues, potentially worsening the pressure injury.
B) Improving the client's hydration: While hydration is essential for overall skin health, it is not directly related to reducing shearing force on a pressure injury. Hydration can help maintain skin integrity and promote healing but does not directly address the mechanical forces contributing to pressure injuries.
C) Lubricating the area with skin cream: While skin cream can help moisturize and protect the skin, it may not necessarily reduce shearing force on a pressure injury. While lubrication can reduce friction between surfaces, it may not be sufficient to prevent shearing forces that occur during movement or repositioning.
D) Preventing the client from sliding in bed: This is the most appropriate action to decrease shearing force on a stage II pressure injury. Sliding in bed can exacerbate shearing forces on the skin, leading to further damage or delayed healing of the pressure injury. Using devices such as pillows, positioning aids, or specialized mattresses can help prevent the client from sliding and minimize shearing forces on the affected area, promoting healing and preventing further injury.
Correct Answer is C
Explanation
A) Gelatin: Gelatin is a suitable choice for a clear liquid diet. It is transparent and easily digestible, making it appropriate for individuals requiring clear liquids, such as those recovering from certain medical procedures or surgeries.
B) Popsicle: Popsicles are commonly included in clear liquid diets. They provide hydration and can help soothe a sore throat or provide relief from nausea. However, it is essential to ensure that the popsicle is clear and does not contain any solid fruit or pieces.
C) Yogurt: Yogurt is not typically included in a clear liquid diet. Clear liquid diets consist of transparent or translucent fluids that are easily digested and leave minimal residue in the gastrointestinal tract. Yogurt, being a semi-solid food, contains particles that are not clear and is typically considered a full liquid or soft diet item rather than a clear liquid. Therefore, the client's choice of yogurt indicates a need for further teaching regarding appropriate food choices for a clear liquid diet.
D) Broth: Broth, such as chicken or beef broth, is a staple of clear liquid diets. It is easily digested and provides essential electrolytes and hydration. Broth can be consumed hot or cold, depending on the client's preference and medical condition.
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