A nurse is teaching a client who has a diagnosis of heart failure about furosemide.
Which of the following instructions should the nurse include in the teaching about this medication? Select all that apply.

Report any indications of hearing loss.

Take the daily dose of furosemide at bedtime.

Check weight daily.

Eat foods high in potassium regularly.

Rise slowly from a sitting or lying position.

Answer and Explanation

Correct Answer : A,C,D,E

Choice A rationale

Furosemide, a loop diuretic, can cause ototoxicity, particularly with rapid IV administration or high doses. This adverse effect manifests as tinnitus, vertigo, or irreversible hearing loss due to its impact on the hair cells in the organ of Corti within the inner ear. Therefore, reporting any indications of hearing loss is crucial for client safety.

Choice B rationale

Taking the daily dose of furosemide at bedtime is generally not recommended. Furosemide has a rapid onset and relatively short duration of action, typically leading to increased urine production for several hours. Administering it at bedtime can disrupt sleep patterns due to frequent nocturia, making morning administration preferable to minimize nocturnal diuresis.

Choice C rationale

Daily weight monitoring is essential for clients taking furosemide for heart failure. Furosemide promotes diuresis, reducing fluid overload. Daily weight checks (normal variations are within 0.5-1 kg/day) allow for assessment of fluid balance and the effectiveness of the diuretic therapy, helping to identify both fluid excess and dehydration promptly.

Choice D rationale

Furosemide is a potassium-wasting diuretic, meaning it promotes the excretion of potassium from the body. Chronic use can lead to hypokalemia (normal range 3.5-5.0 mEq/L), which can cause muscle weakness, fatigue, and cardiac arrhythmias. Consuming foods high in potassium regularly helps mitigate this electrolyte imbalance and maintain physiological function.

Choice E rationale

Furosemide can cause orthostatic hypotension, a sudden drop in blood pressure upon standing. This occurs due to fluid volume depletion and vasodilation induced by the diuretic effect. Rising slowly from a sitting or lying position allows the cardiovascular system to compensate, reducing the risk of dizziness, syncope, and falls.

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Correct Answer is ["B","E"]

Explanation

Choice A rationale

Blood glucose levels are not directly impacted by epoetin alfa. Epoetin alfa stimulates erythropoiesis, the production of red blood cells, and its effectiveness is assessed by parameters related to red blood cell mass and oxygen-carrying capacity, not glucose metabolism.

Choice B rationale

Iron levels are crucial to monitor when a client is receiving epoetin alfa. Epoetin alfa stimulates red blood cell production, which requires adequate iron stores for hemoglobin synthesis. Insufficient iron can limit the therapeutic response to epoetin alfa.

Choice C rationale

Alanine aminotransferase (ALT) levels are indicators of liver function. Epoetin alfa does not have a direct hepatotoxic effect, and therefore, monitoring ALT is not a primary method to assess its effectiveness. Liver enzyme levels are not directly related to erythropoiesis.

Choice D rationale

Thyroid-stimulating hormone (TSH) levels are indicators of thyroid function. Epoetin alfa does not directly influence thyroid hormone production or regulation, and monitoring TSH would not provide information about the medication's effectiveness in stimulating red blood cell production.

Choice E rationale

Hemoglobin levels are the primary laboratory test to monitor the effectiveness of epoetin alfa. The medication's purpose is to stimulate erythropoiesis, leading to an increase in red blood cell mass and subsequently, a rise in hemoglobin concentration (normal range for adult males: 13.5–17.5 grams/dL; for adult females: 12.0–15.5 grams/dL).

A. Notify the client's provider of the incident. B. Complete an incident report describing the details of the incident. C. Review the possible adverse effects of clonidine. D. Administer clonazepam to the client as prescribed.

Correct Answer is A

Explanation

Choice A rationale

Notifying the client's provider is the first and most critical step. The provider needs to be immediately informed of the medication error, as they are responsible for assessing the client's current condition, determining the potential impact of the incorrect medication, and ordering necessary interventions or monitoring.

Choice B rationale

Completing an incident report is important for quality improvement and safety, but it should be done after the immediate safety of the client has been addressed and the provider has been notified. The priority is always patient well-being and clinical management.

Choice C rationale

While reviewing possible adverse effects is part of understanding the situation, the nurse's primary action should be to involve the prescribing authority. The provider can then provide specific guidance for monitoring and management based on the client's individual health status.

Choice D rationale

Administering clonazepam as prescribed should be done once the immediate risk from the clonidine has been assessed and managed, and the provider has given appropriate instructions. Giving the correct medication immediately without assessing the impact of the error could be premature or harmful.

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A nurse is teaching a client who has a diagnosis of heart failure about furosemide. Which of the following instructions should the nurse include in the teaching about this medication? Select all that apply.

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medical record of a client who is taking epoetin alfa. Which of the following laboratory tests should the nurse monitor to determine the effectiveness of the medication? Select all that apply.

Correct Answer is ["B","E"]

Explanation

A nurse is administering medications to a client and realizes the client received clonidine rather than the prescribed clonazepam. After checking the client's blood pressure, which of the following actions should the nurse take first?

Correct Answer is A

Explanation

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A nurse is teaching a client who has a diagnosis of heart failure about furosemide.
Which of the following instructions should the nurse include in the teaching about this medication? Select all that apply.