A patient has been placed on a loop diuretic to reduce the fluid that has been accumulating in the lungs.
Which statement made by the patient indicates a need for further teaching about the medication by the nurse?
“I weigh myself each day before breakfast.”.
“If my shortness of breath returns, I’ll contact my healthcare provider.”.
“I’ll have a banana with my breakfast every morning.”.
“I’ll be sure to take my medication with supper.”.
The Correct Answer is D
Taking a loop diuretic with supper is not advisable because it can cause nocturia, which is the need to urinate frequently at night. This can disrupt sleep and affect quality of life. Loop diuretics should be taken in the morning or early afternoon to avoid this problem.
Choice A is wrong because weighing oneself each day before breakfast is a good way to monitor fluid balance and detect any signs of fluid retention or dehydration. This can help adjust the dose of the loop diuretic as needed.
Choice B is wrong because contacting the healthcare provider if shortness of breath returns is a sensible precaution and indicates awareness of the symptoms of worsening heart failure. Shortness of breath is caused by fluid accumulation in the lungs, which loop diuretics help to prevent or reduce.
Choice C is wrong because having a banana with breakfast every morning is a good source of potassium, which can help prevent hypokalemia, a common side effect of loop diuretics. Loop diuretics increase the excretion of potassium in the urine, which can lead to low blood levels of potassium and cause muscle weakness, cramps, fatigue, arrhythmias, and increased sensitivity to digoxin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
This is because low potassium levels (hypokalemia) increase the sensitivity of the heart to digoxin and can lead to toxicity even with normal serum digoxin levels. Digoxin inhibits the sodium-potassium pump on the cardiac cells, which causes potassium to accumulate outside the cells.Low potassium levels in the blood create a larger gradient for potassium to move out of the cells, which enhances the effect of digoxin and can cause arrhythmias.
Choice B is wrong because calcium 9.2 mg/dL is within the normal range (8.5 to 10.2 mg/dL) and does not increase the risk of digoxin toxicity.However, high calcium levels (hypercalcemia) can potentiate the effects of digoxin and cause toxicity.
Choice C is wrong because sodium 140 mEq/L is within the normal range (135 to 145 mEq/L) and does not increase the risk of digoxin toxicity.However, high sodium levels (hypernatremia) can reduce the binding of digoxin to the sodium-potassium pump and decrease its efficacy.
Choice D is wrong because magnesium 2.2 mg/dL is within the normal range (1.7 to 2.4 mg/dL) and does not increase the risk of digoxin toxicity.However, low magnesium levels (hypomagnesemia) can increase the sensitivity of the heart to digoxin and cause toxicity.
Correct Answer is D
Explanation
Angiotensin receptor blockers (ARBs) are a class of drugs that block the action of angiotensin II, a hormone that causes blood vessels to constrict and raise blood pressure. Examples of ARBs include losartan, valsartan, candesartan, and irbesartan.ARBs are used to treat hypertension, heart failure, and chronic kidney disease.
Choice A is wrong because calcium channel blockers (CCBs) are a class of drugs that prevent calcium from entering the cells of the heart and blood vessels, causing them to relax and lower blood pressure.
Examples of CCBs include amlodipine, diltiazem, verapamil, and nifedipine.CCBs are used to treat hypertension, angina, and arrhythmias.
Choice B is wrong because beta blockers are a class of drugs that reduce the heart rate and force of contraction, lowering the cardiac output and blood pressure.
Examples of beta blockers include atenolol, metoprolol, propranolol, and bisoprolol.Beta blockers are used to treat hypertension, angina, heart failure, and arrhythmias.
Choice C is wrong because platelet inhibitors are a class of drugs that prevent platelets from clumping together and forming blood clots.
Examples of platelet inhibitors include aspirin, clopidogrel, ticagrelor, and prasugrel.Platelet inhibitors are used to prevent or treat cardiovascular events such as heart attack or stroke.
Choice E is wrong because ACE inhibitors are a class of drugs that inhibit the enzyme that converts angiotensin I to angiotensin II, reducing the production of this vasoconstrictor hormone.
Examples of ACE inhibitors include lisinopril, enalapril, ramipril, and captopril.ACE inhibitors are used to treat hypertension, heart failure, and chronic kidney disease.
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