A patient prescribed a thiazide diuretic reports frequent urination and muscle cramps.
What should not be included in the nurse's actions? Select all that apply.
Check serum electrolyte levels, especially sodium and potassium.
Instruct the patient to increase fluid intake.
Advise the patient to stop the medication immediately.
Recommend the patient take the medication with food.
The Correct Answer is C
Choice A rationale
Thiazide diuretics, such as hydrochlorothiazide, increase the excretion of sodium and potassium. Muscle cramps and frequent urination are classic signs of electrolyte imbalance, particularly hypokalemia (normal range 3.5-5.0 mEq/L) and hyponatremia (normal range 135-145 mEq/L). It is crucial for the nurse to check these levels to confirm the cause of the symptoms.
Choice B rationale
Instructing the patient to increase fluid intake is inappropriate because it could worsen electrolyte imbalances or lead to fluid overload, especially if the diuretic is already working effectively. A better approach would be to assess the patient's fluid balance and intake and provide specific, tailored advice based on their clinical status.
Choice C rationale
Advising the patient to stop the medication immediately is not an appropriate action. This can lead to a rebound of the condition being treated (e.g., hypertension, edema) and could be dangerous. The nurse should not unilaterally stop a prescribed medication; instead, they should notify the healthcare provider for a change in therapy or further instructions.
Choice D rationale
Taking thiazide diuretics with food can help to mitigate some gastrointestinal side effects and potentially improve absorption. This is a common and appropriate nursing intervention to enhance patient tolerance and adherence to the medication regimen, as it is a non-pharmacologic way to manage a common side effect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Giving the insulin is not safe because there is a possibility the patient has already received it, even though the record is not signed. Administering a second dose of insulin could lead to hypoglycemia, a life-threatening condition where the blood glucose level drops dangerously low, causing symptoms like confusion, seizures, and unconsciousness.
Choice B rationale
Holding the insulin is the initial safe action, but simply holding it doesn't resolve the issue and leaves the patient's care plan incomplete. The primary concern is the potential for a double dose and the lack of proper documentation. The problem requires a more formal and structured response than simply holding the medication and moving on.
Choice C rationale
Contacting the night nurse is an option, but it is not the most immediate or appropriate action. The night nurse may be asleep or unreachable. The nurse on duty is responsible for the patient's safety and should follow proper chain of command and reporting protocols to resolve the issue promptly and ensure patient safety.
Choice D rationale
This situation involves a medication discrepancy, a potential medication error, and a significant safety risk to the patient. Reporting it to the nursing supervisor is the correct and necessary action. The supervisor can initiate a formal investigation, ensure the patient is safe, and address the documentation issue to prevent future errors.
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale
Propylthiouracil (PTU) is an antithyroid drug that works by inhibiting the enzyme thyroid peroxidase, which is responsible for the organification and coupling steps of thyroid hormone synthesis. This action reduces the production of new thyroid hormones, making it effective in treating hyperthyroidism.
Choice B rationale
Levothyroxine is a synthetic thyroid hormone used to treat hypothyroidism. It does not inhibit thyroid hormone production and is not an antithyroid medication; rather, it replaces deficient thyroid hormone, acting in direct opposition to antithyroid drugs.
Choice C rationale
Radioactive iodine is an antithyroid medication used to treat hyperthyroidism. When ingested, it is selectively absorbed by the thyroid gland, where its radiation destroys a portion of the thyroid tissue, thereby reducing the production of thyroid hormones.
Choice D rationale
Methimazole is a thionamide antithyroid drug that inhibits thyroid hormone synthesis by blocking the oxidation of iodide and the coupling of iodotyrosine residues, similar to PTU. It is a common and effective treatment for hyperthyroidism.
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