A patient with a history of heart failure is prescribed furosemide (Lasix). Several days after the aggressive diuretic therapy started, the patient began to exhibit confusion, tremors, muscle cramps, and nausea.
What does the nurse suspect?

Hypokalemia is a condition where the blood potassium level is too low, which can cause muscle weakness, arrhythmias, and other problems. Diuretics are drugs that increase urine output and help remove excess fluid from the body. Some diuretics, such as loop diuretics, also cause potassium loss in the urine.To prevent hypokalemia, a combination of diuretics may be prescribed, such as a loop diuretic with a potassium-sparing diuretic or a thiazide diuretic. These combinations help balance the potassium level while still removing sodium and water.

Choice A is wrong because they are not a part of the initial diuretic therapy.Combination diuretic therapy is usually reserved for patients who have resistant edema or hypertension that does not respond to monotherapy.

Choice C is wrong because they do not boost the blood-pressure-lowering effect of other medications.Diuretics can lower blood pressure by reducing blood volume and relaxing blood vessels, but they are not used to enhance the effect of other antihypertensive drugs.

Choice D is wrong because they do not have fewer side effects when used in a drug combination.Combination diuretic therapy can increase the risk of electrolyte imbalances, such as hyponatremia, hypokalemia, hypomagnesemia, and metabolic alkalosis.It can also cause hypotension, dehydration, and worsening renal function.Therefore, combination diuretic therapy should be used with caution and close monitoring.

Normal ranges for blood potassium level are 3.5 to 5.0 mmol/L or 3.5 to 5.0 mEq/L.Normal ranges for blood sodium level are 135 to 145 mmol/L or 135 to 145 mEq/L.

Normal ranges for blood pressure are less than 120/80 mm Hg for normal, 120-129/less than 80 mm Hg for elevated, 130-139/80-89 mm Hg for stage 1 hypertension, and 140 or higher/90 or higher mm Hg for stage 2 hypertension.

Pentoxifylline is a medication that improves blood flow and oxygen delivery to the tissues in patients with peripheral vascular disease (PVD), a condition that causes narrowing of the arteries in the legs.Pentoxifylline can help reduce the symptoms of intermittent claudication, which is cramping pain in the legs that occurs with walking and improves with rest.

Choice A is correct because smoking is a major risk factor for PVD and quitting smoking can improve blood flow and prevent further damage to the arteries.

Choice B is correct because prolonged sitting or standing can reduce blood flow to the legs and worsen symptoms of PVD.

Patients should avoid crossing their legs, wearing tight clothing, or exposing their legs to cold temperatures.They should also elevate their legs when resting and move them frequently.

Choice C is wrong because pentoxifylline should be taken on an empty stomach, at least one hour before or two hours after meals, to increase its absorption and effectiveness.

Choice D is wrong because physical activity is beneficial for patients with PVD and intermittent claudication.

Exercise can improve blood circulation, increase muscle strength, reduce pain, and lower cardiovascular risk factors.Patients should be encouraged to walk regularly, as tolerated, and follow a supervised exercise program if available.