A patient with ﬂuid overload is prescribed furosemide (Lasix) 20 mg by mouth each day. What should the nurse include when teaching the patient about this medication? (Select all that apply.)

Measure body weight every day.

Expect urination to increase.

Take the medication before going to sleep.

Report swelling of the face or hands.

Expect to feel weak and dizzy.

Answer and Explanation

Correct Answer : A,B,D,E

Choice A: Measure body weight every day is correct because body weight is an indicator of ﬂuid balance and can help monitor the eﬀectiveness of the medication. The nurse should instruct the patient to weigh themselves at the same time each day, preferably in the morning, and report any significant changes to the provider.

Choice B: Expect urination to increase is correct because furosemide is a diuretic that works by blocking the reabsorption of sodium and water in the kidneys, thus increasing urine output and reducing ﬂuid volume. The nurse should instruct the patient to drink enough ﬂuids to prevent dehydration and electrolyte imbalance and to avoid taking the medication at night to prevent nocturia and sleep disturbance.

Choice C: Taking the medication before going to sleep is incorrect because taking furosemide at night can cause nocturia and sleep disturbance, as well as increase the risk of falls. The nurse should instruct the patient to take the medication in the morning or early afternoon and to avoid caﬀeine and alcohol, which can also increase urination.

Choice D: Report swelling of the face or hands is correct because swelling of the face or hands can indicate an allergic reaction or angioedema, which are rare but serious side effects of furosemide. The nurse should instruct the patient to stop taking the medication and seek immediate medical attention if they experience swelling of the face or hands, as well as difficulty breathing, hives, or itching.

Choice E: Expecting to feel weak and dizzy is correct because weakness and dizziness are common side effects of furosemide, especially when starting or increasing the dose. The nurse should instruct the patient to rise slowly from a sitting or lying position and to use caution when driving or performing other activities that require alertness. The nurse should also instruct the patient to report any signs of hypotension, such as fainting, blurred vision, or chest pain.

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Correct Answer is C

Explanation

Choice A: Sodium 165 mEq/L is incorrect. This value indicates hypernatremia, which is a high level of sodium in the blood. Hypernatremia can be caused by dehydration, but it does not indicate that the client is responding to treatment. A normal sodium level is between 135 and 145 mEq/L.

Choice B: Potassium 5.2 mEq/L is incorrect. This value indicates hyperkalemia, which is a high level of potassium in the blood. Hyperkalemia can be caused by dehydration, but it does not indicate that the client is responding to treatment. A normal potassium level is between 3.5 and 5.0 mEq/L.

Choice C: Urine specific gravity 1.020 is correct. This value indicates that the urine is concentrated, but within the normal range. Urine specific gravity measures the amount of solutes in the urine compared to water. A high urine specific gravity indicates dehydration, while a low urine specific gravity indicates overhydration. A normal urine specific gravity is between 1.005 and 1.030.

Choice D: Hct 62% is incorrect. This value indicates polycythemia, which is a high level of red blood cells in the blood. Polycythemia can be caused by dehydration, but it does not indicate that the client is responding to treatment. A normal hematocrit (Hct) level is between 37% and 52% for men and between 32% and 47% for women.

A. Bicarbonate excess B. Lethargy C. Kussmaul's respirations D. Circumoral paresthesia E. Flushing

Correct Answer is ["A","B","D"]

Explanation

Choice A: Bicarbonate excess is a sign of metabolic alkalosis, because this condition occurs when the body has too much bicarbonate or loses too much acid. This can happen in patients who have excessive vomiting, gastric suctioning, diuretic therapy, or antacid intake.

Choice B: Lethargy is a sign of metabolic alkalosis, because this condition aﬀects the central nervous system and causes decreased level of consciousness, confusion, and drowsiness. Lethargy can also result from hypoxemia, which is a condition that occurs when the blood oxygen level is too low. This can happen in patients with metabolic alkalosis who have respiratory compensation and hypoventilation.

Choice C: Kussmaul's respirations are not a sign of metabolic alkalosis, but rather of metabolic acidosis. This is a condition that occurs when the body produces too much acid or loses too much bicarbonate. This can happen in patients who have diabetic ketoacidosis, renal failure, or lactic acidosis. Kussmaul's respirations are deep, rapid, and labored breathing that help to eliminate excess carbon dioxide and acid from the blood.

Choice D: Circumoral paresthesia is a sign of metabolic alkalosis, because this condition causes hypocalcemia, which is a condition that occurs when the blood calcium level is too low. This can happen in patients with metabolic alkalosis who have increased binding of calcium to albumin due to alkaline pH. Circumoral paresthesia is a tingling sensation around the mouth that indicates neuromuscular irritability.

Choice E: Flushing is not a sign of metabolic alkalosis, but rather of hypercalcemia, which is a condition that occurs when the blood calcium level is too high. This can happen in patients who have hyperparathyroidism, malignancy, or excessive calcium intake. Flushing is a reddening of the skin that indicates vasodilation and increased blood ﬂow.

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A patient with ﬂuid overload is prescribed furosemide (Lasix) 20 mg by mouth each day. What should the nurse include when teaching the patient about this medication? (Select all that apply.)

Nursing Test Bank

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Correct Answer is C

Explanation

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Correct Answer is ["A","B","D"]

Explanation

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