A patient with heart failure develops hyperaldosteronism and is prescribed spironolactone.
What instructions should the nurse include in the patient’s care plan?
Substitute salt with a salt substitute.
Protect your skin before going outside.
Limit intake of high-potassium foods.
Monitor skin for excessive bruising.
The Correct Answer is C
Choice A rationale
While salt substitutes can be a good option for some patients with heart failure, they are often high in potassium. Because spironolactone is a potassium-sparing diuretic, using a salt substitute could lead to dangerously high levels of potassium.
Choice B rationale
Protecting your skin before going outside is generally good advice, but it’s not specifically related to the use of spironolactone.
Choice C rationale
Spironolactone is a potassium-sparing diuretic, which means it can cause the body to retain potassium. Therefore, patients taking spironolactone should limit their intake of high- potassium foods to prevent hyperkalemia.
Choice D rationale
While it’s always important to monitor for side effects when taking a new medication, excessive bruising is not a common side effect of spironolactone.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Diarrhea is a common side effect of many medications, including metoclopramide. However, it is not considered a serious adverse effect that would require immediate medical attention.
Choice B rationale
Unusual irritability can be a side effect of metoclopramide, but it is not the most serious adverse effect of this medication. It is important to monitor for changes in mood or behavior, but these changes do not typically require immediate medical intervention.
Choice C rationale
Nausea is actually one of the conditions that metoclopramide is used to treat. If a patient experiences nausea while taking this medication, it may indicate that the medication is not effectively managing the patient’s symptoms, but it is not considered a serious adverse effect.
Choice D rationale
Involuntary movements, also known as tardive dyskinesia, are a serious potential side effect of metoclopramide. This condition is characterized by repetitive, involuntary movements, most often affecting the lower face. Tardive dyskinesia can be irreversible, even after
discontinuation of the medication, and can be debilitating. Therefore, any signs of involuntary movements should be reported to a healthcare provider immediately.
Correct Answer is A
Explanation
Choice A rationale
St. John’s Wort is known to interact with many prescription drugs, including cyclosporine, a medication often given to transplant patients to prevent organ rejection. St. John’s Wort can decrease plasma concentrations of cyclosporine, thus endangering the success of organ transplantations.
Choice B rationale
There is no evidence to suggest that consumption of St. John’s Wort can reduce the patient’s sodium intake.
Choice C rationale
Adding the herb does not decrease the need for corticosteroids. In fact, it can interact with many medications and cause serious complications.
Choice D rationale
While St. John’s Wort is often used to treat depression, in the context of a patient who has undergone a renal transplant, the most significant information is its potential to interact with cyclosporine and endanger the success of the transplant.
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