A patient with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in the patient's plan of care?

Limit the intake of foods high in potassium.

Cover your skin before going outside.

Replace salt with a salt substitute.

Monitor skin for excessive bruising.

Answer and Explanation

The Correct Answer is A

A. Limit the intake of foods high in potassium: Spironolactone is a potassium-sparing diuretic, which means it can cause potassium levels to rise. Therefore, the nurse should advise the patient to limit the intake of potassium-rich foods to avoid hyperkalemia.
B. Cover your skin before going outside: This instruction is not specifically related to the use of spironolactone. It is more relevant for medications that cause photosensitivity or skin reactions.
C. Replace salt with a salt substitute: Many salt substitutes contain potassium, which could increase the risk of hyperkalemia when taking spironolactone. Therefore, replacing salt with a potassium-containing salt substitute is not recommended.
D. Monitor skin for excessive bruising: While monitoring for bruising is important, it is more relevant for anticoagulants or medications that affect blood clotting, not specifically for spironolactone.

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Correct Answer is C

Explanation

A. Gout: Aspirin is not typically used for treating gout. Gout is commonly treated with medications like allopurinol or colchicine, and nonsteroidal anti-inflammatory drugs (NSAIDs) are used selectively.
B. Sepsis: Aspirin is not a primary treatment for sepsis. Sepsis is usually treated with antibiotics, fluid resuscitation, and supportive care.
C. Myocardial infarction: Aspirin is beneficial for preventing further myocardial infarctions (heart attacks) in patients with a history of cardiovascular events or at high risk. It works by inhibiting platelet aggregation, thereby reducing the risk of blood clot formation that can lead to heart attacks.
D. Rheumatoid arthritis: Although aspirin can be used for symptomatic relief in rheumatoid arthritis due to its anti-inflammatory properties, it is not the primary treatment. Other medications, such as disease-modifying antirheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs (NSAIDs), are typically used.

A. Pull up 30 units from the 70/30 vial, but only administer one third. B. Withdraw ten units regular insulin from the 70/30 vial. C. Withhold the dose until insulin regular is available on the unit. D. Obtain a new vial of regular insulin and withdraw ten units.

Correct Answer is C

Explanation

A) Pull up 30 units from the 70/30 vial, but only administer one third: The 70/30 insulin vial contains a mixture of 70% isophane (NPH) insulin and 30% regular insulin. If 30 units of this mixture are drawn, the actual amount of regular insulin would be 30% of 30 units, which equals 9 units. This does not equate to the 10 units of regular insulin required, making this option inaccurate for precise dosing.
B) Withdraw ten units regular insulin from the 70/30 vial: The 70/30 vial provides a fixed ratio of regular to NPH insulin. Extracting 10 units from this vial would not yield exactly 10 units of regular insulin; instead, it would include both types in the specified ratio, leading to an incorrect dosage of regular insulin.
C) Withhold the dose until insulin regular is available on the unit: Since the 70/30 vial contains a mixture and not solely regular insulin, it is necessary to withhold the dose until a vial of regular insulin is available. This ensures that the precise amount of regular insulin needed is administered, avoiding the imprecision and potential errors that could arise from using a mixed insulin vial.
D) Obtain a new vial of regular insulin and withdraw ten units: While obtaining a new vial of regular insulin is the correct approach for ensuring accurate dosing, the option of withdrawing ten units directly from a vial of regular insulin is not feasible if the current medication available is a mixture. This option assumes that the correct type of insulin is already available for use.

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A patient with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in the patient's plan of care?

Nursing Test Bank

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