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

Monitor skin for excessive bruising.

Replace salt with a salt substitute.

Cover your skin before going outside.

Limit the intake of foods high in potassium.

Answer and Explanation

The Correct Answer is D

Choice A Reason:

Spironolactone is a potassium-sparing diuretic often prescribed for heart failure. While monitoring for side effects is important, excessive bruising is not a common side effect of spironolactone. Bruising might be more relevant for patients on anticoagulants or those with clotting disorders.

Choice B Reason:

Replacing salt with a salt substitute is not advisable for patients on spironolactone. Many salt substitutes contain potassium chloride, which can lead to hyperkalemia (high potassium levels) when combined with spironolactone. Hyperkalemia can cause serious cardiac issues, including arrhythmias.

Choice C Reason:

Covering the skin before going outside is not specifically related to the use of spironolactone. This advice might be more relevant for medications that cause photosensitivity, such as certain antibiotics or diuretics like hydrochlorothiazide, but not spironolactone.

Choice D Reason:

Limiting the intake of foods high in potassium is crucial for patients taking spironolactone. Spironolactone can increase potassium levels in the blood, and consuming high-potassium foods (like bananas, oranges, and potatoes) can exacerbate this effect, leading to hyperkalemia. Hyperkalemia can be dangerous and cause symptoms such as muscle weakness, fatigue, and cardiac arrhythmias.

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Correct Answer is B

Explanation

Choice A reason: Insulin glargine is a long-acting insulin used to manage blood glucose levels in patients with diabetes. It is not typically used for the acute management of severe hypoglycemia. Instead, fast-acting glucose sources or glucagon injections are recommended for severe hypoglycemia. Therefore, teaching the family how to inject insulin glargine for severe hypoglycemia is not appropriate.

Choice B reason: Teaching the client self-injection skills for daily subcutaneous administration is crucial. Insulin glargine is administered once daily to provide a steady level of insulin throughout the day and night. Proper self-injection technique ensures that the medication is delivered correctly and effectively, which is essential for managing blood glucose levels in type 2 diabetes.

Choice C reason: While it is important for patients to monitor their blood sugar levels, insulin glargine dosing is typically fixed and not adjusted based on before-meal blood sugar readings. Instead, adjustments to the dose are made based on overall blood glucose trends and A1C levels, under the guidance of a healthcare provider.

Choice D reason: Increasing the dosage of insulin glargine in response to ketoacidosis is not appropriate. Diabetic ketoacidosis (DKA) is a medical emergency that requires immediate treatment with rapid-acting insulin, fluids, and electrolytes. Patients should be instructed to seek emergency medical care if they experience symptoms of DKA.

A. Omeprazole. B. Acetaminophen. C. Captopril. D. Prednisone.

Correct Answer is B

Explanation

Choice A reason: Omeprazole is a proton pump inhibitor used to treat gastroesophageal reflux disease (GERD). While it is generally safe, it is not commonly associated with causing jaundice. Omeprazole can cause liver enzyme elevations in rare cases, but it is not a primary concern for drug-induced jaundice.

Choice B reason: Acetaminophen is known to cause hepatotoxicity, especially in high doses or with prolonged use. It is one of the most common causes of drug-induced liver injury, which can lead to jaundice. The nurse should notify the healthcare provider about the use of acetaminophen, as it is a likely culprit for the client’s jaundice.

Choice C reason: Captopril is an ACE inhibitor used to treat hypertension. While it can cause various side effects, it is not typically associated with causing jaundice. The primary concerns with captopril are related to renal function and electrolyte imbalances.

Choice D reason: Prednisone is a corticosteroid used to reduce inflammation in conditions like osteoarthritis. Although long-term use of corticosteroids can affect liver function, it is not commonly associated with causing jaundice. The nurse should still monitor liver function but focus on more likely causes.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

Correct Answer is B

Explanation

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