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:

Irritable bowel syndrome (IBS) is not a primary concern when administering sumatriptan succinate. While IBS can cause significant discomfort and affect the quality of life, it does not pose a direct contraindication to the use of sumatriptan. Sumatriptan is primarily metabolized in the liver and excreted by the kidneys, and its use is not significantly impacted by gastrointestinal conditions like IBS1.

Choice B reason:

Coronary artery disease (CAD) is a critical consideration before administering sumatriptan succinate. Sumatriptan is a selective serotonin receptor agonist that causes vasoconstriction of cranial blood vessels to relieve migraine symptoms. However, it can also cause vasoconstriction in coronary arteries, which can be dangerous for clients with CAD. This can lead to serious cardiovascular events such as myocardial infarction or angina. Therefore, it is essential to assess for any history of CAD or other significant cardiovascular conditions before administering this medication.

Choice C reason:

Seasonal allergic rhinitis is not a significant concern when administering sumatriptan succinate. While allergic rhinitis can cause symptoms such as nasal congestion, sneezing, and itching, it does not interact with the pharmacological action of sumatriptan. Therefore, it is not a contraindication for the use of this medication.

Choice D reason:

Type 2 diabetes mellitus is not a primary concern when administering sumatriptan succinate. Although diabetes can increase the risk of cardiovascular disease, the presence of diabetes alone does not contraindicate the use of sumatriptan. However, it is important to consider the overall cardiovascular risk profile of the client, including any complications related to diabetes.

A. Decreased episodes of incontinence. B. Improved ability to concentrate. C. Exhibits fewer emotional outbursts. D. Sleeps soundly through the night.

Correct Answer is D

Explanation

Choice A reason:

Decreased episodes of incontinence are not a relevant outcome of administering zolpidem. Zolpidem is a sedative-hypnotic medication primarily used to treat insomnia by enhancing the activity of GABA, an inhibitory neurotransmitter. It does not affect urinary function or bladder control. Incontinence may be caused by other factors such as aging, prostate problems, or urinary tract infections, but it is not influenced by zolpidem.

Choice B reason:

Improved ability to concentrate is not a pertinent outcome of administering zolpidem. This medication does not enhance cognitive function or attention span. In fact, zolpidem may impair memory and cause daytime drowsiness or confusion in some patients. Its primary function is to induce sleep, not to improve concentration.

Choice C reason:

Exhibiting fewer emotional outbursts is not a significant outcome of administering zolpidem. This medication does not affect mood or behavior. In some cases, zolpidem may cause paradoxical reactions such as agitation, aggression, or hallucinations, especially in older adults. Therefore, it is not used to manage emotional outbursts.

Choice D reason:

Sleeps soundly through the night is the desired outcome of administering zolpidem. This medication is specifically designed to treat sleep problems, particularly difficulty falling asleep or staying asleep. By enhancing the activity of GABA, zolpidem helps induce and maintain sleep, which is the primary goal when prescribing this medication to patients with insomnia.

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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

Before administering the initial dose of sumatriptan succinate to a client with a migraine headache, it is most important to determine if the client’s history includes which problem?

Correct Answer is B

Explanation

When administering zolpidem to an older client, which computer documentation indicates that the desired outcome has been achieved?

Correct Answer is D

Explanation

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