The nurse is caring for a patient who is taking hydrochlorothiazide (HydroDIURIL) and digoxin (Lanoxin). Which potential electrolyte imbalance will the nurse monitor for in this patient?
Hypernatremia
Hypokalemia
Hypocalcemia
Hypermagnesemia
The Correct Answer is B
A. Hypernatremia: Hydrochlorothiazide promotes sodium excretion, so high sodium levels are unlikely. The medication tends to lower sodium, making hypernatremia an uncommon concern in this combination therapy.
B. Hypokalemia: Hydrochlorothiazide increases renal potassium excretion, which can lower serum potassium levels. Low potassium enhances the risk of digoxin toxicity, including arrhythmias, making close monitoring essential. This electrolyte imbalance is the most significant concern with this drug combination.
C. Hypocalcemia: Thiazide diuretics like hydrochlorothiazide actually decrease calcium excretion, so low calcium levels are not expected. Monitoring calcium is not a primary concern for this patient.
D. Hypermagnesemia: Hydrochlorothiazide increases magnesium excretion, but high magnesium levels are unlikely. Hypermagnesemia is not a common side effect of this therapy and is not a priority for monitoring in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["10\u201320"]
Explanation
10–20 mcg/mL: This is the established therapeutic range for phenytoin (Dilantin) in serum. Maintaining levels within this range ensures adequate seizure control while minimizing toxicity. Levels below 10 mcg/mL may be ineffective, and levels above 20 mcg/mL increase the risk of adverse effects such as nystagmus, ataxia, and confusion.
Correct Answer is C
Explanation
A. “Take a lower dose than normal when you have to drive.” Lowering the dose does not reliably prevent sedation, and even mild drowsiness can impair alertness needed for safe driving. Dose reduction still carries unpredictable effects on reaction time and concentration.
B. “Take the medication only when you are not driving.” This may prevent sedation during driving but does not offer a practical solution for someone who drives frequently for work. The patient may need allergy relief during driving hours, so this advice may not meet daily functional needs.
C. “You may be able to safely take a second-generation antihistamine.” Second-generation antihistamines such as loratadine and fexofenadine cause minimal sedation and are preferred for individuals who must remain alert. They provide symptom relief without the high risk of drowsiness seen in first-generation drugs.
D. “You are correct: you should not take antihistamines.” This overgeneralizes and may withhold effective treatment, since not all antihistamines impair alertness. Avoiding all antihistamines is unnecessary when safer second-generation options are available.
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