The nurse is monitoring a client taking a potassium sparing diuretic. Which of the following findings would prompt the nurse to notify the health care provider?
Serum sodium level of 140 mEq/L
Blood pressure of 130/80 mmHg
Serum potassium level of 5.5 mEq/L
Serum potassium level of 3.5 mEq/L
The Correct Answer is C
Choice A reason: Serum sodium level of 140 mEq/L is within the normal range of 135145 mEq/L. It does not indicate any adverse effect of the potassium sparing diuretic, which does not affect sodium excretion significantly. The nurse does not need to notify the health care provider about this finding.
Choice B reason: Blood pressure of 130/80 mmHg is slightly above the normal range of 120/80 mmHg, but it is not a cause for concern. The potassium sparing diuretic can lower the blood pressure by reducing the fluid volume and preventing sodium retention. The nurse should monitor the blood pressure regularly but does not need to notify the health care provider about this finding.
Choice C reason: Serum potassium level of 5.5 mEq/L is above the normal range of 3.55.0 mEq/L. It indicates hyperkalemia, which is a serious and potentially life-threatening complication of the potassium sparing diuretic. The potassium sparing diuretic can increase the potassium level by inhibiting its secretion in the distal tubule of the kidney. The nurse should notify the health care provider immediately and prepare to administer interventions such as calcium gluconate, insulin, or sodium bicarbonate to lower the potassium level and prevent cardiac arrhythmias.
Choice D reason: Serum potassium level of 3.5 mEq/L is at the lower end of the normal range of 3.55.0 mEq/L. It does not indicate any adverse effect of the potassium sparing diuretic, which does not cause potassium loss. The nurse does not need to notify the health care provider about this finding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This is correct. Excedrin contains a combination of aspirin, acetaminophen, and caffeine. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that reduces pain, inflammation, and swelling. Acetaminophen is a pain reliever and a fever reducer. Caffeine is a central nervous system stimulant that enhances the pain-relieving function of aspirin and acetaminophen.
Choice B reason: This is incorrect. Ibuprofen and naproxen are both NSAIDs, but they are not the same as aspirin. They have different chemical structures and may have different effects and side effects. Caffeine is not an ingredient in ibuprofen or naproxen products.
Choice C reason: This is incorrect. Loratadine is an antihistamine that is used to treat allergies, not headaches. It does not have any pain-relieving or anti-inflammatory properties. Caffeine is not an ingredient in loratadine products.
Choice D reason: This is incorrect. Naproxen is an NSAID, but it is not the same as aspirin. It has a different chemical structure and may have different effects and side effects. Loratadine is an antihistamine that is used to treat allergies, not headaches. It does not have any pain-relieving or anti-inflammatory properties. Caffeine is not an ingredient in acetaminophen, naproxen, or loratadine products.
Correct Answer is D
Explanation
Choice A reason: Administering the medication with meals only is not a valid adjustment for a medication that is primarily excreted by the kidneys. The food intake does not affect the renal clearance of the drug, unless it alters the pH of the urine or the blood flow to the kidneys. The nurse should follow the instructions on the medication label or the prescriber's order regarding the timing of the administration.
Choice B reason: No dose adjustment is required is an incorrect statement for a medication that is primarily excreted by the kidneys. The renal impairment can reduce the elimination of the drug and increase its concentration in the blood. This can cause adverse effects and toxicity. The nurse should consult with the prescriber or the pharmacist about the appropriate dose reduction or frequency change for the patient's level of renal function.
Choice C reason: Increasing the dose to ensure therapeutic effect is a dangerous and inappropriate adjustment for a medication that is primarily excreted by the kidneys. The renal impairment can reduce the elimination of the drug and increase its concentration in the blood. This can cause adverse effects and toxicity. The nurse should not increase the dose without the prescriber's order and should monitor the patient for signs of overdose or toxicity.
Choice D reason: Decreasing the dose to prevent toxicity is the correct and rational adjustment for a medication that is primarily excreted by the kidneys. The renal impairment can reduce the elimination of the drug and increase its concentration in the blood. This can cause adverse effects and toxicity. The nurse should consult with the prescriber or the pharmacist about the appropriate dose reduction or frequency change for the patient's level of renal function. The nurse should also monitor the patient for the therapeutic response and the adverse effects of the drug.
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