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 B
Explanation
Choice A reason: 3% sodium chloride is a hypertonic solution that can cause fluid shifts and dehydration. It is not a suitable replacement for TPN, which is also hypertonic but provides calories, electrolytes, vitamins, and minerals. Infusing 3% sodium chloride can lead to hypernatremia, increased intracranial pressure, and cellular damage.
Choice B reason: Dextrose 10% in water is a hypertonic solution that can provide some calories and prevent hypoglycemia. It is the best option among the choices to replace TPN temporarily, until the new container arrives. However, it does not provide adequate nutrition or electrolytes, so it should not be used for a long time.
Choice C reason: Lactated Ringer's is an isotonic solution that can maintain fluid balance and electrolytes. It is not a suitable replacement for TPN, which is hypertonic and provides more calories and nutrients. Infusing Lactated Ringer's can lead to fluid overload, hyponatremia, and metabolic alkalosis.
Choice D reason: 0.9% sodium chloride is an isotonic solution that can maintain fluid balance and sodium levels. It is not a suitable replacement for TPN, which is hypertonic and provides more calories and nutrients. Infusing 0.9% sodium chloride can lead to fluid overload, hyponatremia, and metabolic acidosis.
Correct Answer is D
Explanation
Choice A reason: Increased respiratory rate is not a sign of adverse reaction to metoprolol, but rather a normal response to hypoxia or distress. Metoprolol is a betablocker that can lower the heart rate and blood pressure, but it does not affect the respiratory rate directly.
Choice B reason: Bronchodilation is not a sign of adverse reaction to metoprolol, but rather a desired effect of asthma medications such as betaagonists or anticholinergics. Metoprolol is a betablocker that can block the beta receptors in the lungs, which can cause bronchoconstriction or narrowing of the airways. This is why metoprolol is contraindicated or used with caution in clients with asthma.
Choice C reason: Decreased sputum production is not a sign of adverse reaction to metoprolol, but rather a result of effective asthma management. Metoprolol is a betablocker that does not have any direct effect on the mucus secretion or inflammation in the lungs.
Choice D reason: Wheezing is a sign of adverse reaction to metoprolol, as it indicates bronchoconstriction or narrowing of the airways. Metoprolol is a betablocker that can block the beta receptors in the lungs, which can reduce the bronchodilation effect of beta agonists or other asthma medications. This can worsen the asthma symptoms and cause wheezing, coughing, dyspnea, or chest tightness. The nurse should monitor the client for these signs and report them to the prescriber immediately.
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