The prescriber orders furosemide 80 mg for a patient who has been retaining extra fluid after surgery. The nurse notes the following: BP of 142/88 (lying) and 108/60 (sitting); daily weight of 154 lb, a 1-lb drop from day before; serum potassium of 2.8 mEq/L.
What should the nurse do?
Administer medication.
Contact provider.
Hold medication
Give potassium supplement
The Correct Answer is B
The nurse should contact the provider before administering furosemide because the patient has a low serum potassium level of 2.8 mEq/L, which is below the normal range of 3.5 to 5.0 mEq/L. Furosemide is a diuretic that can cause potassium loss and worsen hypokalemia, which can lead to cardiac arrhythmias, muscle weakness, and fatigue. The nurse should also monitor the patient’s blood pressure, weight, and urine output, as furosemide can lower blood pressure and cause dehydration.
Choice A. Administer medication is wrong because the nurse should not give furosemide without checking with the provider first, as it could be harmful to the patient with low potassium.
Choice C. Hold medication is wrong because the nurse should not withhold furosemide without a valid reason or an order from the provider, as it could cause fluid overload and worsen the patient’s condition.
Choice D. Give potassium supplement is wrong because the nurse should not give potassium supplement without an order from the provider, as it could cause hyperkalemia or interact with other medications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Anticoagulants are medicines that increase the time it takes for blood to clot.They do not dissolve existing clots, but they can stop them from getting bigger or prevent new clots from forming.Anticoagulants work by interfering with different steps of the blood coagulation pathway, which is a complex process that involves many clotting factors.
Choice A is wrong because anticoagulants do not dissolve existing clots.To dissolve clots, you need medicines called thrombolytics or fibrinolytics, which break down the fibrin that holds the clots together.
Choice B is wrong because anticoagulants do not transport platelets.
Platelets are blood cells that help with clotting by sticking together and forming a plug at the site of an injury.Anticoagulants may affect the function of platelets, but they do not move them around.
Choice D is wrong because anticoagulants do not increase blood viscosity.
Viscosity is a measure of how thick and sticky a fluid is.
Anticoagulants are sometimes called blood thinners, but they do not actually change the viscosity of blood.They just make it less likely to clot.
Normal ranges for blood clotting tests vary depending on the type of test and the laboratory that performs it.
Some common tests and their normal ranges are:
• Prothrombin time (PT): 11 to 13.5 seconds
• International normalized ratio (INR): 0.8 to 1.2
• Activated partial thromboplastin time (aPTT): 25 to 35 seconds
• Anti-factor Xa: 0.3 to 0.7 units/mL
• D-dimer: less than 0.5 mcg/mL
Correct Answer is D
Explanation
HDL stands for high-density lipoprotein, which is a type of cholesterol that carries excess cholesterol from other parts of the body to the liver, where it can be removed.
HDL is sometimes called “good” cholesterol because it helps protect against heart disease.Having high HDL levels is not a characteristic of metabolic syndrome, but rather a protective factor.
Metabolic syndrome is a group of conditions that increase the risk of heart disease, stroke, and type 2 diabetes.These conditions include:
• Low HDLs (choice A): Having low levels of HDL cholesterol is a risk factor for metabolic syndrome, as it means there is less “good” cholesterol to remove excess cholesterol from the blood vessels.
• Type II diabetes mellitus (choice B): This is a condition where the body does not use insulin properly, leading to high blood sugar levels.
Insulin is a hormone that helps the cells take up glucose from the blood.
Insulin resistance is a key feature of metabolic syndrome.
• Hypertension (choice C): This means having high blood pressure, which can damage the heart and blood vessels over time.
High blood pressure is often associated with obesity and insulin resistance, which are common in metabolic syndrome.
• Abdominal obesity (choice E): This means having excess fat around the waist and trunk, also known as central or visceral obesity.
This type of fat is more harmful than fat in other parts of the body, as it can release inflammatory substances that affect the metabolism and increase the risk of cardiovascular disease.
• Hyperglycemia (choice F): This means having high blood sugar levels, which can damage the blood vessels and organs over time.
Hyperglycemia can result from insulin resistance or type 2 diabetes, which are both components of metabolic syndrome.
The normal ranges for some of these conditions are:
• HDL cholesterol: more than 40 mg/dL for men and more than 50 mg/dL for women
• Blood pressure: less than 120/80 mmHg
• Blood sugar: less than 100 mg/dL after fasting or less than 140 mg/dL two hours after eating
• Waist circumference: less than 40 inches for men and less than 35 inches for women
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