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 A
Explanation
Dry mouth is a common adverse effect of anticholinergic agents used to treat overactive bladder syndrome (OAB).Anticholinergic agents prevent involuntary contractions of the bladder detrusor muscle by blocking the action of acetylcholine, a neurotransmitter that stimulates the muscle.However, anticholinergics are not tissue specific, and they also affect other parts of the body where acetylcholine is involved, such as the salivary glands, the gastrointestinal tract, and the eyes.
Choice B is wrong because restlessness is not a typical side effect of anticholinergic agents.In fact, anticholinergics can cause sedation and drowsiness in some people.
Choice C is wrong because increased salivation is the opposite of what anticholinergics do.Anticholinergics reduce the secretion of saliva, causing dry mouth.
Choice D is wrong because diarrhea is also the opposite of what anticholinergics do.Anticholinergics slow down the movement of the gastrointestinal tract, causing constipation.
Some other possible adverse effects of anticholinergic agents include blurred vision, urinary retention, confusion, memory impairment, and increased risk of dementia and mortality.
Therefore, these drugs should be used with caution and under medical supervision.
Correct Answer is B
Explanation
Hypokalemia is a condition where the blood potassium level is too low, which can cause muscle weakness, arrhythmias, and other problems. Diuretics are drugs that increase urine output and help remove excess fluid from the body. Some diuretics, such as loop diuretics, also cause potassium loss in the urine.To prevent hypokalemia, a combination of diuretics may be prescribed, such as a loop diuretic with a potassium-sparing diuretic or a thiazide diuretic. These combinations help balance the potassium level while still removing sodium and water.
Choice A is wrong because they are not a part of the initial diuretic therapy.Combination diuretic therapy is usually reserved for patients who have resistant edema or hypertension that does not respond to monotherapy.
Choice C is wrong because they do not boost the blood-pressure-lowering effect of other medications.Diuretics can lower blood pressure by reducing blood volume and relaxing blood vessels, but they are not used to enhance the effect of other antihypertensive drugs.
Choice D is wrong because they do not have fewer side effects when used in a drug combination.Combination diuretic therapy can increase the risk of electrolyte imbalances, such as hyponatremia, hypokalemia, hypomagnesemia, and metabolic alkalosis.It can also cause hypotension, dehydration, and worsening renal function.Therefore, combination diuretic therapy should be used with caution and close monitoring.
Normal ranges for blood potassium level are 3.5 to 5.0 mmol/L or 3.5 to 5.0 mEq/L.Normal ranges for blood sodium level are 135 to 145 mmol/L or 135 to 145 mEq/L.
Normal ranges for blood pressure are less than 120/80 mm Hg for normal, 120-129/less than 80 mm Hg for elevated, 130-139/80-89 mm Hg for stage 1 hypertension, and 140 or higher/90 or higher mm Hg for stage 2 hypertension.
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