Which lab results should be monitored for a patient on furosemide?

Creatinine

Platelets

Chloride

RBC

Answer and Explanation

The Correct Answer is A

Choice A reason: Furosemide, a loop diuretic, increases renal workload, risking kidney injury. Creatinine rises (>1.2 mg/dL) with reduced glomerular filtration, a critical marker to monitor for nephrotoxicity or dehydration in heart failure patients.

Choice B reason: Platelets (150,000-450,000/µL) assess clotting, unaffected by furosemide directly. Diuretics alter volume, not hematopoiesis, so monitoring platelets is irrelevant unless bleeding or unrelated conditions complicate the patient’s status.

Choice C reason: Chloride may drop with furosemide, but it’s less critical than creatinine. Hypochloremia affects acid-base balance, yet renal function takes priority, as kidney damage has broader, immediate implications in therapy.

Choice D reason: RBC count reflects anemia, not furosemide’s primary effects. Diuretics cause hemoconcentration if overused, but creatinine better captures renal impact, making red cell monitoring secondary in this context.

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Correct Answer is B

Explanation

Choice A reason: Metabolic alkalosis shows pH >7.45 with HCO3- >26 mEq/L from base excess. Here, pH is 7.48, but HCO3- is normal at 24 mEq/L, ruling out metabolic cause. PaO2 of 55 mmHg indicates hypoxemia, but the primary issue isn’t metabolic.

Choice B reason: Respiratory alkalosis occurs with pH >7.45 and PaCO2 <35 mmHg from hyperventilation. Here, pH is 7.48, PaCO2 is 28 mmHg, and HCO3- is normal, confirming respiratory etiology. PaO2 of 55 mmHg shows hypoxemia, matching this acute ventilatory pattern.

Choice C reason: Metabolic acidosis has pH <7.35 and HCO3- <22 mEq/L from acid gain. Here, pH is 7.48 and HCO3- is 24 mEq/L, contradicting acidosis. PaO2 of 55 mmHg indicates hypoxemia, but the acid-base status is alkalotic, not acidic.

Choice D reason: Respiratory acidosis features pH <7.35 and PaCO2 >45 mmHg from CO2 retention. Here, pH is 7.48 and PaCO2 is 28 mmHg, showing CO2 loss, not retention. Hypoxemia (PaO2 55 mmHg) is present, but the pattern is alkalotic.

A. A 40-yr-old with a pleural effusion who reports chest discomfort B. A 72-yr-old with cor pulmonale who has 4+ bilateral edema in his legs and feet C. A 64-yr-old with lung cancer and tracheal deviation after subclavian catheter insertion D. A 28-yr-old with a history of a lung transplant 1 month ago and a fever of 101°F (38.3°C)

Correct Answer is C

Explanation

Choice A reason: Pleural effusion with chest discomfort suggests fluid buildup, causing pain but not immediate airway compromise. It’s stable compared to tracheal deviation, prioritizing respiratory distress over this less acute issue.

Choice B reason: Cor pulmonale with 4+ edema indicates chronic right heart failure, a serious but slower process. It’s less urgent than acute airway obstruction, as it’s manageable with diuretics, not an immediate threat.

Choice C reason: Tracheal deviation post-catheter insertion signals tension pneumothorax, a life-threatening emergency. It compresses airways and vessels, requiring immediate assessment and intervention to restore breathing and circulation.

Choice D reason: Fever of 101°F post-lung transplant suggests infection or rejection, critical but not airway-immediate. It’s urgent, yet tracheal deviation’s acute respiratory collapse takes precedence over this systemic concern.

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Which lab results should be monitored for a patient on furosemide?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Interpret the ABG results: pH: 7.48, PaCO2: 28 mmHg, PaO2: 55 mmHg, HCO3-: 24 mEq/L, SaO2: 87%

Correct Answer is B

Explanation

After change-of-shift report, which patient would the nurse assess first?

Correct Answer is C

Explanation

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