Which patient assessment would alert the nurse to withhold a loop diuretic?
Crackles in the lung bases
Serum potassium of 2.6 mEq/L
+2 pitting peripheral edema
Weight gain of 2 pounds in 2 days
The Correct Answer is B
Choice A reason: Crackles in the lung bases may indicate fluid overload or pulmonary edema, which could be a reason to administer a loop diuretic to help remove excess fluid from the body. Therefore, this assessment would not typically lead to withholding the diuretic.
Choice B reason: A serum potassium level of 2.6 mEq/L is significantly low (hypokalemia). Loop diuretics, such as furosemide, can further decrease potassium levels, which can be dangerous and lead to severe complications such as cardiac arrhythmias. Therefore, the nurse should withhold the diuretic and address the low potassium level before considering further diuretic therapy.
Choice C reason: +2 pitting peripheral edema indicates fluid retention, which is commonly treated with loop diuretics. The presence of edema would not usually warrant withholding the diuretic; instead, it suggests a need for the medication to help reduce the fluid buildup.
Choice D reason: Weight gain of 2 pounds in 2 days could indicate fluid retention, especially in patients with conditions such as heart failure. This would be an indication to use a loop diuretic rather than to withhold it, as the medication would help remove the excess fluid from the body.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Severe hypotension is associated with prerenal acute kidney injury, not postrenal. Prerenal acute kidney injury results from decreased blood flow to the kidneys due to conditions like severe hypotension, leading to reduced kidney perfusion.
Choice B reason: Acute tubular necrosis (ATN) is a form of intrinsic or intrarenal acute kidney injury, not postrenal. ATN is typically caused by prolonged ischemia or exposure to nephrotoxic agents, which directly damage the kidney tubules.
Choice C reason: Postrenal acute kidney injury is caused by an obstruction in the urinary tract that prevents urine from leaving the kidneys, leading to increased pressure and kidney damage. Bilateral kidney stones partially blocking the flow of urine can cause such an obstruction, leading to postrenal acute kidney injury.
Choice D reason: Glomerulonephritis is a type of intrinsic or intrarenal acute kidney injury, not postrenal. It involves inflammation and damage to the glomeruli, the filtering units within the kidneys, and is not typically caused by an obstruction in the urinary tract.
Correct Answer is D
Explanation
Choice A reason: Hypernatremia (high sodium levels) is not typically associated with ACE inhibitors like enalapril. These medications do not significantly affect sodium levels in the body.
Choice B reason: Hypokalemia (low potassium levels) is not a common concern with ACE inhibitors. In fact, these medications can sometimes cause the opposite effect, leading to higher potassium levels.
Choice C reason: Hypertension (high blood pressure) is the condition that ACE inhibitors like enalapril are prescribed to treat. While monitoring blood pressure is important, it is not the specific concern related to potassium levels.
Choice D reason: Hyperkalemia (high potassium levels) is a significant concern for patients taking ACE inhibitors like enalapril. These medications can increase potassium levels in the blood, which can lead to serious complications such as cardiac arrhythmias. Therefore, patients need to be monitored carefully for signs of hyperkalemia, and their potassium levels should be checked regularly.
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