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: Anuria, which is the absence of urine production, is not a typical symptom of acute pyelonephritis. This condition usually presents with symptoms related to inflammation and infection of the kidneys rather than complete cessation of urine output.
Choice B reason: Edema, or swelling due to fluid accumulation, is more commonly associated with chronic kidney diseases or conditions like nephrotic syndrome. Acute pyelonephritis primarily involves an active infection and inflammation rather than fluid retention.
Choice C reason: Fever is a common and significant symptom of acute pyelonephritis. This condition is an infection of the kidneys that often presents with systemic signs of infection such as fever, chills, and malaise. Patients may also experience flank pain, nausea, and vomiting.
Choice D reason: Hypertension, or high blood pressure, can be seen in chronic kidney disease but is not a hallmark symptom of acute pyelonephritis. The acute infection of the kidneys primarily manifests with fever, pain, and urinary symptoms rather than elevated blood pressure.
Correct Answer is B
Explanation
Choice A reason: Red-orange colored bodily secretions are a well-known side effect of the medication rifampin, not isoniazid. Rifampin is often used in combination therapy for tuberculosis, and it can cause the patient's urine, sweat, tears, and other bodily fluids to become red or orange in color. However, this specific side effect is not associated with isoniazid, which is used as a part of the treatment regimen for tuberculosis but does not cause this particular discoloration.
Choice B reason: Tingling sensation in fingers and toes, also known as peripheral neuropathy, is a recognized side effect of isoniazid. Isoniazid can interfere with vitamin B6 (pyridoxine) metabolism, leading to a deficiency. This deficiency causes neuropathy, resulting in tingling, numbness, or burning sensations in the extremities. To prevent this side effect, patients receiving isoniazid are often prescribed vitamin B6 supplements. These supplements help prevent the development of peripheral neuropathy by ensuring adequate levels of vitamin B6 in the body, which is essential for nerve health.
Choice C reason: Difficulty distinguishing the color red from green, or color blindness, is not a side effect of isoniazid. Color vision deficiency is not associated with the use of isoniazid. Other medications, such as ethambutol, used in tuberculosis treatment can cause visual disturbances, including changes in color vision, but isoniazid does not typically affect color perception. Isoniazid's primary neurological side effect is peripheral neuropathy rather than issues with color vision.
Choice D reason: Light sensitivity, or photophobia, is not a common side effect of isoniazid. This symptom is more likely to be associated with other conditions or medications that affect the eyes or central nervous system. Isoniazid's side effects are primarily related to liver toxicity and peripheral neuropathy, rather than causing sensitivity to light. Therefore, experiencing photophobia would not be directly attributable to isoniazid therapy and would require further investigation to determine the underlying cause.
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