Chapter 24 Diuretic Therapy and Drugs for Renal Failure

Which of the following actions by the nurse is the most important when caring for a client with renal disease who has an order for furosemide (Lasix)? 1. Assess urine output and renal laboratory values for signs of nephrotoxicity. 2. Check the specific gravity of the urine daily. 3. Eliminate potassium- rich foods from the diet. 4. Encourage the client to void every 4 hours.

1

The nurse is providing teaching to a client who has been prescribed furosemide (Lasix). Which of the following should the nurse teach the client? 1. Avoid consuming large amounts of kale, cauliflower, or cabbage. 2. Rise slowly from a lying or sitting position. 3. Count the pulse for one full minute before taking this medication. 4. Restrict fluid intake to no more than 1L per 24 hour period.

2

Which of the following manifestations may indicate the the client taking metolazone (Zaroxolyn) is experiencing hypokalemia? 1. Hypertension 2. Polydipsia 3. Cardiac dysrhythmias 4. Skin rash

3

While planning for a client's discharge from the hospital, which of the following teaching points would be included for a client going home with a prescription for chlorothiazide (Diuril)? 1. Increase fluid and salt intake to make up for the losses caused by the drug. 2. Increase intake of vitamin C- rich foods such as grapefruit and oranges. 3. Report muscle cramping or weakness to the health care provider. 4. Take the drug at night because it may cause drowsiness.

3

The client admitted for heart failure (HF) has been receiving hydrochlorothiazide (Microzide). Which of the following laboratory levels should the nurse carefully monitor? (Select all that apply) 1. Platelet count 2. WBC count 3. Potassium 4. Sodium 5. Uric acid

3,4,5

A client with a history of HF will be started on spironolactone (Aldactone). Which of the following drug groups should not be used, or used with extreme caution in patients taking potassium-sparing diuretics? 1. NSAIDs 2. Corticosteroids 3. Loop diuretics 4. ACE inhibitors or ARBs

4

Administration of potassium supplements is contraindicated in clients taking which of the following diuretics? a. Spironolactone (Aldactone) b. Furosemide (Lasix) c. Chlorothiazide (Diuril) d. Bumetanide (Bumex)

A

The client admitted for congestive heart failure (CHF) is receiving digoxin (Lanoxin) and furosemide (Lasix). Which of the following laboratory findings should the nurse carefully monitor? a. Potassium b. Creatinine c. Calcium d. Sodium

A

Which of the following actions by the nurse is most important when caring for a client with renal disease? a. Identify medications that have the potential for nephrotoxicity. b. Check the specific gravity of the urine daily. c. Eliminate potassium-rich foods from the diet. d. Encourage the client to void every four hours.

A

Which of the following actions is dependent upon proper functioning of the kidneys or the administration of Epogen? a. Stimulates the production of RBCs. b. Inhibits the release of renin. c. Detoxifies drugs in the bloodstream. d. Secretes the hormone cortisol.

A

Which of the following medications acts by blocking the reabsorption of sodium and chloride in Henle's loop? a. Furosemide (Lasix) b. Chlorothiazide (Diuril) c. Spironolactone (Aldactone) d. Metolazone (Zaroxolyn)

A

Client education as relates to loop diuretics should include goals of therapy and should include which of the following points? (Select all that apply.) a. Take in the morning to avoid nighttime urination that could result in increased risk of injury. b. Expect decreased urine output. c. Take potassium supplements, if ordered, and eat potassium-rich foods. d. Check weight daily, and report a weight gain of 2 pounds or greater in 24 hours. e. Report any change in hearing (deafness).

A, C, D, E

For which of the following disorders should the nurse assess before administering chlorothiazide (Diuril)? a. Chronic urinary tract infections b. Low blood pressure c. Congenital malformations d. Hyperkalemia

B

Which of the following is an important point of emphasis the nurse should include when teaching a client with diabetes regarding thiazides? a. Hypocalcemia b. Hyperglycemia c. Urinary tract infections d. Anemia

B

Which of the following clinical manifestations might indicate that the client has excessive potassium loss? a. Hypertension; angina b. Excessive thirst; urination c. Low blood pressure; cardiac arrhythmias d. Pitting edema; weight gain

C

Which of the following is the most important baseline value prior to initiation of diuretic therapy? a. Glucose level b. Amino acids c. Blood pressure d. Sodium bicarbonate

C