chapter 38
when compared to thiazides, how do loop diuretics differ? a. they are more effective as antihypertensives b. they promote potassium absorption c. they cause calcium reabsorption d. they are more potent as diuretics
D
what is the optimal time to administer diuretics? a. at bedtime b. after arising for the day c. on an empty stomach d. with meals
B
increased urine flow
diuresis
two main purposes of diuretics
- decrease hypertension - decrease edema
a patient who has had an acute myocardial infarction has been started on spironolactone 50 mg/day. when evaluating routine lab work, the nurse discovers the patient has a potassium level of 5.8 mEq/L. what is the priority nursing intervention? a. dose should be held and intake of foods rich in potassium should be restricted b. dose should be continued and the patient should be encouraged to eat fruits and vegetables c. dose should be increased and the patient instructed to decrease foods rich in potassium d. instruct the patient to continue with the current dose and report any signs or symptoms of hypokalemia
A
in which patient are loop diuretics contraindicated? a. the patient with anuria b. patient with asthma c. patient with allergy to ceftriaxone d. patient with gastric ulcers
A
what does the nurse know to be correct concerning the use of mannitol in patients? a. decreases intracranial pressure b. increases intraocular pressure c. causes sodium and potassium retention d. causes diuresis in several days
A
what is the classification of furosemide? a. loop diuretic b. osmotic c. potassium sparing d. thiazide
A
the nurse assesses the patient who is taking HCTZ for hypertension. what might the nurse expect to see if the patient is experiencing undesired side effects? (select all that apply) a. diarrhea b. dizziness c. headache d. hypocalcemia e. vomiting
A, B
A patient is admitted to the intensive care unit with increased intracranial pressure. The nurse would anticipate administering a. furosemide. b. mannitol. c. triamterene. d. spironolactone.
B
A patient is receiving furosemide. It is most important for the nurse to monitor the patient for the development of a. hyperkalemia. b. hypokalemia. c. hyponatremia. d. hypernatremia.
B
Before administering triamterene, it is most important for the nurse to determine if the patient is also receiving a. digoxin. b. potassium chloride. c. acetaminophen. d. doxazosin.
B
a patient has heart failure and a high dose of furosemide is ordered. what suggests a favorable response to furosemide? a. decrease in level of consciousness occurs, and the patient sleeps more b. respiratory rate decreases form 28 to 20/min and depth increases c. increased congestion is heard in breath sounds, and the patient complains of shortness of breath d. urine output is 50 ml/4h and intake is 200 mL
B
a patient is taking HCTZ 50 mg/day and digoxin 0.25 mg/day. the nurse plans to monitor the patient for which potential electrolyte imbalance? a. hypocalcemia b. hypokalemia c. hyperkalemia d. hypermagnesemia
B
the patient has been prescribed HCTZ for her hypertension. when she comes to the office for a follow up appointment, the nurse observes her drinking an energy drink. which herb, commonly found in some energy drinks, can increase blood pressure when taken with thiazide diuretics? a. ginger b. ginkgo c. licorice d. st. johns wort
B
the patient has been receiving spironolactone 50 mg/day for heart failure. the nurse should closely monitor for which condition? a. hypokalemia b. hyperkalemia c. hypoglycemia d. hypermagnesemia
B
what is the pharmacological action of spironolactone? a. increase potassium and sodium excretion b. promote potassium retention c. promote potassium and calcium retention d. promote potassium excretion and sodium retention
B
what should the nurse do when a patient is taking furosemide? a. instruct the patient to change positions quickly when getting out of bed b. assess blood pressure before administration c. administer the drug at bedtime for maximum effectiveness d. teach the patients to avoid fruits to prevent hyperkalemia
B
the nurse knows that which statement is correct regarding nursing care of a patient receiving HCTZ? (select all that apply) a. monitor patients for signs of hypoglycemia b. administer ordered potassium supplements c. monitor serum potassium and uric acid levels d. assess blood pressure before administration e. notify the health care provider is a patient has had oliguria for 24 hours
B, C, D, E
which type of diuretics are frequently prescribed to treat hypertension and congestive heart failure? (select all that apply) a. carbonic anhydrase inhibitors b. loop diuretics c. osmotic diuretics d. potassium sparing diuretics e. thiazide diuretics
B, D, E
A patient is taking furosemide 40 mg daily for heart failure and hypertension. It is most important for the nurse to assess the patient for the development of a. low serum potassium, sodium, and magnesium, and elevated calcium. b. low serum potassium and sodium, and elevated magnesium and calcium. c. low serum potassium, sodium, magnesium, and calcium. d. low serum potassium and sodium, with magnesium and calcium remaining normal.
C
A patient with congestive heart failure gains 5 pounds in 1 week. This most likely indicates a fluid weight gain of a. ½ L. b. 1 L. c. 2 L. d. 3 L.
C
Which statement will the nurse include when teaching a patient about loop diuretics? a. Take the medication at bedtime. b. Take the medication on an empty stomach. c. Rise slowly from a lying or sitting to standing position to prevent dizziness. d. Avoid fruit and vegetables in the diet.
C
the 65 year old patient had an acute myocardial infarction 6 months ago and has been prescribed spironolactone 100 mg/day to treat an irregular heart rate. what statement by the patient indicates that he understands the medication teaching the nurse has provided? a. I need sodium so my heart beats regularly b. this drug is dangerous if you have had a heart attack c. it helps keep potassium so my heart does not get irregular d. I need to take it with lots of bananas to keep my potassium up
C
the patient has been diagnosed with hypertension and diabetes and has been started on HCTZ. what statement by the patient indicates understanding of the drug teaching the nurse has provided? a. it will start working within minutes b. I don't need to monitor my blood sugar c. I should take my drug on an empty stomach d. I need to to keep track of my weight and blood pressure at home
D
the 70 year old patient has heart failure and has been prescribed HCTZ. what statement by the patient indicates understanding of the dosing regimen? a. I need to take it on an empty stomach for it to work b. I really only need to take my medicine when I am having a hard time breathing c. it may take several weeks before it starts to work d. I should take it in the morning so I don't have to go to the bathroom at night
D
the nurse has received an order to administer 40 mg of furosemide IV to the patient. what does the nurse know about how this drug should be administered? a. must be mixed in 50 mL of normal saline b. can only be give in a central line c. patient must be on a cardiac monitor d. should be given over 1-2 minutes
D
