Pharm201 CH33

A child experiencing edema as a result of a congenital heart defect is prescribed a thiazide diuretic. The nurse should closely monitor which of the client's clinical characteristics? (Select all that apply.)

Potassium level Daily weight Blood pressure Appetite

The nurse is caring for a patient in the Emergency Department (ED) who is in pulmonary edema. The patient is treated with furosemide (Lasix). What should the nurse monitor?

Potassium levels

The pharmacology instructor is discussing the differences among the various diuretic agents. Which would the instructor cite as a difference between spironolactone and hydrochlorothiazide?

Potassium losses are greater with hydrochlorothiazide than with spironolactone.

A client has just begun therapy with furosemide (Lasix). The nurse is instructing the client about the need to consume foods high in potassium in the diet. Which foods should the nurse recommend? Select all that apply.

Prunes Watermelon Lima beans

A client began taking hydrochlorothiazide one week ago and is reporting occasional dizziness when she stands up quickly from sitting or lying. What is the nurse's best action?

Teach the client about the blood pressure effects of the medication and relevant safety measures

A client is prescribed ethacrynic acid to treat edema secondary to heart failure. After teaching the client about this drug, the nurse determines that additional teaching is needed when the client states which of the following?

"I need to avoid eating foods that contain potassium."

After teaching a patient about the action of spironolactone, the nurse determines that the teaching was successful when the patient states:

"I need to make sure I don't eat too many high potassium foods."

The nurse is teaching a 62-year-old client about hydrochlorothiazide, which the health care provider has prescribed for treatment of hypertension. What statement, made by the client, suggests that the client understands the teaching?

"I will need to stand slowly."

A male client has been ordered spironolactone (Aldactone) for hypertension. Which statement by the client indicates a need for further education?

"I will take the medication when my blood pressure is elevated."

Which statement by a 62-year-old patient indicates that the patient understands the nurse's teaching about diuretics?

"I will weigh myself daily and report significant changes."

What information should the nurse discuss with the client considering pregnancy regarding the use of a diuretic during pregnancy?

"Typically, women on diuretics prior to becoming pregnant can remain on the medication during their pregnancy."

A client asks, "Why is my prescription is being switched from furosemide to spironolactone?" What is the nurse's best response?

"You will lose less potassium with spironolactone than with furosemide."

A patient is switched from furosemide (Lasix) to spironolactone (Aldactone). The patient asks the nurse why she has been switched to a new medicine. What is the best answer that will provide patient education regarding the change?

"You will lose less potassium with spironolactone than with furosemide."

A patient is receiving acetazolamide in a sustained release form. The nurse would anticipate the onset of drug action in approximately which time frame?

2 hours

A 10-year-old child has edema caused by a heart defect. The patient is taking furosemide (Lasix). The dosage is 6 mg/kg per day. The child weighs 76 pounds. How many mg does the child receive in each dose?

210 mg

A patient is receiving digoxin (Lanoxin) and a potassium supplement. When monitoring daily laboratory values, what should the potassium level be for this patient?

3.5-5.0 mEq/L

A client with a traumatic head injury has developed increased intracranial pressure and prescribed an initial dose of mannitol 1.5 g/kg IV. The client weighs 130 pounds. The medication is available in pre-mixed 500 mL bags of 20 g/100 mL. How many mL of solution should the nurse administer? Provide your answer to the nearest mL.

443

A patient has been prescribed a daily dosage of 20 mg of torsemide for the treatment of acute pulmonary edema. The drug is available in the form of 10 mg tablets. How many tablets should the nurse get for the course of 4 days?

8

A client with a long-standing diagnosis of heart failure has been taking hydrochlorothiazide (HCTZ) for several weeks. The client reports experiencing moderate diuresis, but the care provider and the client agree that increased diuresis would be of benefit. However, the care provider has explained that the client is likely near the ceiling threshold of this drug. What is the main implication when a client prescribed hydrochlorothiazide (HCTZ) is told they are, "nearing the drug's ceiling threshold"?

A higher dose of HCTZ will not result in increased diuresis.

A client has edema of the lower extremities and abdomen. What is the reason to administer a stronger diuretic than a thiazide diuretic to this client?

A thiazide diuretic will be ineffective when immediate diuresis is needed.

A nurse demonstrates understanding of diuretics when identifying which medication as exerting its effect by inhibiting the enzyme carbonic anhydrase?

Acetazolamide

A patient with glaucoma has been prescribed a diuretic as treatment of her disease process. What drug does the nurse suspect that the patient will be prescribed?

Acetazolamide (Diamox)

You have been prescribed HydroDIURIL. What will the nurse tell you is considered a contraindication to the administration of hydrochlorothiazide (HydroDIURIL)?

Allergy to sulfa drugs

What would be a contraindication to the use of carbonic anhydrase inhibitors?

Allergy to sulfonamides

A patient who was recently prescribed spironolactone calls the clinic. The patient states that they aren't going to the bathroom any more than before they started talking the spironolactone. What would be an appropriate question to ask this patient?

Are you taking a salicylate?

A nurse is providing patient teaching for a 62-year-old woman who is taking triamterene. The nurse will teach the patient to avoid what in her diet?

Avocados

What sign is most indicative of dehydration in a patient taking diuretics?

Body weight

The nurse is caring for a client who has been prescribed hydrochlorothiazide for the management of hypertension. The medical history of the client states that the client is sensitive to tartrazine. The nurse would assess the client for which finding as a possible adverse reaction?

Bronchial asthma

A patient is prescribed a thiazide diuretic that is to be administered intravenously. Which agent would this most likely be?

Chlorothiazide

The nurse is caring for a client with peripheral edema who has just begun taking a diuretic. What assessments should the nurse use to evaluate the effectiveness of this medication? Select all that apply.

Daily weights Inspection of lower legs and feet Urine output

The staff educator in the ICU is talking with a group of new nurses about osmotic diuretics. The educator would tell the new nurses that osmotic diuretics act upon which site in the nephron?

Descending limb of loop of Henle

Diuretics increase the production and output of urine. Which statement helps explain how diuretics achieve these effects?

Diuretics reduce the reabsorption of water in the kidneys.

A client has been prescribed hydrochlorothiazide for hypertension. The nurse is giving the client discharge instructions. Which adverse effects would the nurse caution the client about? Select all that apply.

Dizziness Nocturia Muscle cramps

What type of diet should a patient taking diuretics have?

Eat potassium-rich or low-potassium diet as appropriate

A nurse encourages a patient who is receiving a diuretic to maintain his fluid intake to prevent the risk for developing:

Fluid rebound

After teaching a group of nursing students about diuretics, the instructor determines that the teaching was successful when the group identifies which as a loop diuretic?

Furosemide

An elderly patient with a history of congestive heart failure has been admitted to hospital with failure to thrive and admission blood work reveals a hemoglobin level of 6.9 g/dL. The care team has consequently administered two units of packed red blood cells, but auscultation of the client's lungs now reveals diffuse crackles. Administration of what drug is likely to resolve the patient's pulmonary edema?

Furosemide

Which is an example of a loop diuretic?

Furosemide (Lasix)

When preparing the teaching plan for a male client who is prescribed spironolactone, the nurse would alert the client to the possibility of which of the following?

Gynecomastia

As part of a class presentation, a nursing student is describing the actions of the different diuretics. Which medication would the student include as exerting its diuretic effect by inhibiting the reabsorption of sodium and chloride ions in the ascending portion of the loop of Henle and the early distal tubule of the nephron?

Hydrochlorothiazide

A 91-year-old client, who is being prepared for discharge, has been prescribed the diuretic spironolactone. While teaching the client about the drug, what major adverse effect should the nurse be sure to mention?

Hyperkalemia

A 91-year-old patient is being discharged on the diuretic spironolactone (Aldactone). What is the major adverse effect of this type of medication?

Hyperkalemia

After reviewing information about thiazide diuretics, a group of students demonstrate the need for additional teaching when they identify what as a possible adverse effect?

Hypocalcemia

A client comes to the clinic for a 1-month follow-up appointment. The client states taking chlorothiazide (Diruil) for the month it has been prescribed and now has leg cramps and "feels tired all the time." What will the nurse consider as the cause of the patient's symptoms?

Hypokalemia

The nurse assesses the client for which of the following symptoms that may indicate that the client has excessive potassium loss?

Hypotension

The client has been taking hydrochlorothiazide for hypertension. Which manifestations would indicate the client is experiencing hyponatremia? Select all that apply.

Hypotension Confusion Tachycardia

A patient is receiving bumetanide. The nurse would instruct the patient to be alert for what issues? (Select all that apply.)

Hypotension Dizziness Weakness Muscle cramps

A nurse is writing a plan of care for a patient who is taking a diuretic. What would be an appropriate nursing diagnosis for this patient?

Impaired urinary elimination

A client takes digoxin and furosemide (Lasix), a potassium-wasting diuretic, for edema related to congestive heart failure. The nurse knows that hypokalemia has what effect on digoxin?

Increased risk of cardiac arrhythmias

Hydrochlorothiazide works by what mechanism of action?

Increasing the excretion of sodium and chloride in the distal tubule

A nurse has been assigned to patient who receives hydrochlorothiazide each morning for the treatment of primary hypertension. Which of the following components of the patient's morning blood work should prompt the nurse to temporarily hold the drug this morning and consult with the physician?

K+ 3.0 mEq/L

The nurse understands that the action of most diuretics typically results in which effects? (Select all that apply.)

Loss of water Loss of chloride

The nurse is caring for a client who is experiencing elevated intracranial pressure following neurosurgery. The health care provider orders an osmotic diuretic to reduce pressure. Which medication would the nurse expect to be ordered?

Mannitol

When teaching a class about diuretics, a nursing instructor describes a class of drugs that increases the density of the filtrate in the glomerulus. Which medication would the instructor cite as an example?

Mannitol

The nurse is caring for a patient with a severe head injury. An osmotic diuretic is ordered. Which drug is an osmotic diuretic?

Mannitol (Osmitrol)

Following a referral from the client's optometrist, a client has been assessed and diagnosed with open-angle glaucoma. When administering the client's subsequent medications, the nurse should prioritize what action?

Monitor the client's potassium levels

A nurse is caring for a client receiving diuretic therapy for the treatment of ascites due to malignancy. The nurse suspects that the client is developing hypomagnesemia based on which of the following? Select all that apply.

Paresthesias Tachycardia Tremors

A patient has been prescribed furosemide (Lasix). Because this drug causes potassium loss, what will the nurse instruct the patient to eat?

Peaches

An adult client with a diagnosis of hypertension has been prescribed oral furosemide. What goal should the nurse identify when planning this client's medication teaching session?

The client will identify strategies for limiting sodium intake.

Why would potassium-sparing diuretics be contraindicated for clients experiencing renal failure?

They may cause hyperkalemia.

A 27-year-old client has a history of frequent bladder infections. Which classification of diuretic would be contraindicated for this client?

Thiazide diuretics

A nurse obtains an allergy history from a client based on the understanding that which class is associated with a cross-sensitivity reaction with sulfonamides?

Thiazide diuretics

The nurse is caring for a client who has just been diagnosed with essential hypertension. The nurse should expect to administer what classification of diuretics as first-line therapy?

Thiazide diuretics

A nurse is explaining about the diuretic the patient has just been ordered. Why would the nurse tell the patient to drink 8 to 10 glasses of water daily (unless it is counterindicated)?

To avoid rebound edema

The nurse is providing discharge instructions to a 72-year-old patient who has been discharged home on a diuretic. What would the patient's instructions regarding the use of a diuretic at home include?

To weigh themselves on the same scale, at the same time of day, in the same clothing

A nurse is teaching a nursing student about loop diuretics. What drugs would the nurse include? Select all that apply.

Torsemide Ethacrynic acid Bumetanide

A nurse is providing care to a client who is to receive acetazolamide for epilepsy. Before administering this drug, the nurse would assess which of the following?

Vital signs and weight

A patient with glaucoma has been prescribed acetazolamide (Diamox). What adverse effects would the nurse caution the patient about? (Mark all that apply.)

Weakness Rash Anorexia

A hospital client demonstrating peripheral edema has been prescribed furosemide. How should the nurse best determine the extent of the client's desired fluid loss?

Weigh the client daily.

When providing medication teaching about to a client prescribed spironolactone, what foods should the client be instructed to avoid?

bananas

An elderly client with a history of heart failure has presented to the emergency department in respiratory distress. Assessment reveals the presence of pulmonary edema, and an infusion of IV furosemide has been prescribed. For the duration of treatment, the nurse should prioritize assessments related to which expected age-related dysfunctions? Select all that apply.

cardiac function renal function hepatic function

A 49-year-old client reports frequent muscle cramps while on hydrochlorothiazide therapy. The nurse would advise the client to do which?

eat potassium-rich foods.

Which diuretic will most likely be the initial drug of choice when a client demonstrates dyspnea related to pulmonary edema?

furosemide

A hospital client with a diagnosis of liver failure has been prescribed a low dose of spironolactone in order to treat ascites. The nurse who is providing this client's care should prioritize assessments for the signs and symptoms of what health problem?

hepatic encephalopathy

A 68-year-old patient, an insulin-dependent diabetic, is to receive hydrochlorothiazide (HydroDIURIL). Prior to administering the dose, the nurse should inform the patient that:

her insulin dose may need to be increased.

An older adult client has a complex medical history that includes heart failure, type 1 diabetes, and diabetic nephropathy. The nurse has questioned a care provider's prescription for oral spironolactone because the client's health problems would contribute to a high risk of which adverse reaction?

hyperkalemia

A nurse notes that a newly admitted client is currently prescribed both a loop diuretic as well as a thiazide diuretic. The nurse understands what primary rationale for the concurrent use of these two drugs?

increased diuretic effect

A health care provider has prescribed triamterene to a male client with renal disease. The client informs the nurse that he is taking potassium supplements to address some heart problems. The nurse would be alert for:

increased risk of hyperkalemia.

A client is unconscious and experiencing increasing intracranial pressure. What type of diuretic will the client most likely be prescribed?

osmotic diuretic

An adult client with multiple chronic health problems has been prescribed furosemide in the management of hypertension. When reviewing this client's current medication administration record, what drug should signal the nurse to a potentially increased risk of hypokalemia?

prednisonev

An elderly client's compromised nutritional status has necessitated the use of a nutritional formula. When reviewing this client's laboratory findings, the nurse should prioritize which value?

serum albumin

What substance is reabsorbed in the ascending limb of the loop of Henle?

sodium

What assessment should the nurse make before administering the first dose of hydrochlorothiazide?

sulfonamide allergy

A nurse is caring for a patient who is receiving mannitol. The nurse should be aware that the ongoing mannitol administration should be withheld if

the urine output is less than 30 mL/hour after the test dose.