51 pharm

A patient with a longstanding diagnosis of chronic renal failure has experienced a significant decline in urine output in recent days, prompting him to seek care at a local clinic. A nurse at the clinic has suggested to a colleague that the administration of a diuretic such as hydrochlorothiazide may improve the patient's urine output. How should the colleague best respond to this suggestion? "Actually, patients with renal failure usually can't take hydrochlorothiazide." "That would probably help, but we'd have to do blood work first." "Maybe, but hydrochlorothiazide affects the bladder more than the kidneys." "That would only work if he could come in twice a day to get it intravenously."

"Actually, patients with renal failure usually can't take hydrochlorothiazide."

A client asks, "Why is my prescription being switched from furosemide to spironolactone?" What is the nurse's best response? "You will have greater potassium losses with spironolactone than with furosemide." "You will have greater water losses with spironolactone than with furosemide." "You will lose less potassium with spironolactone than with furosemide." "You will have greater sodium losses with spironolactone than with furosemide."

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

A client is receiving hydrochlorothiazide. The nurse would expect this drug to begin acting within which time frame? 1 hour 2 hours 3 hours 4 hours

2 hours

The nurse is administering furosemide IV to a client. How soon after administration does the nurse expect diuretic effects to peak? 30 minutes 60 minutes 15 minutes 5 minutes

30 minutes

A client receives a dose of furosemide intravenously at 8:00 AM. The nurse would expect this drug to exert is peak effects at which time? 8:15 AM 8:30 AM 8:45 AM 9:00 AM

8:30 AM

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? Bell peppers Fresh pineapple Avocados Mushrooms

Avocados

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 Proximal tubule Collecting tubule Ascending limb of loop of Henle

Descending limb of loop of Henle

A 75-year-old client is diagnosed with atrial fibrillation and chronic congestive heart failure. The health care provider orders a combination of digoxin and diuretics to treat the client's diseases. Recent laboratory results indicate that the client's potassium level is 2 mEq/L. This client is at risk for which problem? Digoxin toxicity Exacerbation of the atrial fibrillation Subtherapeutic levels of serum digoxin Congestive heart failure

Digoxin toxicity

A client has been prescribed both digoxin and furosemide. The nurse should monitor the client for development of what adverse effect? Hyperglycemia Digoxin toxicity Hyperkalemia Tachycardia

Digoxin toxicity

What type of diet should a patient taking diuretics have? No effect on diet Eat sodium-rich or low-sodium diet as appropriate Eat potassium-rich or low-potassium diet as appropriate Eat low-sodium, low-potassium diet

Eat potassium-rich or low-potassium diet as appropriate

A nurse is caring for a patient with edema due to congestive heart failure (CHF). The physician has prescribed indapamide to the patient. The patient is also undergoing treatment with digitalis glycoside. Which intervention should the nurse perform when caring for this patient? Frequently monitor the patient's pulse rate and rhythm. Encourage the patient to eat or drink between meals and in the evening. Closely monitor the patient's condition for signs of hyperkalemia. Encourage oral fluids at frequent intervals at waking hours.

Frequently monitor the patient's pulse rate and rhythm.

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? Spironolactone Acetazolamide Furosemide Hydrochlorothiazide

Furosemide

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? Hypertension Hypokalemia Hyperkalemia Angina

Hyperkalemia

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? Hypokalemia Hypertension Angina Hyperkalemia

Hyperkalemia

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

Hyperkalemia

A health care provider has prescribed a loop diuretic for a client with hypertension. The client also has diabetes mellitus. What condition should the nurse monitor for in this client after administering the prescribed drug? Occurrence of gout attacks Increased blood glucose levels Sudden pain in the joints Sudden increase in weight

Increased blood glucose levels

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 adherence to treatment Increased diuretic effect Decreased blood pressure without a risk of bradycardia Reduced risk of potassium imbalances

Increased diuretic effect

A female client is diagnosed with hyponatremia. What type of diuretic would most likely cause this symptom? Potassium sparing Loop Thiazide Osmotic

Loop

When describing where bumetanide acts, what would the nurse include? Proximal convoluted tubule Loop of Henle Collecting tubule Glomerulus

Loop of Henle

A client is diagnosed with increased intracranial pressure. Which would the nurse expect to be ordered? Mannitol Amiloride Furosemide Bumetanide

Mannitol

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 Bumetanide Spironolactone Ethacrynic acid

Mannitol

After reviewing the different classes of diuretics available, a student demonstrates understanding when the student identifies what as an example of a thiazide-like diuretic? Furosemide Metolazone Chlorothiazide Triamterene

Metolazone

A client with renal impairment is in need of a diuretic. Because of the renal problem, potassium-sparing diuretics are contraindicated but may be used if there is no other option. If they are used at all, what nursing intervention would be most important for this client? Monitoring of CBC and serum albumin Administration of a thiazide diuretic Monitoring of serum electrolytes, creatinine, and BUN Administration of concurrent potassium

Monitoring of serum electrolytes, creatinine, and BUN

A client is receiving hydrochlorothiazide. The nurse would expect to administer this drug by which route? Intravenous Oral Intramuscular Subcutaneous

Oral

A client is unconscious and experiencing increasing intracranial pressure. What type of diuretic will the client most likely be prescribed? Thiazide diuretic Loop diuretic Potassium-sparing diuretic Osmotic diuretic

Osmotic diuretic

What is the term for the action of a diuretic in a patient with glaucoma? IOP Potassium sparing Diuresis Osmotic pull

Osmotic pull

A male client has cirrhosis and is receiving diuretic therapy. The nurse knows that what drug will help prevent metabolic alkalosis or hypokalemia in this client? Dyazide Bumetanide Hydrochlorothiazide Spironolactone

Spironolactone

A nurse is preparing to administer a diuretic that antagonizes the action of aldosterone. Which drug would the nurse be most likely to administer? Hydrochlorothiazide Acetazolamide Spironolactone Furosemide

Spironolactone

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 describe the rationale for increasing fluid intake. The client will identify strategies for limiting sodium intake. The client will accurately describe the basic structure and functions of the kidneys. The client will be able to demonstrate correct technique for blood glucose monitoring.

The client will identify strategies for limiting sodium intake.

The health care provider indicates that a client experiencing renal failure is not a candidate for therapy with potassium-sparing diuretics. How will the nurse respond when the client's family member asks why this is the case? They are the strongest form of diuretics. They may cause hyperkalemia. They promote excretion of potassium. They may cause rebound edema.

They may cause hyperkalemia.

The health care provider indicates that a client experiencing renal failure is not a candidate for therapy with potassium-sparing diuretics. How will the nurse respond when the client's family member asks why this is the case? They promote excretion of potassium. They are the strongest form of diuretics. They may cause rebound edema. They may cause hyperkalemia.

They may cause hyperkalemia.

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. include high-sodium foods in her diet. take calcium supplements. drink plenty of fluids.

eat potassium-rich foods.

A health care provider prescribes spironolactone, a potassium-sparing diuretic, for a client with cirrhosis. For which category of clients is the use of potassium-sparing diuretics contraindicated? hyperkalemia diabetes liver disease gout

hyperkalemia

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. decreased diuretic effectiveness. increased risk of arrhythmias. increased risk of bleeding.

increased risk of hyperkalemia.

A patient with a longstanding diagnosis of chronic renal failure has experienced a significant decline in urine output in recent days, prompting him to seek care at a local clinic. A nurse at the clinic has suggested to a colleague that the administration of a diuretic such as hydrochlorothiazide may improve the patient's urine output. How should the colleague best respond to this suggestion? "That would probably help, but we'd have to do blood work first." "Maybe, but hydrochlorothiazide affects the bladder more than the kidneys." "Actually, patients with renal failure usually can't take hydrochlorothiazide." "That would only work if he could come in twice a day to get it intravenously."

"Actually, patients with renal failure usually can't take hydrochlorothiazide."

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." "I can still use my salt substitute if I want to." "I need to take the drug on an empty stomach." "I should take the medicine around dinnertime for the best effect."

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

Which instruction would be most appropriate for a client who is taking a diuretic? "It's okay to take it with food." "Lie down after taking the drug." "Limit the amount of fluids you drink." "Take the daily dose around dinnertime."

"It's okay to take it with food."

Which instruction would be most appropriate for a client who is taking a diuretic? "It's okay to take it with food." "Take the daily dose around dinnertime." "Lie down after taking the drug." "Limit the amount of fluids you drink."

"It's okay to take it with food."

A client is receiving triamterene. The nurse instructs the client to avoid what foods? (Select all that apply.) Bananas Prunes Lettuce Broccoli Apples

Bananas Prunes Broccoli