CH 24: Diuretics

The patient admitted for heart failure has been receiving hydrochlorothiazide (Microzide). Which laboratory levels should the nurse carefully monitor? (Select all that apply.) A) Platelet count B) White blood cell count C) Potassium D) Sodium E) Uric acid

Potassium, sodium, uric acid

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

Report muscle cramping or weakness to the healthcare provider.

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

Rise slowly from a lying or sitting position to standing.

Which action by the nurse is most important when caring for a patient with chronic kidney disease who has an order for furosemide (Lasix)? A) Assess urine output and renal laboratory values for signs of nephrotoxicity. B) Check the specific gravity of the urine daily. C) Eliminate potassium-rich foods from the diet. D) Encourage the patient to void every 4 hours.

Assess urine output and renal laboratory values for signs of nephrotoxicity.

A patient with severe chronic kidney disease (CKD) has ascites and peripheral edema despite treatment with furosemide (Lasix). Which medication should the nurse anticipate being substituted for furosemide (Lasix)? a) amiloride (Midamor) b) bumetanide (Bumex) c) triameterene (dyrenium) d) hydrochlorothiazide (microzide)

Bumetanide

The nurse administers an osmotic diuretic to a patient with glaucoma. Which therapeutic effect should the nurse expect? a) increased serum sodium b) increased intracranial pressure c) decreased intraocular pressure d) decreased serum sodium

decreased intraocular pressure

A patient's medication is changed from hydrochlorothiazide (Microzide) to eplerenone (Inspra). Which effect should the nurse expect this medication change to have on the patient? a) decrease peripheral edema b) eliminate risk of hyponatremia c) increase UA output d) eliminate risk of hypokalemia

eliminate risk of hypokalemia

A patient's blood pressure has increased despite taking hydrochlorothiazide (Microzide) as prescribed. For which herbal supplement should the nurse assess this patient? a) hawthorn b) ginseng c) aloe vera d) ginkgo biloba

ginko biloba

A patient has been taking a diuretic as prescribed. For which assessment finding should the diuretic be changed from a thiazide to a loop diuretic? a) increased UA output b) decreased serum sodium level c) increased edema d) decreased serum potassium level

increased edema

A patient asks if furosemide (Lasix) affects the bones. Which information about furosemide should the nurse include in the response? a) it prevents future bone loss b) it may cause a loss of calcium c) it can reverse bone loss d) it effectively treats osteoarthritis

it may cause a loss of calcium

A patient with diabetes is prescribed a thiazide diuretic. Which should the nurse instruct this patient? a) measure blood glucose level more often b) expected blurred vision and hunger c) reduce the amount of antihyperglycemic medications d) restrict fluid and elevate legs

measure blood glucose level more often

The nurse is caring for a patient taking a loop diuretic. For which patient statement should the nurse question administering the next dose of this medication? a) the doctor said my potassium level is high b) my feet are more swollen c) my ears are ringing d) i need a diuretic that makes me urinate as much as possible

my ears are ringing

A patient with chronic kidney disease (CKD) asks why polystyrene sulfate (Kayexalate) with sorbitol has been prescribed. Which response should the nurse make? a) the med will help improve kidney function b) the med will help lower your potassium level c) the med will stimulate the production of RBC d) the med will help improve metabolic acidosis

the med will help lower your potassium level

A patient requires a diuretic that acts on the early distal tubule. Which class of diuretic should the nurse anticipate being prescribed? a) loop b) potassium-sparing c) osmotic d) thiazide

thiazide

A patient with a history of heart failure will be started on spironolactone (Aldactone). Which drug group should not be used, or used with extreme caution in patients taking potassium-sparing diuretics? A) Nonsteroidal anti-inflammatory drugs B) Corticosteroids C) Loop diuretics D) Angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers

Angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers

Which of the following clinical manifestations may indicate that the patient taking metolazone (Zaroxolyn) is experiencing hypokalemia? A) Hypertension B) Polydipsia C) Cardiac dysrhythmias D) Skin rash

Cardiac dysrhythmias

A patient is prescribed a loop diuretic. Which patient statement should indicate that additional teaching is required? a) ill call the HC provider if I have vertigo b) ill call the HC provider if i gain more than 3lb in 24 hours c) ill increase my intake of potassium rich foods d) ill limit my intake of sodium

ill call the HC provider if I gain more than 3lb in 24 hours

A patient is prescribed eplerenone (Inspra) and an angiotensin-converting enzyme inhibitor medication. For which patient statement should nurse provide additional teaching? a) ill eat more bananas, prunes, beets and legumes b) its important for me to change positions slowly c) i wont cook with salt or salt substitutes d) its important for me to monitor by BP closely

ill eat more bananas, prunes, beets and legumes

The nurse teaches a patient about a prescribed thiazide diuretic. Which patient statement should indicate to the nurse that the teaching has been effective? a) i do not need to carry a wallet ID card b) I'll weigh myself every week c) ill take the med early in the day d) i'm glad that blood tests are not required

ill take med early in the day

A patient has been taking a diuretic as prescribed. For which assessment finding should the diuretic be changed from a thiazide to a loop diuretic? a) Decreased serum sodium level b) Increased urine output c) Increased edema d) Decreased serum potassium level

increased edema

What are some side effects of using a loop diuretic to treat edema? (SATA) a)dehydration b)hypertension c)hypercalcemia d)hypokalemia e)ototoxicity

dehydration, hypokalemia, ototoxicity

A patient is prescribed a potassium-sparing diuretic. Which adverse effect should the nurse instruct the patient to report? a) hypokalemia symptoms b) ototoxicity symptoms c) hypernatremia symptoms d) dysrhythmia symptoms

dysrhythmia symptoms

A patient is diagnosed with glomerulonephritis. Which statement should the nurse include when teaching about this disease process? a) albuminuria is an expected finding b) optimal kidney functioning is expected c) glomeruli are inflamed d) proteins are unable to enter the filtrate

glomeruli are inflamed

A patient is prescribed mannitol (Os-mitrol). Which should the nurse consider when administering this medication? a) bradycardia may develop as an AE b) medication may decrease the excretion of many meds c) onset of action is 4-6 hours after admin d) hyponatremia may develop

hypernatremia may develop

A patient is prescribed a loop diuretic for heart failure. Which consideration should the nurse address before administering the medication to the patient? a) consumes 2000mg of dietary sodium each day b) elevated serum potassium level c) hypersensitivity to sulfonamide antibiotics d) pitting edema of the legs

hypersensitivity to sulfonamide antibiotics

A client is taking Bumetanide and Spironolactone. You explain to the client that using these drugs together may reduce the risk of which adverse effect? a) hypokalemia b) hyponatremia c) hyperglycemia d) hypochloremia

hypokalemia

A patient is prescribed spironolactone (Aldactone). For which patient statement should the nurse withhold the medication and contact the healthcare provider? a) my doctor says i have cirrhosis of the liver b) my doctor says my potassium level is low c) i had a positive pregnancy test this morning d) i think i consumed too much sodium yesterday

i had a positive pregnancy test this morning

A patient is prescribed an average dose of a nonsteroidal anti-inflammatory drug. Which patient statement should concern the nurse? a) I have migraines b) I have severe renal disease c) I have chronic back pain d) I have osteoarthritis

i have severe renal disease

The nurse reviews new prescriptions written for a patient. For which reason should the nurse expect the prescription for a potassium supplement to be discontinued? a) med is changed from metolazone (Zaroxolyn) to mannitol (Osmitrol) b) med is changed from hydrochlorothiazide (Microzide) to eplerenone (inspra) c) med is changed from furosemide (Lasix) to bumetanide (Bumex) d) med is changed from torsemide (Demadex) to ethacrynic acid (Edecrin)

med is changed from hydrochlorothiazide (Microzide) to eplerenone (inspra)

A patient is prescribed spironalactone (Aldactone). Which symptoms should the nurse report before administering this medication? a) muscle weakness, muscle cramping and palpitations b) tinnitus, vertigo and decreased hearing c) muscle weakness, fatigue and bradycardia d) peripheral edema, crackles in lungs, hypertension

muscle weakness, fatigue and bradycardia

The nurse reviews nephron physiology with a new colleague. Which feature should the nurse describe as processing the filtrate? a) collecting ducts b) nephron loop and DCT c) renal artery and vein d) Bowmans capsule

nephron loop and DCT

A patient is prescribed an aminoglycoside antibiotic. Which laboratory values should the nurse closely monitor? a) low density and high density lipoproteins b) glucose tolerance test and sodium level c) serum creatinine and BUN d) erythrocyte sedimentation rate and platelets

serum creatinine and BUN

The nurse suspects that a patient has overdosed on acetazolamide (Diamox). Which should the nurse expect to be prescribed? a) furosemide (Lasix) b) glycerin c) sodium polystyrene sulfonate (Kayexalate) d) sodium bicarbonate

sodium bicarbonate

A patient is diagnosed with end-stage renal disease (ESRD). Which statement should the nurse include when teaching about this disease process? a) your kidney function may improve over time b) your kidneys no longer function c) you are not a candidate for kidney transplant d) dialysis will not longer remove waste products from your body

your kidneys no longer function