Pham I EAQ Ch 28

A diabetic patient who is taking an oral hypoglycemic has been prescribed metolazone. Which symptoms does the nurse assess for while caring for the patient? Select all that apply.

- Dizziness - Hyperglycemia

For which disorder does the nurse expect acetazolamide to be prescribed? Select all that apply.

- Edema - Acute glaucoma - High-altitude sickness

In the given figure of a nephron, identify the site of action of diuretics used to treat hyperaldosteronism and hypertension

1

A patient who is undergoing oral therapy with loop diuretics tells the nurse "I do not feel like eating food after initiating the therapy. I feel nauseous and lethargic." The blood pressure of the patient is determined to be 100/65 mm Hg. Which intervention will the health care provider prescribe in this situation?

A potassium-sparing diuretic with loop diuretic

Which assessment finding constitutes a contraindication for the administration of mannitol in a patient with acute renal failure?

Accumulation of fluid in the lungs.

The nurse is assessing a patient who has lower-extremity edema. The nurse learns that the patient is a mountain climber and has been suffering from headaches, nausea, and shortness of breath for the last few days. Which drug does the nurse expect the primary health care provider to prescribe for the patient?

Acetazolamide

Which adjunct drug is useful in the long-term management of open-angle glaucoma?

Acetazolamide

The nurse is caring for a patient who is undergoing diuretic therapy to relieve hypertension. Which intervention is used by the nurse to assess hypertensive episodes?

Ask the patient about signs like tingling of fingers and dizziness.

Which intervention will the nurse perform when monitoring a patient receiving triamterene?

Assess potassium levels

A patient is taking hydrochlorothiazide. On assessment, the nurse notices the patient has muscle weakness and hypotension. What is the nurse's first intervention?

Assess the serum potassium level

A patient reveals that he or she is taking daily ibuprofen for chronic back pain. On reviewing the patient's medical history, the nurse learns that the patient is also taking furosemide for high blood pressure. What does the nurse anticipate that the primary health care provider will prescribe?

Increase dose of furosemide

A patient with hypertension has been prescribed furosemide. On reviewing the patient's medical history, the nurse learns that the patient is also taking ibuprofen for rheumatoid arthritis. Which action does the nurse anticipate the primary health care provider will prescribe?

Increased dose of furosemide

The nurse notices that a patient who is receiving lithium has moderate bilateral pitting edema. The primary health care provider has prescribed a loop diuretic for the patient. For which side effect does the nurse monitor?

Lithium levels

The nurse observes that a patient's vision is not improving after acetazolamide treatment. Which drug does the nurse anticipate will be prescribed for the patient for reducing intraocular pressure?

Mannitol

Which symptom would the nurse report to the health care provider for a patient taking spironolactone?

Nausea/Vomiting

Which class of diuretic drugs act as the descending loop of Henle?

Osmotic diurectics

Which intervention does the nurse incorporate while caring for a patient who experiences furosemide toxicity?

Replace the fluids and the electrolytes.

What determines the potency of a diuretic medication?

Site of mechanism of action

The nurse is caring for a patient who has severe hepatic failure. The patient's blood pressure is 160/100 mm Hg. Which medication does the nurse anticipate that the PHCP will prescribe for this patient?

Spironolactone

Which information would the nurse provide to a patient who is receiving spironolactone and furosemide therapy?

The combination promotes diuresis but decreases the risk of hypokalemia

The nurse applies slight pressure on the fingertips of a patient undergoing diuretic therapy. When the pressure is released, the nurse observes that the patient's fingertips have slowly turned pink. How would the nurse interpreter this situation?

The patient has decrease cardiac output

A patient diagnosed with congestive heart failure is prescribed a combination of furosemide and amiloride. Which outcome indicates the effectiveness of the therapy?

The patient has strong pedal pulses and warm, pink extremities with rapid capillary refill

The laboratory report of a patient is given in the exhibit. How would the nurse interpreter the patient's condition?

The patient has weak pedal pulses

Which information will the nurse teach the patient how is prescribed chlorthalidone?

Wear protective clothing and sunscreen while taking this medication

A patient with congestive heart failure has pulmonary edema. After reviewing the patient's medical history, the nurse informs the PHCP that the patient has taken sulfa drugs in the past for pneumonia. Which drugs may the nurse expect to be initially prescribed for the patient? Select all that apply.

- Bumetanide - Chlorthalidone

A patient has recently undergone kidney transplantation and is receiving cycloporine therapy. On the follow-up visit, the nurse finds that the patient has severe ocular pain as a result of an accumulation of aqueous humor. Which treatments does the nurse anticipate the PHCP will prescribe for the patient? Select all that apply.

- Lower the dose of cyclosporine. - Give an oral dose of acetazolamide

It is ordered that a patient be given furosemide via intravenous push. Which interventions will the nurse perform? Select all that apply.

- Maintain accurate intake and output record - Assess lung sounds before and after administration - Assess blood pressure before and after administration

Which information will the nurse obtain prior to administering furosemide to a patient? Select all that apply.

- The patient's allergies - The patient's serum potassium level - The patient's baseline renal function - The patient's fluid intake and urine output

After reviewing the laboratory reports of a male patient who is taking amiloride, the nurse finds that the patient has renal dysfunction by not hepatic dysfunction. Which finding enabled the nurse to make this conclusion?

- The serum creatinine level of the patient is 2.0 mg/100 mL. - The blood urea nitrogen (BUN) level of the patient is 40 mg/100 mL. - The aspartate aminotransferase (AST) level of the patient is 42 units/L.

At which concentration is the intravenous injection of mannitol likely to crystallize?

20%

Which is the usual daily dose of spironolactone for an adult patient?

25 to 200 mg/day

How long after intravenous (IV) administration of furosemide does the nurse anticipate the beginning of diuresis?

5 minutes

The nurse questions the use of mannitol for which patient?

A 47 year old patient with anuria

Which patient would the nurse need to assess INITIALLY if the patient is receiving mannitol?

A 47 year old patient with anuria

A nurse is caring for a patient receiving acetazolamide. Which assessment finding will require immediate nursing intervention?

A decrease in arterial pH

The nurse is assessing a patient who is taking furosemide. The patient's potassium level is 3.4 mEq/L, the chloride level is 90 mmol/L, and the sodium level is 140 mEq/:. Based on the nurse's understanding of the laboratory results, which prescribed therapy can the nurse anticipate administering?

Administer 2 mEq potassium chloride per kilogram per day intravenously

A patient has been prescribed HCTZ. After reviewing the patient's lab report, the nurse informs the PHCP that the patient has hypokalemia. Which drug does the nurse expect to be included in the patient's prescription?

Amiloride

A patient taking spironolactone has been taught about the medication. Which menu selection indicates that the patient understands teaching related to this medication?

Carrots

A patient has abnormal levels of antidiuretic hormone. The nurse knows that this hormone is primarily active in which part of the nephron?

Collecting duct

A person calls that clinic and tells the primary health care provider, "last night I traveled to a ski resort located on the mountaintop. After arriving ,I began to have difficult breathing. I aslo have a headache, and I am very tired. Is there a medication you can prescribe to help me?" Which question does the nurse anticipate that the primary health care provider will ask the patient before prescribing the medication?

Do you have diabetes mellitus?

Which laboratory value will the nurse report to the health care provider adverse response to hydrochlorothiazide?

Fasting blood glucose level of 140 mg/dL

A patient with hypertension is receiving spironolactone therapy. The nurse notices that the patient's serum potassium level is 6.2 mEq/L. What does the nurse anticipate will be prescribed for the patient?

Furosemide

The nurse is caring for a patient who has congestive heart failure that resulted from diastolic dysfunction. The patient's medical history indicates that the patient has a history of chronic kidney disease. Which drug dose that nurse anticipate will be prescribed for the patient?

Furosemide

When reviewing the laboratory reports of a patient who is taking triamterene; the nurse finds that the creatinine clearance of the patient is 9 mL/min. Which drug does the nurse expect the primary health care provider to prescribe?

Furosemide

Which drug is the strongest diuretic?

Furosemide

Which drug is used cautiously in patients with a sulfa drug allergy?

Furosemide

The nurse is assessing a patient who has been prescribed diuretics. One reviewing the patient's laboratory reports, the nurse finds that the patient's creatinine clearance rate is 20 mL/min. Which dosage regimen does the nurse expect the provider to order?

Furosemide 5 mg/kg/day by mouth in the morning in a single dose

Following the assessment of a patient who is receiving furosemide, the nurse informs the primary health care provider that the patient has a serum creatinine of 2.5 mg/dL. The primary health care provider prescribes metolazone for the patient. Which intervention does the nurse follow before administering the new drug?

Give the drug 30 minutes before the furosemide.

Which diuretic is a poor choice for a patient who has gout?

HCTZ

Which side effect would the nurse include when teaching a patient who is beginning a loop diuretic?

Headache

Which side effect is associated with furosemide?

Hypokalemia

A patient with acute pulmonary edema is receiving furosemide. Which assessment finding indicates to the nurse that the intervention is working?

Lungs clear

Which class of diuretic drugs act at the descending loop of Henle?

Osmotic diuretics

A 10-year-old child who has congestive heart failure has been prescribed furosemide. Which instruction does the nurse give to the child's parents to prevent adverse effects of the medication?

Protect your child from excessive sunlight exposure.

A patient with congestive heart failure is prescribed furosemide and amiloride. However, while assessing the patient's medical record, the nurse observes that the patient is on therapy with lithium carbonate to treat bipolar disorder. How would the nurse respond in this situation?

Report to the health care provider about the patient's lithium carbonate therapy.

The nurse will expect to administer which diuretic medication to treat a patient diagnosed with primary hyperaldosteronism?

Spironolactone

The nurse is assessing a patient who has been prescribed hydrochlorothiazide. Which information does the nurse give the patient about the medication regimen?

Take the dose only in the morning

The primary health care provider instructs the nurse to administer a 20% solution of mannitol to a patient who has cerebral edema. Which information does the nurse recall before administering the drug to the patient?

To maintain normal room temperature

An elder patient who has hypertension has been prescribed furosemide. The nurse advises the patient to take the medication in the morning. Which rationale does the nurse give the patient?

To prevent the patient from urinating at night

A patient asks the nurse about taking potassium supplements while taking triamterene. What is the nurse's best response?

You are on a diuretic that is potassium-sparing, so there is no need for extra potassium