Pharm Ch 33 PrepU

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."

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 client with glaucoma has been prescribed acetazolamide. What adverse effects would the nurse caution the client about? Select all that apply.

-- Paresthesia ( abnormal sensation of the skin (tingling, pricking, chilling, burning, numbness) with no apparent physical cause) -- Confusion -- Drowsiness

The nurse is providing education to a client who has been prescribed long-term diuretic therapy. Which client statement demonstrates an understanding of self-monitoring to identify fluid-related issues?

--- "I take my scale with me when I stay overnight with friends." --- "I weigh myself in the same clothes every day." --- "I weigh myself immediately before breakfast every day."

A 10-year-old child has edema caused by a heart defect. The client is taking furosemide. The dosage is 3 mg/kg/d. The child weighs 76 lbs. How many milligrams does the child receive each day?

105 mg The nurse will administer 105 mg/dose of the drug (76 lbs divided by 2.2 = 34.5 kg, 35 kg times 3 mg = 105 mg). ---- page 379

A 91-year-old client is being discharged on the diuretic spironolactone. What assessment finding would the nurse attribute to adverse effects of this medication?

Confusion and irregular heart rate

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

A client prescribed both an ACE inhibitor and a beta-blocker for the treatment of hypertension has been consistently obtaining blood pressure readings in the vicinity of 145/90 mm Hg. As a result, the client's primary health care provider has prescribed furosemide. What order would be most consistent with this client's health needs?

Furosemide 40 mg PO BID

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 (High potassium)

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?

Hyperkalemia (high potassium)

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 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

The nurse is caring for a client with a severe head injury. An osmotic diuretic is ordered. The nurse understands which drug is an osmotic diuretic?

Mannitol

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

Osmotic diuretic

A client with hypertension has been prescribed spironolactone. The client's previous diuretic, furosemide, has been discontinued. The nurse should explain what benefit of this change?

Potassium losses are lower with spironolactone than with furosemide.

A client began taking hydrochlorothiazide 1 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 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 providing discharge instructions to a 72-year-old client who has been discharged home on a diuretic. What should the nurse include when providing discharge instructions regarding the use of a diuretic at home?

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

The nurse is conducting an admission assessment of a client who has been prescribed hydrochlorothiazide. The nurse should contact the provider because of the client's:

allergy to sulfa drugs.

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.

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

sodium

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.