Pharm Ch 34 study guide off of course point

A client with heart failure is prescribed a loop diuretic. Which client statement indicates that teaching provided by the nurse about this medication was effective?

"I will change positions slowly if I feel dizzy."

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 client with a history of kidney infections is diagnosed with early kidney failure. Which pathophysiologic reason would the nurse use to explain the reason for the client's decline in renal function?

"Repeated infections reduced the number of functioning nephrons."

After teaching a group of students about the formation of urine by the kidneys, the instructor determines that the teaching was successful when the students state which amount is usually filtered out by the kidneys each day?

180

The amount of fluid excreted as urine each day averages approximately less than how many liters?

2 L

The nurse is providing health promotion education to a client regarding proper hydration. How much urine will the nurse indicate an adequately hydrated adult produces each day?

2 L/d

A clinic nurse has been assigned to follow up with a group of patients on hydrochlorothiazide therapy. Which patient will the nurse most closely monitor for hyponatremia?

A 71-year-old female who has advanced arteriosclerosis

A client has been diagnosed with renal failure and is surprised to learn of the large volume of blood that is filtered by the kidneys. The client asks, "If that much blood gets filtered, why don't people produce more urine?" In response, the nurse should describe what phenomenon?

A very large majority of filtrate is returned to circulation.

A patient with a longstanding diagnoses 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

A nurse is preparing a teaching plan for a client with edema who is prescribed a diuretic. Which teaching should the nurse prioritize?

Administer early in the day.

A nurse is caring for a client with acute renal failure. The health care provider has prescribed a diuretic therapy for the client to promote dieresis. What intervention should the nurse perform to prevent the inconvenience caused by increased urination

Administer the drug early in the day

Aldosterone levels would be affected if which gland was dysfunctional?

Adrenal

The nurse has finished a teaching session with a client who is prescribed a diuretic to be taken twice a day. The nurse determines the session is successful when the client correctly chooses which times to take the drug.

At breakfast and midafternoon

When describing the action of spironolactone, the nurse would explain that this drug acts by:

Blocking aldosterone in the distal tubule

Much of the sodium in the filtrate is reabsorbed in the proximal convoluted tubule to the peritubular capillaries. As the sodium is moved out of the filtrate, what does it take with it?

Chloride ions

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

Descending limb of the loop of Henle

When explaining the underlying mechanisms associated with renal failure, which would be most important for the nurse to keep in mind?

Extensive kidney damage has usually occurred by the time the patient is symptomatic.

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

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 client is admitted in acute renal failure and prescribed mannitol. The nurse prepares to administer this drug via which route?

Intravenously

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

A group of students are reviewing the structure and function of the renal system. The students demonstrate understanding when they identify what as the functional unit?

Nephron

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 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.

What is the expected outcome when the glomerular membrane is damaged?

The filtration of fluid from the blood into the kidney's nephron tubule is impaired

What best describes the structure of the kidneys?

The renal pelvises drain urine into the ureters.

A nurse administers chlorothiazide to a client with renal compromise. Which action should the nurse prioritize after noting the BUN level is rising?

Withhold the next dose of the drug.

The nurse is caring for a client suspected of having renal dysfunction. The presence of what substances in the client's urine would be considered pathological?

blood cells and protein

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

furosemide

A client with heart failure has developed acute shortness of breath and pulmonary edema. The nurse will prepare for administration of what medication and via what route?

furosemide IV

The nurse is providing education to a 72-year-old client who has been discharged home on a diuretic. What should the nurse include in the discharge instructions?

how to properly weigh themselves at home

A male client is prescribed potassium-sparing diuretics to treat his disease process. During his annual visit to the health care provider, he reports experiencing muscle weakness and tingling in his fingers. What does the nurse suspect is wrong with this client?

hyperkalemia

A health care provider is considering ordering hydrochlorothiazide for a client. This drug must be used cautiously, if at all, if the client has a history of:

hypersensitivity to sulfonamides.

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

mannitol

The client is newly diagnosed with acute renal failure. The client asks the nurse what functional units of the kidneys are involved. What would the nurse reply?

nephrons

The students are studying the male reproductive system. The instructor tells the students that in the male, the urethra leaves the urinary bladder and passes through the:

prostate gland.

The nurse is caring for a client with hyperaldosteronism. For which diuretic would the nurse prepare teaching for the client?

spironolactone

The nurse reviews the past medical history of a client with symptoms of kidney failure in the Nurse's Note. Which condition would the nurse identify as contributing to the client having a low serum calcium level? Hypertension for 5 years Type 2 diabetes for 7 years Thyroidectomy 3 years ago Total hip replacement 1 year ago Atrial fibrillation was diagnosed 2 years ago

thyroidectomy