chapter 51 prep U

A patient has edema of the lower extremities with crackles in the lung bases. The patient is prescribed furosemide 40 mg two times per day orally. What is the recommended weight loss per day?

2 lbs

a group of students are reviewing the various classes of diuretics. the students demonstrated understanding of the information when they identify which of the following as a loop diuretic.

Furosemide

Which of the following drugs cause diuresis by inhibiting re-absorption of sodium and chloride ions in the distal and proximal tubules and in the loop of Henle? Select all that apply

Furosemide and bumetanide

A patient has edema of the lower extremities and abdomen. What is the reason to administer a stronger diuretic than a thiazide diuretic to this patient

a thiazide diuretic will be ineffective for immediate diuresis.

which of the following drugs are sulfonamides with non bacteriostatic action , that inhibit the enzyme carbonic anhydrase

acetazolamide methazolamide

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 cant take hydrochorothiazide.

a nurse is caring for a patient with acute renal failure. the physician has prescribed a diuretic therapy for the patient to promote dieresis. what intervention should the nurse perform to prevent the inconvenience caused by increased urination

administer drug early in the day

Which of the following would be a contraindication to the use of carbonic anhydrase inhibitors?

allergy to sulfonamides

a patient is taking spironolactone. when providing patient teaching about this medication, what foods should the patient be instructed to avoid

bananas

when describing the action of chlorothiazide which of the following would a nurse include

blocking of the chloride pump

upon her visit to your primary care physician's office, your patient with 14 lbs of additional weight since her last visit 3 weeks ago. her lower extremities are quite swollen, and her facial features are puffy. the physician prescribes a diuretic and request a follow up visit in 3 days. by which mechanism should the prescribed diuretic decrease the patient's onboard fluid?

decreasing plasma volume

A patient has been prescribed digoxin (Lanoxin) and furosemide (Lasix) for treatment of congestive heart failure. What is the patient at risk for developing with this combination of medications?

digoxin toxicity

The pharmacology instructor is discussing the various diuretic agents and their sites of action in the nephron. In what part of the nephron do thiazide diuretics act?

distal tubule

A client is taking spironolactone (Aldactone) for edema. The nurse identifies that the client's potassium level is 5.4 mEq/L. Which of the following questions would be appropriate for the nurse to ask the client?

do you have use of salt substitue

a female patient reports that she has frequent muscle cramps while on hydrochlorothiazide therapy. the nurse will advise to

eat potassium rich foods

The nurse should advise male patients taking spironolactone (Aldactone) that which of the following may occur?

gynecomastia

After reviewing information about thiazide diuretics, a group of students demonstrate the need for additional teaching when they identify which of the following as a possible adverse effect?

hypocalcemia

A client who has been taking hydrochlorothiazide arrives at the clinic for his 1-month follow-up appointment. The client tells the nurse that he feels weaker since he began taking the drug. What should the nurse consider as a possible cause of these symptoms?

hypokalemia

after teaching a patient about the action of spironolactone, the nurse determines that the teaching was successful when the patient states that

i need to make sure i dont eat too many potassium foods

The client has been ordered spironolactone (Aldactone) for hypertension. Which of the following statements by the client indicates a need for further education?

i will take the medication when my blood pressure is elevated

a physician has prescribed a loop diuretic for a patient with hypertension. the patient has also diabetes mellitus. what condition should the nurse monitor for in this patient after missing the prescribed drug.

increase of blood glucose levels

a physician has prescribed triamterene to a patient with renal disease. the patient informs the nurse that he is taking potassium supplements to overcome cardiovascular problems. what effect of the interaction between these two drugs should the nurse look for in the patient.

increased risk for hyperkalemia

n her visit to your primary care physician's office, your patient presents with 14 pounds of additional weight since her visit 3 weeks ago. Her lower extremities are quite swollen, and her facial features are puffy. The physician prescribes a diuretic and requests a follow-up visit in 3 days. Two days later, the patient contacts the office so dyspneic she is hard to understand over the phone. An ambulance is dispatched, and she is admitted to the hospital for rapid diuresing. Which diuretic will most likely be the initial drug of choice?

loop diuretic

The nurse understands that the action of most diuretics typically results in which of the following

loss of water loss of chloride

you are caring for a patient who is experiencing elevated intracranial pressure following neurosurgery. the physician orders an osmotic diuretic to reduce pressure. which of the following agents would the physician select.

mannitol

Due to the action of methazolamide, the nurse would assess a patient closely for signs and symptoms of which acid-base imbalance?

metabolic acidosis R. methazolamide is a carbonic anhydrase inhibitor can cause metabolic acidosis due to loss of bicarbonate

Ms. Crampton is prescribed furosemide for chronic heart failure. The nurse knows that furosemide can cause electrolyte imbalances and what other serious side effect?

metabolic alkalosis

a patient is admitted to the ER and is unconscious as a result of head injury. the patient's intracranial pressure increased. what diuretic will be administered to the patient.

osmotic diuretic

a physician prescribes a spironolactone, a potassium sparing diuretic, for a patient with cirrhosis. for which of the following categories of patients is the used of potassium diuretic contraindicated.

patients with hyperkalemia.

a nurse administered a patient's schedule oral dose of 20 mg furosemide at 8 am this morning. the drug administration would have bearing on which of the following assessments?

pedal pulses and ankle circumference

you are a ED nurse caring for a patient who is receiving furosemide for treatment of pulmonary edema. which of the following will you monitor to observe for adverse effects of the drug

potassium levels

About 80% of water, sodium, potassium, and other substances is reabsorbed during renal processing; the remaining 20% enters the loop of Henle. What substance is reabsorbed in the ascending limb of the loop of Henle?

sodium

which of the following excerpts its diuretic effect by antagonizing the action of aldosterone?

spironolactone

A 64-year-old patient is admitted to the emergency department with pulmonary edema. The physician orders furosemide 40 mg IV. If the drug is available in a 100 mg/10 mL preparation, how will the nurse administer it?

the nurse will administer 4ml over 1-2 mins

your patient is a 36 yrs old man who undergoes dialysis 3 times weekly while waiting for renal transplant. a diuretic been added to his current medications to combat developing edema. why would potassium sparing diuretics be contraindicated

they may cause hyperkalemia

A nurse should obtain an allergy history from patients as which of the following classes of diuretics may result in a cross-sensitivity reaction with sulfonamides?

thiazides diuretics

which of the following excerpts its effect by depressing the reabsorption of sodium in the kidney tubules, thereby increasing sodium and water excretion.

triamterene

a nurse is caring for a patient with epilepsy. the physician has prescribed acetazolamide to the patient. what should the nurse assess in the patient before the drug.

vitals and weight

a patient is switched from furosemide to spironolactone. the patient asks the patient ask the nurse why she has been switched to a new medicine. what is the best answer that will provided education regarding the change

you will lose less potassium with spironolactone than with furosemide