Pharm - Diuretic Review Quiz

C - Bananas are high in potassium and should be avoided with potassium-sparing diuretics. It is acceptable for the client to eat fish, apples, and crackers because of their low sodium content.

1. When providing medication teaching to a client who has been prescribed spironolactone, what foods should the nurse instruct the client to minimize consumption of? a. fish b. apples c. bananas d. crackers

C - Spironolactone (Aldactone) should be taken daily to decrease blood pressure, not only when blood pressure is elevated. Spironolactone (Aldactone) is a potassium-sparing diuretic; therefore, no additional potassium is needed. Adverse reactions include gynecomastia, headache, diarrhea, and cramping. It is important that the client weigh himself daily.

10. A male client has been ordered spironolactone (Aldactone) for hypertension. Which statement by the client indicates a need for further education? a. "I will weigh myself daily." b. "I may experience breast enlargement." c. "I will take the medication when my blood pressure is elevated." d. "I do not need to increase my potassium intake with this medication."

B - A cross-sensitivity reaction may occur with the thiazide diuretics and sulfonamides. For clients who take carbonic anhydrase inhibitors during treatment for glaucoma, contact the primary health care provider immediately if eye pain is not relieved or if it increases. When a client with epilepsy is being treated for seizures, a family member of the client should keep a record of all seizures witnessed and bring this to the primary health care provider at the time of the next visit. Contact the primary health care provider immediately if the number of seizures increases. Potassium-sparing diuretics can lead to hyperkalemia and is most likely to occur in clients with an inadequate fluid intake and urine output, those with diabetes or renal failure, older adults, and those who are severely ill, and teach the client to avoid the use of salt substitutes containing potassium. Osmotic diuretics such as mannitol or urea for treatment of increased intracranial pressure caused by cerebral edema, perform neurologic assessments (response of the pupils to light, level of consciousness, or response to a painful stimulus) in addition to vital signs at the time intervals ordered by the primary health care provider.

6. 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? a. Osmotic diuretics b. Thiazide diuretics c. Potassium-sparing diuretics d. Carbonic anhydrase inhibitors

D - Prevent any sleep disturbance caused by increased urination when caring for a client receiving a diuretic therapy for acute renal failure. The nurse need not ask the client to decrease fluid intake, gradually increase the drug dosage, or encourage the client to exercise as these are not appropriate interventions and will not help in reducing the discomfort caused by increased urination.

2. 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? a. Encourage the client to exercise. b. Gradually increase the drug dosage. c. Ask the client to decrease fluid intake. d. Administer the drug at the start of the client's day

A - The nurse should measure and record weights to assist in determining the amount of mobilization of excess fluid. This is a more accurate gauge of changes in fluid status than skin turgor, urine osmolarity, or chest auscultation.

3. A hospital client demonstrating peripheral edema has been prescribed furosemide. How should the nurse best determine the extent of the client's desired fluid loss? a. Weigh the client daily. b. Auscultate the client's chest each morning. c. Assess the client's skin turgor on a daily basis. d. Test the osmolarity of the client's urine regularly.

A - Mannitol is an osmotic diuretic used frequently in cases of increased ICP. Bumetanide and ethacrynic acid are loop diuretics, and spironolactone is a potassium-sparing diuretic.

4. 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? a. Mannitol b. Bumetanide c. Spironolactone d. Ethacrynic acid

D - Provide potassium-rich or low-potassium diet as appropriate to maintain electrolyte balance and replace lost potassium or prevent hyperkalemia.

5. What type of diet should a patient taking diuretics have? a. No effect on diet b. Eat low-sodium, low-potassium diet c. Eat sodium-rich or low-sodium diet as appropriate d. Eat potassium-rich or low-potassium diet as appropriate

A - The reason for furosemide use should guide client teaching. In most instances, it is necessary to initiate measures to limit sodium intake. Key considerations should include not adding salt to food during preparation or at the dinner table, reading food labels carefully to be aware of hidden sources of sodium, and avoiding processed or high-sodium foods. Blood glucose monitoring is not indicated, and there is no need for increased fluid intake. Renal anatomy and physiology are not priority teaching points.

7. An adult client with a diagnosis of hypertension has been prescribed oral furosemide. What goal should the nurse identify when planning this client's medication teaching session? a. The client will identify strategies for limiting sodium intake. b. The client will describe the rationale for increasing fluid intake. c. The client will accurately describe the basic structure and functions of the kidneys. d. The client will be able to demonstrate correct technique for blood glucose monitoring.

B - Loop diuretics are the diuretics of choice when rapid effects are required, such as in the treatment of pulmonary edema. The health care provider is, therefore, less likely to prescribe one of the other medications at this time.

8. A client is admitted to the emergency department with pulmonary edema. What diuretic does the nurse expect the health care provider to prescribe to achieve rapid therapeutic effect? a. Thiazide b. Loop diuretic c. Osmotic diuretic d. Potassium-sparing diuretic

B - Corticosteroids increase the risk of hypokalemia in clients who are taking furosemide. Vitamin D, calcium supplements, and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen do not have this effect.

9. An adult client with multiple chronic health problems has been prescribed furosemide in the management of hypertension. When reviewing this client's current medication administration record, what drug should signal the nurse to a potentially increased risk of hypokalemia? a. ibuprofen b. prednisone c. vitamin D d. calcium carbonate