Prep You Chapter 51

A nurse is providing patient teaching for a 62-year-old woman who is taking triamterene. The nurse will teach the patient to avoid what in her diet?

Avocados

A client is receiving triamterene. The nurse instructs the client to avoid what foods?

Bananas Prunes Broccoli

Which instruction would be most appropriate for a client who is taking a diuretic?

It's okay to take it with food."

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

hypocalcemia

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.

A client is receiving hydrochlorothiazide. The nurse would expect to administer this drug by which route?

oral

An elderly client's compromised nutritional status has necessitated the use of a nutritional formula. When reviewing this client's laboratory findings, the nurse should prioritize which value?

serum albumin

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 usually can't take hydrochlorothiazide."

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."

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 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."

The nurse is evaluating an 82-year-old client's medical record. The client is receiving hydrochlorothiazide. What abnormal laboratory result is related to the medication?

Elevated uric acid levels

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 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 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

A health care provider has prescribed a loop diuretic for a client with hypertension. The client also has diabetes mellitus. What condition should the nurse monitor for in this client after administering the prescribed drug?

Increased blood glucose levels

When describing where bumetanide acts, what would the nurse include?

Loop of Henle

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

Metabolic acidosis

An ED nurse is caring for a patient who is receiving furosemide for treatment of pulmonary edema. What will the nurse monitor to observe for adverse effects of the drug?

Potassium levels

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 male client has cirrhosis and is receiving diuretic therapy. The nurse knows that what drug will help prevent metabolic alkalosis or hypokalemia in this client?

Spironolactone

Why would potassium-sparing diuretics be contraindicated for clients experiencing renal failure?

They may cause hyperkalemia.

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

An elderly client with a history of heart failure has presented to the emergency department in respiratory distress. Assessment reveals the presence of pulmonary edema, and an infusion of IV furosemide has been prescribed. For the duration of treatment, the nurse should prioritize assessments related to which expected age-related dysfunctions? Select all that apply (3 things)

cardiac function renal function hepatic function

A nurse understands that loop diuretics are considered high ceiling diuretics because they

cause a greater diuresis.

A client, prescribed digoxin and furosemide, is at risk for developing which adverse effect?

digoxin toxicity

A 49-year-old client reports frequent muscle cramps while on hydrochlorothiazide therapy. The nurse would advise the client to do which?

eat potassium-rich foods.

A hospital client with a diagnosis of liver failure has been prescribed a low dose of spironolactone in order to treat ascites. The nurse who is providing this client's care should prioritize assessments for the signs and symptoms of what health problem

hepatic encephalopathy

A health care provider prescribes spironolactone, a potassium-sparing diuretic, for a client with cirrhosis. For which category of clients is the use of potassium-sparing diuretics contraindicated?

hyperkalemia

An older adult client has a complex medical history that includes heart failure, type 1 diabetes, and diabetic nephropathy. The nurse has questioned a care provider's prescription for oral spironolactone because the client's health problems would contribute to a high risk of which adverse reaction?

hyperkalemia

A nurse notes that a newly admitted client is currently prescribed both a loop diuretic as well as a thiazide diuretic. The nurse understands what primary rationale for the concurrent use of these two drugs?

increased diuretic effect

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

osmotic diuretic

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

sodium