A client is taking furosemide (Lasix) for management of mild hypertension. The nurse knows to assess laboratory results for a side effect of this diuretic. Select the lab value that matches a common side effect of this medication.
A serum potassium level of 5.6 mEq/L
A serum sodium level of 142 mEq/L
A serum sodium level of 138 mEq/L
A serum potassium level of 2.8 mEq/L
The Correct Answer is D
Choice A reason: A serum potassium level of 5.6 mEq/L is not a common side effect of furosemide, but of hyperkalemia. Hyperkalemia is a condition where the blood potassium level is too high. It can cause muscle weakness, irregular heartbeat, and cardiac arrest. Furosemide is a loop diuretic that increases the urinary excretion of water, sodium, chloride, and potassium. It can cause hypokalemia, which is a low blood potassium level, not hyperkalemia.
Choice B reason: A serum sodium level of 142 mEq/L is not a common side effect of furosemide, but of normal sodium level. The normal range of serum sodium level is 135 to 145 mEq/L. Sodium is an electrolyte that helps regulate the fluid balance, nerve impulses, and muscle contractions in the body. Furosemide can cause hyponatremia, which is a low blood sodium level, but not a normal sodium level.
Choice C reason: A serum sodium level of 138 mEq/L is also not a common side effect of furosemide, but of normal sodium level. As explained in choice B, the normal range of serum sodium level is 135 to 145 mEq/L. Furosemide can cause hyponatremia, which is a low blood sodium level, but not a normal sodium level.
Choice D reason: A serum potassium level of 2.8 mEq/L is a common side effect of furosemide, and of hypokalemia. Hypokalemia is a condition where the blood potassium level is too low. It can cause muscle cramps, fatigue, weakness, arrhythmias, and paralysis. Furosemide is a loop diuretic that increases the urinary excretion of water, sodium, chloride, and potassium. It can cause hypokalemia, which is a low blood potassium level. The nurse should monitor the client's serum potassium level and signs of hypokalemia, and advise the client to eat potassium-rich foods, such as bananas, oranges, and potatoes. The nurse should also report the lab value to the prescriber, who may adjust the dose of furosemide or prescribe a potassium supplement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Urine dipstick for glucose is not a reliable test to evaluate the effectiveness of treatment for type 2 diabetes. Urine glucose testing can only detect glucose in the urine when the blood glucose level is very high, above the renal threshold of 180 mg/dL. Urine glucose testing does not reflect the average blood glucose level over time, and can be affected by factors such as hydration, medication, and urinary tract infections.
Choice B reason: Fasting blood glucose is a test that measures the blood glucose level after an overnight fast of at least 8 hours. Fasting blood glucose is a useful test to diagnose diabetes, but it is not the best test to evaluate the effectiveness of treatment for type 2 diabetes. Fasting blood glucose only reflects the blood glucose level at one point in time, and can vary depending on the time of day, the amount and type of food eaten, and the activity level.
Choice C reason: Oral glucose tolerance is a test that measures the blood glucose level before and after drinking a solution containing 75 g of glucose. Oral glucose tolerance is another test that can diagnose diabetes, but it is not the most convenient or accurate test to evaluate the effectiveness of treatment for type 2 diabetes. Oral glucose tolerance requires the patient to fast for at least 8 hours, drink the glucose solution, and have blood samples taken at 0, 30, 60, 90, and 120 minutes. Oral glucose tolerance can also be influenced by factors such as stress, illness, medication, and menstrual cycle.
Choice D reason: Glycosylated hemoglobin (Hemoglobin A1C) is a test that measures the percentage of hemoglobin that has glucose attached to it. Hemoglobin is a protein in the red blood cells that carries oxygen. Red blood cells have a lifespan of about 120 days, so the hemoglobin A1C test reflects the average blood glucose level over the past 2 to 3 months. Hemoglobin A1C is the best test to evaluate the effectiveness of treatment for type 2 diabetes, as it shows how well the blood glucose level has been controlled over time, and is not affected by factors such as fasting, food intake, or daily fluctuations.
Correct Answer is A
Explanation
Choice A reason: Metabolic acidosis is a condition where the blood pH is lower than normal, due to an excess of acids or a loss of bases in the body. Jo is most at risk of developing metabolic acidosis, because of the high blood glucose level. High blood glucose can cause diabetic ketoacidosis, a complication of Type 1 Diabetes, where the body breaks down fat for energy and produces ketones, which are acidic substances. Ketones can accumulate in the blood and lower the pH, causing symptoms such as nausea, vomiting, abdominal pain, fruity breath, and confusion.
Choice B reason: Metabolic alkalosis is a condition where the blood pH is higher than normal, due to an excess of bases or a loss of acids in the body. Jo is not likely to develop metabolic alkalosis, because of the high blood glucose level. Metabolic alkalosis can be caused by conditions such as vomiting, diuretic use, or excessive antacid intake, which can increase the bicarbonate level or decrease the chloride level in the blood. These conditions are not related to Jo's diabetes.
Choice C reason: Respiratory acidosis is a condition where the blood pH is lower than normal, due to an accumulation of carbon dioxide in the body. Jo is not prone to developing respiratory acidosis, because of the high blood glucose level. Respiratory acidosis can be caused by conditions that impair the lung function, such as asthma, chronic obstructive pulmonary disease (COPD), or pneumonia, which can reduce the ventilation and increase the carbon dioxide level in the blood. These conditions are not related to Jo's diabetes.
Choice D reason: Respiratory alkalosis is a condition where the blood pH is higher than normal, due to a loss of carbon dioxide in the body. Jo is not susceptible to developing respiratory alkalosis, because of the high blood glucose level. Respiratory alkalosis can be caused by conditions that increase the breathing rate, such as anxiety, fever, or hyperventilation, which can reduce the carbon dioxide level in the blood. These conditions are not related to Jo's diabetes.
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