A client who is taking furosemide reports experiencing leg cramps, a cough, feeling tired, and palpitations. Which action should the nurse take first?

Apply warm compresses to legs.

Monitor intake and output.

Raise the head of the bed.

Place on cardiac monitoring.

Answer and Explanation

The Correct Answer is D

A. Apply warm compresses to legs:
While leg cramps can be uncomfortable, addressing them with warm compresses does not address the potential underlying issues related to the client's symptoms, especially considering the possibility of more severe conditions.

B. Monitor intake and output:
Monitoring intake and output is important in managing fluid balance, especially with diuretics like furosemide. However, this action does not directly address the immediate concerns raised by symptoms like palpitations and a cough.

C. Raise the head of the bed:
Raising the head of the bed can be helpful if the client is experiencing shortness of breath or orthopnea. However, it does not address the need to evaluate cardiac function, which is crucial given the presence of palpitations and other symptoms.

D. Place on cardiac monitoring:
The client's symptoms—palpitations, cough, fatigue—could indicate significant electrolyte imbalances or cardiac issues, which are common with furosemide use. Cardiac monitoring is the most appropriate initial action to quickly identify and address any cardiac complications.

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Correct Answer is D

Explanation

A) Avoid prolonged exposure to direct sunlight: While erythromycin can increase sensitivity to sunlight, this is not directly related to the interaction between oral contraceptives and erythromycin. The primary concern with erythromycin and oral contraceptives is their interaction rather than sun exposure.

B) Stop the oral contraceptive immediately: There is no need to stop oral contraceptives when taking erythromycin. However, erythromycin can potentially reduce the effectiveness of oral contraceptives, so additional precautions should be taken rather than discontinuing the contraceptive.

C) Take the medications at least 12 hours apart: Timing of administration is not a primary concern for this interaction. The main issue is the potential reduction in contraceptive efficacy rather than timing the doses of the medications.

D) Use an additional form of contraception: Erythromycin can potentially decrease the effectiveness of oral contraceptives due to its effect on liver enzymes and drug metabolism. It is advisable to use an additional form of contraception to prevent unintended pregnancy while taking erythromycin.

A. No known allergies B. Peripheral IV in large vein C. Potassium 4.4 mEq/L (4.4 mmol/L) D. Used for prophylaxis E. Blood urea nitrogen 17 mg/dL (6.07 mmol/L) F. Dosage in safe range

Correct Answer is ["A","B","D","F"]

Explanation

A. No known allergies:
Having no known allergies is a significant factor in determining the safety of administering vancomycin, as it reduces the risk of an allergic reaction. Vancomycin can cause allergic reactions or hypersensitivity, so it’s important to ensure the client is not allergic to this medication.

B. Peripheral IV in large vein:
Vancomycin should be administered through a large vein because it can be irritating to smaller veins and potentially cause thrombophlebitis or vein damage. Using a large vein helps to minimize these risks and ensure safe administration.

C. Potassium 4.4 mEq/L (4.4 mmol/L):
While potassium levels are important to monitor, they are not directly related to the safety of administering vancomycin. Vancomycin does not have a direct impact on potassium levels, so this finding does not specifically indicate the safety of vancomycin administration.

D. Used for prophylaxis:
Vancomycin is often used as prophylaxis in certain surgical procedures to prevent infection, especially in cases where there is a high risk of methicillin-resistant Staphylococcus aureus (MRSA) infection. The use of vancomycin for prophylaxis is a common practice and indicates it is being administered for an appropriate reason.

E. Blood urea nitrogen 17 mg/dL (6.07 mmol/L):
A blood urea nitrogen (BUN) level of 17 mg/dL is slightly elevated but not necessarily a contraindication for vancomycin administration. However, vancomycin can impact kidney function, so it is important to monitor renal function but not the sole factor in determining safety.

F. Dosage in safe range:
Ensuring the dosage of vancomycin is within the safe range is crucial for preventing toxicity and achieving therapeutic efficacy. This is an essential consideration when administering the medication to avoid adverse effects and ensure effective treatment.

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A client who is taking furosemide reports experiencing leg cramps, a cough, feeling tired, and palpitations. Which action should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Correct Answer is ["A","B","D","F"]

Explanation

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