A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this patient’s plan of care?

Replace salt with a salt substitute.

Limits intake of high-potassium foods.

Cover your skin before going outside.

Monitor skin for excessive bruising.

Answer and Explanation

The Correct Answer is B

Spironolactone is a potassium-sparing diuretic that works by blocking the actions of aldosterone, a hormone that can lead to potassium loss in the urine. However, in some cases, spironolactone can cause hyperkalemia (high levels of potassium in the blood), which can be dangerous for patients with heart failure. Therefore, it is important to instruct the patient to limit their intake of high-potassium foods such as bananas, oranges, tomatoes, spinach, and salt substitutes containing potassium.

Option a (Replace salt with a salt substitute) is incorrect because salt substitutes often contain potassium, which can further increase the risk of hyperkalemia.

Option c (Cover your skin before going outside) is unrelated to the use of spironolactone and hyperkalemia.

Option d (Monitor skin for excessive bruising) is not directly related to the use of spironolactone and hyperkalemia, although it is a potential side eﬀect of other medications used to treat heart failure.

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Correct Answer is D

Explanation

Anaphylaxis is a severe and potentially life-threatening allergic reaction that occurs rapidly after exposure to an allergen. The symptoms of anaphylaxis can vary but usually involve multiple organ systems, including the skin, respiratory, cardiovascular, and gastrointestinal systems.

Wheezing and dyspnea are two common symptoms of anaphylaxis that indicate the respiratory system's involvement.

Urticaria and pruritis are skin manifestations that can also be present in anaphylaxis, but they are not specific to this condition.

Insomnia and irritability are not typical symptoms of anaphylaxis.

Tinnitus and diplopia are also not common symptoms of anaphylaxis.

A. Reports on increased energy levels and decreased fatigue. B. Takes concurrent iron therapy without adverse eﬀects. C. The hemoglobin level increased to 12 grams/dL (120mmol/L). D. Food diary shows increased consumption of iron rich foods.

Correct Answer is C

Explanation

Epoetin alfa is a medication that stimulates the production of red blood cells and is commonly used to treat anemia in patients with chronic kidney disease. Hemoglobin level is the most important parameter to monitor the eﬀectiveness of epoetin alfa therapy. An increase in hemoglobin level indicates an improvement in the patient's anemia and suggests that the medication is eﬀective.

While options a, b, and d are also important considerations in the management of anemia, they do not provide a definitive indication of the eﬀectiveness of epoetin alfa therapy. Reports of increased energy levels and decreased fatigue can be subjective and inﬂuenced by many factors. Taking concurrent iron therapy without adverse eﬀects is important to support the production of red blood cells but does not confirm the eﬀectiveness of epoetin alfa. Increased consumption of iron-rich foods can be helpful in managing anemia, but it does not provide a direct indication of the eﬀectiveness of epoetin alfa therapy.

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A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this patient’s plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which assessment data indicated to the nurse that a client is having an anaphylactic reaction to a medication?

Correct Answer is D

Explanation

A client with anemia secondary to chronic kidney disease started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is eﬀective?

Correct Answer is C

Explanation

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