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.
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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Naxlex Comprehensive Predictor Exams
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Correct Answer is C
Explanation
Restless legs syndrome is a condition that causes an uncomfortable sensation in the legs and an uncontrollable urge to move them. Melatonin is a natural hormone that helps regulate the sleep-wake cycle and can be used as a sleep aid. Therefore, when evaluating the effectiveness of melatonin in an older adult client with restless legs syndrome, the nurse should assess the client's sleep patterns to determine if the herb is improving their ability to fall and stay asleep.
Assessing anxiety level (a) may be useful in other contexts, but it is not directly relevant to evaluating the effectiveness of melatonin for restless legs syndrome. Observing for peripheral edema (b) and palpating pedal pulse volume (d) are important assessments in clients with peripheral vascular disease or other circulatory disorders, but they are not directly related to restless legs syndrome or the use of melatonin.
Correct Answer is B
Explanation
Sumatriptan succinate is a medication used to treat migraine headaches by narrowing blood vessels in the brain. It is important to determine if the client has a history of coronary artery disease before administering the initial dose because the medication can also cause narrowing of the coronary arteries and potentially lead to a heart attack or other cardiac events.
Type 2 diabetes mellitus (a), seasonal allergic rhinitis (c), and irritable bowel syndrome (d) are not directly related to the use of sumatriptan succinate. However, it is still important to consider the client's medical history and overall health status when prescribing or administering any medication.
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