A nurse is caring for a client who has cirrhosis and has a prescription for bumetanide. When delivering the client's lunch tray, which of the following items should the nurse identify as contraindicated for the client?
Baked potato
Milkshake
Ham sandwich
Stewed tomatoes
The Correct Answer is C
Rationale:
A. Baked potato is low in sodium if prepared without added salt, making it safe for a client on a diuretic.
B. Milkshake is generally safe unless it contains added sodium; in most cases, it is allowed.
C. Ham is high in sodium, which is contraindicated for a client taking bumetanide, a loop diuretic, as high sodium intake can counteract the diuretic effect and worsen fluid retention.
D. Stewed tomatoes can be included if unsalted; they are generally safe in moderation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Elevated AST indicates hepatocellular injury, but it does not directly reflect fluid volume status.
B. In liver cirrhosis, the liver produces less albumin, leading to reduced plasma oncotic pressure. Low albumin allows fluid to leak into interstitial spaces, causing ascites, edema, and overall fluid volume excess.
C. Prolonged PT reflects impaired clotting factor synthesis in cirrhosis, not fluid status.
D. High bilirubin indicates impaired bile excretion and liver dysfunction, but it is not a direct marker of fluid overload.
Correct Answer is []
Explanation
Rationale:
- Potential Condition: The client with cirrhosis shows elevated ammonia (236 mcg/dL), confusion, agitation, and disorientation, which are classic findings of hepatic encephalopathy.
- Actions to Take:
- Lactulose is given to lower ammonia levels by promoting its excretion through the stool.
- Assessing for asterixis (flapping tremor of the hands) is key in identifying worsening encephalopathy.
- Parameters to Monitor:
- Neurologic status (orientation, cognition, responsiveness) should be monitored closely to evaluate improvement or deterioration.
- Safety measures are essential because confusion and agitation increase the client’s risk for falls and injury.
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