A nurse is caring for a client who has heart failure and is prescribed furosemide. Which of the following laboratory values should the nurse monitor closely?

Serum potassium

Serum calcium

Serum albumin

Serum glucose.

Answer and Explanation

The Correct Answer is A

The nurse should monitor the client’s serum potassium level closely because furosemide is a loop diuretic that can cause hypokalemia, which increases the risk of cardiac arrhythmias and digitalis toxicity. The nurse should also monitor the client’s fluid status, blood pressure, and renal function.

Choice B is wrong because Serum calcium is wrong because furosemide does not affect calcium levels significantly. Calcium levels are more likely to be affected by thiazide diuretics, which can cause hypercalcemia.

Choice C is wrong because Serum albumin is wrong because furosemide does not affect albumin levels significantly. Albumin levels are more likely to be affected by liver disease, malnutrition, or nephrotic syndrome.

Choice D is wrong because Serum glucose is wrong because furosemide does not affect glucose levels significantly. Glucose levels are more likely to be affected by diabetes mellitus, corticosteroids, or stress.

Normal ranges for the laboratory values are:

• Serum potassium: 3.5-5.0 mEq/L

• Serum calcium: 8.5-10.5 mg/dL

• Serum albumin: 3.5-5.0 g/dL

• Serum glucose: 70-110 mg/dL

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Correct Answer is A

Explanation

The nurse should monitor the serum potassium level to determine the therapeutic effectiveness of carvedilol (Coreg), which is a beta-blocker that can lower the heart rate and blood pressure. Carvedilol can also cause hyperkalemia, which is a high level of potassium in the blood that can lead to cardiac arrhythmias and muscle weakness.Therefore, the nurse should monitor the serum potassium level and report any values above 5.0 mEq/L to the provider.

Choice B) Serum sodium level is wrong because carvedilol does not affect the sodium level significantly.Sodium level is more relevant for diuretics, which can cause hyponatremia (low sodium) or hypernatremia (high sodium) depending on the type and dose of the medication.

Choice C) Serum magnesium level is wrong because carvedilol does not affect the magnesium level significantly.

Magnesium level is more relevant for digoxin, which is another medication used for heart failure that can cause hypomagnesemia (low magnesium) or hypermagnesemia (high magnesium).Hypomagnesemia can increase the risk of digoxin toxicity, while hypermagnesemia can decrease the effectiveness of digoxin.

Choice D) Serum calcium level is wrong because carvedilol does not affect the calcium level significantly.

Calcium level is more relevant for calcium channel blockers, which are another class of medications used for heart failure that can lower the heart rate and blood pressure by blocking the entry of calcium into the cardiac and vascular smooth muscle cells.

Calcium channel blockers can cause hypocalcemia (low calcium) or hypercalcemia (high calcium), which can affect the cardiac contractility and conduction.

The normal ranges for serum electrolytes are:

• Potassium: 3.5 to 5.0 mEq/L

• Sodium: 135 to 145 mEq/L

• Magnesium: 1.5 to 2.5 mEq/L

• Calcium: 8.5 to 10.5 mg/dL

A. Avoid drinking alcohol while taking this medication. B. Monitor your blood pressure and pulse regularly. C. Report any swelling in your ankles or feet to your provider. D. Do not stop taking this medication abruptly. E. Chew or crush the sustained-release tablet for faster action.

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

Explanation

Nifedipine is a calcium channel blocker that lowers blood pressure by relaxing the blood vessels and reducing the workload of the heart.

The following instructions should be included in the teaching:

• Avoid drinking alcohol while taking this medication.Alcohol can increase the risk of side effects such as dizziness, flushing, headache, and low blood pressure.

• Monitor your blood pressure and pulse regularly.This will help to evaluate the effectiveness of the medication and detect any abnormal changes.Normal blood pressure for adults is less than 130/80 mm Hg and normal pulse rate is 60 to 100 beats per minute.

• Report any swelling in your ankles or feet to your provider.This can be a sign of fluid retention or heart failure, which are possible complications of nifedipine.

• Do not stop taking this medication abruptly.This can cause a rebound increase in blood pressure and chest pain.The dose should be tapered gradually under the supervision of the provider.

Choice E is wrong because chewing or crushing the sustained-release tablet can cause too much of the drug to be released at once, which can lead to overdose or severe side effects.

The tablet should be swallowed whole with a glass of water.

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A nurse is caring for a client who has heart failure and is prescribed furosemide. Which of the following laboratory values should the nurse monitor closely?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has heart failure and is receiving carvedilol (Coreg). The nurse should monitor which of the following laboratory values to determine therapeutic effectiveness of this medication?

Correct Answer is A

Explanation

A nurse is teaching a client who has hypertension and is prescribed nifedipine, a calcium channel blocker, about self-care measures. Which of the following instructions should the nurse include? (Select all that apply.)

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

Explanation

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