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 B

Explanation

Choice B is wrong because “I will eat more green leafy vegetables.” This statement indicates a need for further teaching because green leafy vegetables are high in vitamin K, which can antagonize the effects of warfarin and increase the risk of clotting.The client should be advised to maintain a consistent intake of vitamin K and avoid sudden changes in their diet.

Choice A is wrong because using an electric razor for shaving is a safe practice for a client who is receiving warfarin, as it reduces the risk of bleeding from cuts or nicks.

Choice C is wrong because checking stools for blood is an important measure for a client who is receiving warfarin, as it can indicate gastrointestinal bleeding, which is a serious adverse effect of the medication.

Choice D is wrong because having blood drawn regularly is necessary for a client who is receiving warfarin, as it allows the monitoring of the international normalized ratio (INR), which reflects the degree of anticoagulation and guides the dosage adjustment of the medication.

The normal range for INR for a client who is receiving warfarin is 2 to 3, unless otherwise specified by the provider.

A. Serum potassium level B. Serum sodium level C. Serum magnesium level D. Serum calcium level.

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

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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 evaluating a client who has heart failure and is receiving warfarin. Which of the following statements by the client indicates a need for further teaching?

Correct Answer is B

Explanation

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

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