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

This is because diltiazem (Cardizem) is a calcium channel blocker that lowers blood pressure and can cause orthostatic hypotension, which is a sudden drop in blood pressure when standing up from a sitting or lying position. This can lead to dizziness and lightheadedness, which can increase the risk of falls and injuries. Changing positions slowly can help prevent or reduce these symptoms by allowing the body to adjust to the change in blood pressure.

Choice A) Administer diltiazem as ordered by physician is wrong because it does not address the patient’s complaint of dizziness and lightheadedness, which are side effects of the medication.

The nurse should monitor the patient’s blood pressure and heart rate before and after administering diltiazem, and report any abnormal findings to the physician.

Choice C) Notify physician immediately is wrong because it is not necessary to notify the physician immediately for a common and mild side effect of diltiazem, unless the patient has other signs of severe hypotension, such as fainting, chest pain, or confusion.

The nurse should educate the patient about the possible side effects of diltiazem and how to prevent or manage them.

Choice D) Hold diltiazem and notify physician if symptoms persist is wrong because it is not appropriate to hold a prescribed medication without a valid reason or an order from the physician.

Holding diltiazem could cause the patient’s blood pressure to rise and increase the risk of complications from atrial fibrillation, such as stroke or heart failure.

The nurse should administer diltiazem as ordered and monitor the patient’s response.

A. Beta blockers B. Calcium channel blockers C. Angiotensin II receptor blockers (ARBs) D. Direct acting vasodilators.

Correct Answer is C

Explanation

Angiotensin II receptor blockers (ARBs) block the binding of angiotensin II to its receptors on blood vessels and adrenal glands, preventing its vasoconstrictive and aldosterone-stimulating effects

Choice A is wrong because beta blockers do not block angiotensin II receptors, but rather beta-adrenergic receptors, which are involved in the sympathetic nervous system.Beta blockers reduce heart rate and blood pressure by inhibiting the effects of adrenaline and noradrenaline

Choice B is wrong because calcium channel blockers do not block angiotensin II receptors, but rather calcium channels, which are involved in the contraction of smooth muscle cells.Calcium channel blockers relax blood vessels and lower blood pressure by reducing the influx of calcium into the cells

Choice D is wrong because direct acting vasodilators do not block angiotensin II receptors, but rather act directly on the smooth muscle cells of blood vessels, causing them to relax and dilate.Direct acting vasodilators lower blood pressure by decreasing peripheral resistance

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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

The nurse is caring for a patient with atrial fibrillation who has been prescribed diltiazem (Cardizem). The patient reports feeling dizzy and lightheaded when standing up quickly from a sitting position or when getting out of bed in the morning. What action should the nurse take?

Correct Answer is B

Explanation

Which drug blocks the binding of angiotensin II to its receptors on blood vessels and adrenal glands, preventing its vasoconstrictive and aldosterone-stimulating effects?

Correct Answer is C

Explanation

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