A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia?
Hydrochlorothiazide
Spironolactone
Furosemide
Metolazone
The Correct Answer is B
A) Hydrochlorothiazide: Hydrochlorothiazide is a thiazide diuretic that promotes sodium and water excretion, leading to decreased blood volume and decreased potassium excretion. While it can cause hypokalemia due to increased potassium excretion, it does not typically lead to hyperkalemia.
B) Spironolactone: Spironolactone is a potassium-sparing diuretic that inhibits aldosterone, leading to decreased sodium reabsorption and increased potassium retention. This mechanism of action can predispose clients to hyperkalemia due to potassium retention. Additionally, spironolactone can cause hyponatremia by promoting the excretion of sodium and water. Therefore, clients receiving spironolactone are at risk for both hyperkalemia and hyponatremia.
C) Furosemide: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the loop of Henle, promoting sodium, chloride, potassium, and water excretion. While it can cause hypokalemia due to increased potassium excretion, it does not typically lead to hyperkalemia.
D) Metolazone: Metolazone is a thiazide-like diuretic that acts similarly to hydrochlorothiazide by promoting sodium and water excretion. Like hydrochlorothiazide, it can cause hypokalemia due to increased potassium excretion but does not typically lead to hyperkalemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Continue to talk to the client as if they are awake: Even though the client is unresponsive, hearing can be the last sense to diminish as death approaches. Speaking to the client in a calm and reassuring manner can provide comfort and a sense of presence, even if the client cannot respond verbally.
B. Limit the client's visitors to one at a time: While it's important to manage visitors to prevent overwhelming the client, limiting them to one at a time may not be necessary if the client's condition allows for multiple visitors and the client's wishes or cultural preferences support it.
C. Avoid touching the client: Touch can be a powerful form of communication and comfort, even for an unresponsive client. Gentle touch can convey warmth and support to both the client and their family members.
D. Whisper when talking in the client's room: Whispering may create a sense of unease or anxiety for the client or their family members. Speaking in a calm and soothing voice at a normal volume is more appropriate and can help create a peaceful environment for the client's end-of-life care.
Correct Answer is B
Explanation
B) Placing clean linen that touched the floor in the soiled linen bag: This action demonstrates an understanding of infection control principles because it prevents cross-contamination between clean and soiled linens. Placing clean linens that have come into contact with the floor in the soiled linen bag reduces the risk of spreading pathogens and maintains a clean environment for the client.
A) Placing the soiled linen on the floor before bagging it: This action increases the risk of contamination by exposing the linen to potentially contaminated surfaces. Placing soiled linen on the floor can spread pathogens and is not consistent with infection control practices.
C) Holding the soiled linen against her body while carrying it to the linen bag: This action increases the risk of contamination to the AP's clothing and skin. Contact with soiled linen can transfer pathogens to the caregiver's body, leading to the potential spread of infection.
D) Shaking the soiled linen to remove any toilet paper remnants: This action can aerosolize fecal matter and spread pathogens into the air and onto nearby surfaces. Shaking soiled linen increases the risk of contamination and is not recommended as part of infection control practices.
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