A nurse is reviewing laboratory results for a client who has heart failure and notes a serum potassium level of 5.2 mEq/L (3.5 to 5.0 mEq/L). Which of the following medications should the nurse withheld?

Furosemide

Spironolactone

Metoprolol

Atorvastatin

Answer and Explanation

The Correct Answer is B

A. Furosemide: Furosemide is a loop diuretic that promotes potassium excretion. It does not need to be withheld for a mildly elevated potassium level; in fact, it may help lower potassium levels in hyperkalemia.

B. Spironolactone: Spironolactone is a potassium-sparing diuretic that can increase serum potassium. With a level of 5.2 mEq/L, administering spironolactone could worsen hyperkalemia and increase the risk of cardiac complications, so the dose should be withheld and the provider notified.

C. Metoprolol: Metoprolol, a beta-blocker, does not typically raise potassium levels significantly. While beta-blockers can slightly affect potassium, withholding is not indicated solely based on a potassium level of 5.2 mEq/L.

D. Atorvastatin: Atorvastatin, a lipid-lowering agent, has no effect on serum potassium levels and does not need to be withheld in this situation. It can be continued safely.

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Correct Answer is B

Explanation

A. "I should lie down after my meals.": Lying down immediately after eating can worsen nausea and increase the risk of acid reflux. Clients should remain upright after meals to facilitate digestion and reduce nausea.

B. "I should avoid eating hot foods.": Avoiding hot, spicy, or strong-smelling foods can help reduce nausea and gastrointestinal discomfort. Eating bland, cool, or room-temperature foods is easier on the stomach and aligns with dietary recommendations for gastroenteritis.

C. "I should drink a caffeinated beverage one hour before a meal.": Caffeine can irritate the gastrointestinal tract and worsen nausea. Clients should avoid caffeinated beverages during episodes of gastroenteritis to prevent exacerbation of symptoms.

D. "I should increase my intake of liquids with meals.": Drinking large amounts of liquid with meals can contribute to feelings of fullness, bloating, and nausea. It is generally recommended to sip fluids between meals rather than during meals to maintain hydration without worsening symptoms.

A. Protruding hemorrhoids B. 3+deep-tendon reflexes C. Supine hypotension D. Urinary frequency

Correct Answer is B

Explanation

A. Protruding hemorrhoids: Hemorrhoids are common in late pregnancy due to increased venous pressure and straining, and while uncomfortable, they are not an urgent concern requiring immediate provider notification.

B. 3+ deep-tendon reflexes: Hyperactive reflexes (3+) can indicate potential preeclampsia, which is a serious condition characterized by hypertension and risk of seizures. This finding requires prompt reporting and further evaluation to prevent complications for both the mother and fetus.

C. Supine hypotension: Supine hypotensive syndrome can occur when a pregnant client lies on her back, causing compression of the inferior vena cava. It is typically relieved by repositioning to the left lateral side and is not immediately dangerous if addressed promptly.

D. Urinary frequency: Increased urinary frequency is common in late pregnancy due to fetal pressure on the bladder. While it may cause discomfort, it is an expected finding and does not require urgent reporting to the provider.

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A nurse is reviewing laboratory results for a client who has heart failure and notes a serum potassium level of 5.2 mEq/L (3.5 to 5.0 mEq/L). Which of the following medications should the nurse withheld?

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