A nurse is reviewing the laboratory values for a client who has heart failure and is taking bumetanide for diuresis. For which of the following results should the nurse notify the provider?
Potassium 2.3 mEq/L (3.5-5)
Magnesium 14 mEq/L (1.3-2.1)
Carcum to mg/dL (9.9-10.5)
Sodium 136 mEq/L (136-145)
The Correct Answer is A
A. Potassium 2.3 mEq/L (3.5-5.0): This is a severely low potassium level (hypokalemia), which can cause dangerous arrhythmias, especially in a client with heart failure. Bumetanide is a loop diuretic, which can deplete potassium levels.
B. Magnesium 1.4 mEq/L (1.3-2.1): Although the magnesium level is on the lower end of normal, it is not a critical value, and the primary concern here is the potassium level.
C. Calcium 10 mg/dL (9.9-10.5): This is a normal calcium level, so there is no need to notify the provider based on this result.
D. Sodium 136 mEq/L (136-145): This is a normal sodium level, so it would not warrant notifying the provider. The critical concern is the hypokalemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Low sodium diet: A low sodium diet is generally beneficial for clients with heart disease or hypertension and poses no risk to a client with a pacemaker.
B. Physical therapy: Physical therapy can help improve mobility and strength and is safe for clients with pacemakers, though the affected arm should be limited initially.
C. MRI of the chest: MRI is contraindicated for clients with most types of pacemakers due to the risk of interference with the pacemaker’s function. Newer MRI-compatible pacemakers are available, but this should be clarified with the provider.
D. Serum cardiac enzyme levels: Checking serum cardiac enzymes is standard for clients with a history of heart disease or chest pain and poses no risk to pacemaker function.
Correct Answer is []
Explanation
Condition:
Left-sided heart failure: The client is presenting with classic symptoms of left-sided heart failure, such as fatigue, weakness, nocturia (awakening at night to urinate), crackles in the lungs (due to fluid accumulation), a rapid and irregular apical heart rate, an audible S3 gallop, and a dry, hacking cough. These are indicative of pulmonary congestion, which is typical in left-sided heart failure.
Actions to take:
- Administer supplemental oxygen: Since the client is experiencing pulmonary congestion with crackles and a rapid irregular heart rate, supplemental oxygen will help to improve oxygenation and alleviate dyspnea associated with heart failure.
- Elevate the head of the client’s bed: Elevating the head of the bed will promote better lung expansion, reduce pulmonary congestion, and ease breathing, which is beneficial in managing the symptoms of left-sided heart failure.
Parameters to monitor:
- Urine output: Monitoring urine output helps assess the effectiveness of diuretic therapy and overall kidney function. In heart failure, decreased perfusion to the kidneys may lead to fluid retention, so monitoring urine output is essential in evaluating fluid balance.
- Weight: Daily weight monitoring is important in heart failure management to detect fluid retention. A rapid weight gain may indicate worsening heart failure, while a reduction in weight could signify successful diuresis and fluid management.
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