A nurse understands that a common reason why a patient is prescribed a combination of diuretics is because?
They are a part of the initial diuretic therapy.
They decrease the risk of hypokalemia while still excreting sodium.
They boost the blood-pressure-lowering effect of other medications.
They have fewer side effects when used in a drug combination.
The Correct Answer is B
Hypokalemia is a condition where the blood potassium level is too low, which can cause muscle weakness, arrhythmias, and other problems. Diuretics are drugs that increase urine output and help remove excess fluid from the body. Some diuretics, such as loop diuretics, also cause potassium loss in the urine. To prevent hypokalemia, a combination of diuretics may be prescribed, such as a loop diuretic with a potassium-sparing diuretic or a thiazide diuretic. These combinations help balance the potassium level while still removing sodium and water.
Choice A is wrong because they are not a part of the initial diuretic therapy. Combination diuretic therapy is usually reserved for patients who have resistant edema or hypertension that does not respond to monotherapy.
Choice C is wrong because they do not boost the blood-pressure-lowering effect of other medications. Diuretics can lower blood pressure by reducing blood volume and relaxing blood vessels, but they are not used to enhance the effect of other antihypertensive drugs.
Choice D is wrong because they do not have fewer side effects when used in a drug combination. Combination diuretic therapy can increase the risk of electrolyte imbalances, such as hyponatremia, hypokalemia, hypomagnesemia, and metabolic alkalosis. It can also cause hypotension, dehydration, and worsening renal function. Therefore, combination diuretic therapy should be used with caution and close monitoring.
Normal ranges for blood potassium level are 3.5 to 5.0 mmol/L or 3.5 to 5.0 mEq/L. Normal ranges for blood sodium level are 135 to 145 mmol/L or 135 to 145 mEq/L.
Normal ranges for blood pressure are less than 120/80 mm Hg for normal, 120-129/less than 80 mm Hg for elevated, 130-139/80-89 mm Hg for stage 1 hypertension, and 140 or higher/90 or higher mm Hg for stage 2 hypertension.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Furosemide is a diuretic that lowers blood pressure and increases urine output. It also causes potassium loss, which can lead to hypokalemia (low potassium levels). The patient’s blood pressure is already low when sitting, and the serum potassium is below the normal range of 3.5 to 5.0 mEq/L. Administering furosemide could worsen these conditions and cause adverse effects such as dehydration, dizziness, muscle weakness, cardiac arrhythmias, and renal impairment. Therefore, the nurse should contact the provider before giving the medication and report the vital signs and laboratory results.
Choice A. Administer medication is wrong because it could harm the patient as explained above.
Choice C. Hold medication until next dose is wrong because it does not address the underlying problem of fluid retention and hypokalemia.
The nurse should not delay notifying the provider about the patient’s condition.
Choice D. Check urine output before giving medication is wrong because it is not enough to ensure the patient’s safety.
The nurse should also check the blood pressure and serum potassium levels, which are more critical indicators of the patient’s status.
Correct Answer is C
Explanation
Digoxin is a cardiac glycoside that increases the force of heart contractions (positive inotropy) and decreases the heart rate (negative chronotropy) by inhibiting the sodium-potassium ATPase pump in the cardiac cell membranes and affecting the autonomic tone.This helps to improve the symptoms of heart failure and to control the ventricular rate in atrial fibrillation.
Choice A is wrong because positive chronotropy means increasing the heart rate, which is the opposite of what digoxin does.
Choice B is wrong because negative inotropy means decreasing the force of heart contractions, which is also the opposite of what digoxin does.
Choice D is wrong because positive inotropy and positive chronotropy would both increase the workload of the heart, which is not desirable in heart failure or atrial fibrillation.
Normal ranges for digoxin are 0.5 to 2 ng/mL for heart failure and 0.8 to 2 ng/mL for atrial fibrillation.Digoxin has a narrow therapeutic window and can cause serious side effects if overdosed or underdosed.
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