A patient arrives to the emergency department with crackles audible in the bilateral lungs, and 3+ pitting edema to his lower extremities. The provider orders furosemide 40 mg slow IV push to be given one time. Which of the following assessment findings requires the nurse to hold the medication and contact the provider for further instructions?
Sodium 149 mEq/L
Blood pressure 90/53 mmHg
Client is incontinent of urine
Potassium 53 mEq/L
The Correct Answer is B
A. Hypernatremia can indicate dehydration or other electrolyte imbalances. Furosemide can further affect electrolyte balance, especially sodium and potassium. However, this sodium level is only slightly elevated and may not necessarily require immediate action regarding furosemide administration.
B. Furosemide is a diuretic that can further decrease blood pressure due to its effects on fluid volume reduction. Administering it to a patient with already low blood pressure could potentially lead to significant hypotension and compromise perfusion to vital organs.
C. While incontinence itself may not directly contraindicate furosemide administration, it could indicate underlying issues such as bladder dysfunction or fluid overload that need further evaluation. This finding alone would not necessarily require holding the medication, but it warrants further assessment and consideration in the clinical context.
D. Normal serum potassium levels typically range from 3.5-5.0 mEq/L. A level of 5.3 mEq/L indicates hyperkalemia (elevated potassium). While this potassium level is mildly elevated, it would not be a reason on its own to hold furosemide. Monitoring potassium levels closely and potentially adjusting potassium
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Cancer cells typically lose their specialized functions and characteristics that normal cells have. This loss of differentiation is known as dedifferentiation, where cancer cells become less specialized and more primitive in nature. This allows them to proliferate rapidly and invade surrounding tissues.
B. Contact inhibition refers to the normal process where cells stop dividing when they come into contact with neighboring cells. In cancer cells, this mechanism is disrupted, leading to uncontrolled cell growth and proliferation. Cancer cells continue to divide and grow even when they are in close contact with other cells, which contributes to tumor formation and progression.
C. Cancer cells often acquire mutations that impair their ability to repair DNA damage effectively. This can lead to an accumulation of genetic mutations over time, which is a hallmark of cancer development. While some cancer cells may still have mechanisms to repair DNA damage, they are often less efficient compared to normal cells, leading to genomic instability and further mutation accumulation.
D. Normal cells follow a tightly regulated cell cycle with specific checkpoints that ensure orderly progression through phases such as G1, S, G2, and M phases. In contrast, cancer cells often have dysregulated cell cycle control. They may bypass checkpoints that normally control cell division, leading to uncontrolled proliferation and growth.
Correct Answer is B
Explanation
A. Carbidopa itself does not cross the blood-brain barrier. Its primary role in Sinemet is to inhibit the peripheral breakdown of levodopa (the precursor of dopamine) into dopamine before it reaches the brain.
B. It is true that it may take a few weeks to see the full effects of this medication, as the body needs time to adjust to it.
C. Parkinson's disease is progressive, and as the disease advances, the dosage and frequency of levodopa with carbidopa may need to be adjusted to maintain symptom control. Over time, higher doses or additional medications may be required to manage symptoms effectively.
D. Levodopa does not protect Carbidopa; rather, Carbidopa protects Levodopa from early conversion to dopamine outside the brain, which would make it less effective.
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