A patient has been placed on a loop diuretic to reduce the fluid that has been accumulating in the lungs.
Which statement made by the patient indicates a need for further teaching about the medication by the nurse?
“I weigh myself each day before breakfast.”.
“If my shortness of breath returns, I’ll contact my healthcare provider.”.
“I’ll have a banana with my breakfast every morning.”.
“I’ll be sure to take my medication with supper.”.
The Correct Answer is D
Taking a loop diuretic with supper is not advisable because it can cause nocturia, which is the need to urinate frequently at night. This can disrupt sleep and affect quality of life. Loop diuretics should be taken in the morning or early afternoon to avoid this problem.
Choice A is wrong because weighing oneself each day before breakfast is a good way to monitor fluid balance and detect any signs of fluid retention or dehydration. This can help adjust the dose of the loop diuretic as needed.
Choice B is wrong because contacting the healthcare provider if shortness of breath returns is a sensible precaution and indicates awareness of the symptoms of worsening heart failure. Shortness of breath is caused by fluid accumulation in the lungs, which loop diuretics help to prevent or reduce.
Choice C is wrong because having a banana with breakfast every morning is a good source of potassium, which can help prevent hypokalemia, a common side effect of loop diuretics. Loop diuretics increase the excretion of potassium in the urine, which can lead to low blood levels of potassium and cause muscle weakness, cramps, fatigue, arrhythmias, and increased sensitivity to digoxin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C"]
Explanation
The nurse should contact the provider and ask the patient if they are feeling light headed or dizzy.
Choice A is wrong because administering the medication could worsen the patient’s condition.Furosemide is a diuretic that can cause dehydration, electrolyte imbalance, and hypotension.The patient already has a low serum potassium level of 2.8 mEq/L, which is below the normal range of 3.5 to 5.0 mEq/L.Giving furosemide could lower the potassium level further and increase the risk of cardiac arrhythmias.The patient also has a significant drop in blood pressure from lying to sitting position, which indicates orthostatic hypotension.Giving furosemide could lower the blood pressure more and cause dizziness, fainting, or falls.
Choice D is wrong because encouraging the patient to get up quickly and walk around could also cause dizziness, fainting, or falls due to orthostatic hypotension.The patient should be advised to change positions slowly and carefully, and to avoid activities that require alertness until their blood pressure stabilizes.
Choice E is wrong because holding the medication without contacting the provider could delay the appropriate treatment for the patient’s fluid retention.The nurse should notify the provider of the patient’s vital signs, laboratory results, and symptoms, and follow their orders regarding the medication dosage or alternative therapy.
Correct Answer is B
Explanation
Vitamin K is the antidote for warfarin toxicity because it can reverse the effects of warfarin by restoring the clotting factors.Warfarin is an oral anticoagulant that works by inhibiting vitamin K epoxide reductase, an enzyme that activates vitamin K in the body.Vitamin K is needed for the synthesis of active coagulation factors, such as II, VII, IX and X.By blocking vitamin K, warfarin reduces the blood’s clotting activity and prevents the formation of blood clots.
Choice A is wrong because vitamin B12 is not involved in the coagulation cascade.Vitamin B12 is mainly involved in DNA synthesis, red blood cell production and nerve function.
Choice C is wrong because calcium gluconate is not an antidote for warfarin toxicity.Calcium gluconate is used to treat low blood calcium levels or hypocalcemia.Calcium is also a cofactor for some coagulation factors, but it does not reverse the effects of warfarin.
Choice D is wrong because protamine sulfate is not an antidote for warfarin toxicity.
Protamine sulfate is used to reverse the effects of heparin, another type of anticoagulant that works by inhibiting thrombin and factor Xa.
Protamine sulfate does not affect the vitamin K-dependent coagulation factors that are inhibited by warfarin.
Normal ranges for coagulation tests that are affected by warfarin are:
• Prothrombin time (PT): 11 to 13.5 seconds
• International normalized ratio (INR): 0.8 to 1.2
• Activated partial thromboplastin time (aPTT): 25 to 35 seconds
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