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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Diuretics are drugs that increase the amount of urine and salt (sodium) excreted by the kidneys. They are used to treat high blood pressure, heart failure, and edema (fluid retention). However, some diuretics can cause low levels of potassium in the blood (hypokalemia), which can lead to muscle weakness, cramps, and arrhythmias. To prevent this, a combination of diuretics acting on different parts of the kidney (such as a loop diuretic and a thiazide diuretic) may be prescribed.This way, the potassium-sparing effect of one diuretic can balance the potassium-wasting effect of the other, while still achieving a net sodium loss.
Choice A is wrong because they are not a part of the initial diuretic therapy.Combination diuretic therapy is usually reserved for patients who are resistant to or intolerant of monotherapy.
Choice C is wrong because little follow up is not needed after the initial treatment.Patients on combination diuretic therapy require close monitoring of their blood pressure, electrolytes, renal function, and weight to avoid adverse effects such as dehydration, hyponatremia, hypotension, and worsening renal function.
Choice D is wrong because they do not increase the risk of hypokalemia.As explained above, combination diuretic therapy aims to reduce the risk of hypokalemia by using a potassium-sparing diuretic along with a potassium-wasting diuretic.
Correct Answer is A
Explanation
Intermittent claudication is a condition in which leg pain is produced upon increased activity and ischemia to tissues, but then the pain is reduced with rest. This is because the blood flow to the leg muscles is insufficient to meet the increased demand during exercise, but adequate at rest.Intermittent claudication is a common symptom of peripheral artery disease (PAD), which is a narrowing of the arteries that supply blood to the legs.
Choice B, sporadic ischemia, is wrong because it is not a specific medical term for a condition that causes leg pain.
Ischemia means reduced blood flow to a part of the body, which can cause pain, but it can be caused by various factors and affect different organs.
Choice C, angina, is wrong because it is a term for chest pain caused by reduced blood flow to the heart, not the legs.
Angina can also be triggered by physical activity and relieved by rest, but it is not related to PAD or leg ischemia.
Choice D, restless leg syndrome, is wrong because it is a condition that causes an uncomfortable urge to move the legs, usually at night or when lying down.
Restless leg syndrome does not cause pain or ischemia in the legs, and it is not improved by rest.It is thought to be related to a problem with the nervous system or iron deficiency.
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