A patient hospitalized for heart failure exacerbation has been receiving 40 mg furosemide IV twice daily. What statement by the client would alert the nurse to a possible toxic effect of this medication?
My stomach is distended, and I haven't had a bowel movement in 3 days
This IV site seems irritated, it's red and painful
Everything has started sounding muffled, I'm having difficulty hearing
I feel like I've done nothing but urinate since I've been here
The Correct Answer is C
Choice A reason: This choice is incorrect because stomach distension and constipation are not common side effects of furosemide. They may be related to other causes, such as diet, fluid intake, or medication interactions. The nurse should assess the client's abdominal status and bowel habits and provide appropriate interventions, such as increasing fiber, fluids, or laxatives.
Choice B reason: This choice is incorrect because IV site irritation, redness, and pain are not specific side effects of furosemide. They may be caused by other factors, such as infection, infiltration, or phlebitis. The nurse should inspect the IV site and catheter and change them if needed. The nurse should also monitor the client's vital signs and blood cultures for signs of infection.
Choice C reason: This choice is correct because hearing loss or impairment is a rare but serious side effect of furosemide. It can occur due to damage to the inner ear or the auditory nerve. It may be temporary or permanent, depending on the dose and duration of furosemide therapy. The nurse should stop the infusion of furosemide and notify the provider immediately. The nurse should also assess the client's hearing and balance and provide safety measures.
Choice D reason: This choice is incorrect because frequent urination is an expected effect of furosemide. Furosemide is a diuretic that increases the excretion of water and electrolytes through the urine. It helps to reduce fluid overload and edema in clients with heart failure. The nurse should measure and record the client's intake and output and monitor the client's fluid and electrolyte status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
Choice A reason: Maintaining a healthy weight is important for lowering cholesterol levels and reducing the risk of cardiovascular disease. Obesity is associated with higher levels of LDL-cholesterol (the "bad" cholesterol) and lower levels of HDL-cholesterol (the "good" cholesterol). Losing weight can improve these ratios and lower blood pressure. ¹
Choice B reason: Avoiding cigarettes and other nicotine products is essential for preventing cardiovascular disease. Smoking damages the blood vessels and increases the risk of atherosclerosis, which is the buildup of plaque in the arteries. Smoking also lowers HDL-cholesterol and raises triglycerides, another type of fat in the blood. Quitting smoking can improve cholesterol levels and lower the risk of heart attack and stroke. ²
Choice C reason: Importance of regular exercise is another key factor for improving cholesterol levels and cardiovascular health. Exercise helps to lower LDL-cholesterol and raise HDL-cholesterol, as well as lower blood pressure and blood sugar. Exercise also strengthens the heart muscle and improves blood flow. The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week, or a combination of both. ³
Choice D reason: Positive stress management techniques are not directly related to cholesterol levels or statin medications, but they may have some benefits for cardiovascular health. Stress can increase blood pressure and heart rate, and may trigger unhealthy behaviors such as smoking, drinking, or overeating. Stress can also affect the immune system and inflammation, which may contribute to atherosclerosis. Learning to cope with stress in healthy ways, such as meditation, yoga, breathing exercises, or counseling, may help to lower the risk of cardiovascular disease. ⁴
Choice E reason: Healthy low fat diet options are an important part of lowering cholesterol levels and preventing cardiovascular disease. A diet that is high in saturated fat, trans fat, and cholesterol can raise LDL-cholesterol and lower HDL-cholesterol. A diet that is low in fat and high in fiber, fruits, vegetables, whole grains, and lean protein can lower LDL-cholesterol and raise HDL-cholesterol. Some foods, such as oats, nuts, soy, and fish, may have additional benefits for cholesterol levels. .
Correct Answer is D
Explanation
Choice A reason: This choice is incorrect because fluids should not be limited to 1000 mL daily for a client taking hydrochlorothiazide. Hydrochlorothiazide is a diuretic that causes the body to lose water and salt through urine. Limiting fluids can lead to dehydration, electrolyte imbalance, and kidney damage. The client should drink enough fluids to prevent thirst and dry mouth, and follow the doctor's advice on fluid intake.
Choice B reason: This choice is incorrect because this medication is not best taken at night for a client taking hydrochlorothiazide. Hydrochlorothiazide can cause frequent urination, which can disrupt the sleep cycle and cause fatigue. The client should take this medication in the morning or at least 4 hours before bedtime to avoid nocturia (nighttime urination).
Choice C reason: This choice is incorrect because dairy products should not be avoided while on this medication for a client taking hydrochlorothiazide. Hydrochlorothiazide can lower the level of calcium in the blood, which can cause muscle weakness, cramps, and osteoporosis. Dairy products are a good source of calcium and can help prevent calcium deficiency. The client should consume adequate amounts of calcium and vitamin D, and have their blood calcium level checked regularly.
Choice D reason: This choice is correct because the client should consume high potassium foods such as bananas and oranges while on this medication. Hydrochlorothiazide can lower the level of potassium in the blood, which can cause irregular heartbeat, muscle weakness, and numbness. Potassium-rich foods can help prevent potassium deficiency and maintain normal heart and muscle function. The client should also have their blood potassium level checked regularly and avoid salt substitutes that contain potassium.
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