A patient with a history of heart failure is prescribed furosemide (Lasix). Several days after the aggressive diuretic therapy started, the patient began to exhibit confusion, tremors, muscle cramps, and nausea.
What does the nurse suspect?
Hypokalemia.
Renal failure.
Hyperkalemia.
Heart failure.
The Correct Answer is A
Hypokalemia is a condition of low potassium levels in the blood, which can be caused by diuretics such as furosemide (Lasix) that increase the excretion of potassium in the urine. Potassium is an important electrolyte that helps regulate the function of nerves and muscles, including the heart. Low potassium levels can cause symptoms such as confusion, tremors, muscle cramps, and nausea, which are consistent with the patient’s presentation.
Choice B, renal failure, is wrong because furosemide is used to treat fluid retention and edema caused by kidney disease, not to cause it. Renal failure would also cause symptoms such as decreased urine output, swelling, fatigue, and shortness of breath, which are not mentioned in the question.
Choice C, hyperkalemia, is wrong because hyperkalemia is a condition of high potassium levels in the blood, which can be caused by kidney disease or certain medications that decrease the excretion of potassium in the urine. Hyperkalemia can cause symptoms such as weakness, irregular heartbeat, paralysis, and chest pain, which are different from the patient’s symptoms.
Choice D, heart failure, is wrong because furosemide is also used to treat fluid retention and edema caused by heart failure, not to cause it. Heart failure would also cause symptoms such as shortness of breath, coughing, fatigue, and rapid weight gain, which are not mentioned in the question.
Normal ranges for potassium levels in the blood are 3.5 to 5.0 milliequivalents per liter (mEq/L) for adults and 3.4 to 4.7 mEq/L for children.
A level below 3.5 mEq/L is considered hypokalemic and a level above 5.0 mEq/L is considered hyperkalemic.
Nursing Test Bank
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 D
Explanation
Alpha 1 adrenergic blocking agents have a vasodilating effect and can be used for the management of hypertension.They work by preventing the hormone norepinephrine from tightening the muscles in the walls of smaller arteries and veins, thus lowering the blood pressure.Some examples of alpha 1 blockers are doxazosin, prazosin, and terazosin.
Choice A is wrong because alpha 3 adrenergic blockers do not exist.There are only two subtypes of alpha receptors: alpha 1 and alpha 2.
Choice B is wrong because alpha 2 adrenergic antagonists are not used for hypertension.They are used for conditions like attention deficit hyperactivity disorder (ADHD) and opioid withdrawal.Alpha 2 antagonists block the negative feedback mechanism of norepinephrine release, thus increasing the amount of norepinephrine in the blood and raising the blood pressure.
Choice C is wrong because alpha 1 adrenergic agonists have the opposite effect of alpha 1 blockers.They stimulate the alpha 1 receptors and cause vasoconstriction, which increases the blood pressure.Alpha 1 agonists are used for conditions like nasal congestion and hypotension.
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