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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

Anticoagulants are medicines that increase the time it takes for blood to clot.They do not dissolve existing clots, but they can stop them from getting bigger or prevent new clots from forming.Anticoagulants work by interfering with different steps of the blood coagulation pathway, which is a complex process that involves many clotting factors.

Choice A is wrong because anticoagulants do not dissolve existing clots.To dissolve clots, you need medicines called thrombolytics or fibrinolytics, which break down the fibrin that holds the clots together.

Choice B is wrong because anticoagulants do not transport platelets.

Platelets are blood cells that help with clotting by sticking together and forming a plug at the site of an injury.Anticoagulants may affect the function of platelets, but they do not move them around.

Choice D is wrong because anticoagulants do not increase blood viscosity.

Viscosity is a measure of how thick and sticky a fluid is.

Anticoagulants are sometimes called blood thinners, but they do not actually change the viscosity of blood.They just make it less likely to clot.

Normal ranges for blood clotting tests vary depending on the type of test and the laboratory that performs it.

Some common tests and their normal ranges 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

• Anti-factor Xa: 0.3 to 0.7 units/mL

• D-dimer: less than 0.5 mcg/mL

A. Potassium 3.0 mEq/L. B. Calcium 9.2 mg/dL. C. Potassium 4.8 mEq/L. D. Calcium 10.3 mg/dL.

Correct Answer is A

Explanation

This is because digoxin inhibits the Na-K-ATPase pump on the membrane of cardiac cells, which can cause extracellular potassium levels to rise.Hypokalemia (low potassium) caused by large dosages of diuretics may result in digoxin toxicity even at low serum digoxin levels.Digoxin toxicity can cause gastrointestinal, constitutional, and/or cardiovascular symptoms, as well as ECG changes such as signs of increased automaticity and atrioventricular node blockade.

Choice B is wrong because calcium 9.2 mg/dL is within the normal range of 8.5 to 10.5 mg/dL.Hypercalcemia (high calcium) can increase sensitivity to digoxin effects and lead to toxicity even with a lower concentration of serum digoxin, but this is not the case here.

Choice C is wrong because potassium 4.8 mEq/L is within the normal range of 3.5 to 5.0 mEq/L.

Hyperkalemia (high potassium) can also increase the risk of digoxin toxicity, but this is not the case here.

Choice D is wrong because calcium 10.3 mg/dL is within the normal range of 8.5 to 10.5 mg/dL.Hypercalcemia (high calcium) can increase sensitivity to digoxin effects and lead to toxicity even with a lower concentration of serum digoxin, but this is not the case here.

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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?

Nursing Test Bank

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Explanation

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Correct Answer is A

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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?