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 D
Explanation
This is because digoxin can cause bradycardia (slow heart rate) as a side effect, which can be dangerous and require dose adjustment or discontinuation of the medication.Digoxin helps make the heart beat stronger and with a more regular rhythm by inhibiting sodium-potassium ATPase in cardiac cells.It is used to treat heart failure and atrial fibrillation.
Choice A is wrong because increasing sodium intake can worsen fluid retention and exacerbate heart failure symptoms.Patients with heart failure should follow a low-sodium diet to reduce the workload on the heart.
Choice B is wrong because checking pulse rate for 30 seconds and multiplying result by 2 is not accurate enough to monitor the effects of digoxin.
Patients taking digoxin should check their pulse rate for one full minute before taking each dose and record it daily.If the pulse rate is too fast or too slow, they should contact their provider.
Choice C is wrong because taking digoxin with food may reduce its absorption and effectiveness.Digoxin should be taken on an empty stomach, at least one hour before or two hours after a meal.If nausea occurs, it may be a sign of digoxin toxicity and should be reported to the provider.
Correct Answer is D
Explanation
Diuretics are medicines that help the kidneys get rid of excess water and salt, which can ease the symptoms of heart failure, such as breathlessness and swelling.However, diuretics may have some side effects, such as loss of potassium, which can affect the heart and require regular blood tests and dietary changes.Diuretics can also cause other electrolyte abnormalities, such as hyponatremia, hypomagnesemia, hypocalcemia, and metabolic alkalosis. Electrolyte disturbances can have serious consequences for the heart function and rhythm, as well as other organs.
Choice A is wrong because fluid retention is the opposite of what diuretics do.
Diuretics reduce fluid retention by increasing urine output and decreasing blood volume.
Choice B is wrong because hypotension is not a direct effect of diuretics on the heart, but rather a consequence of reduced blood volume and vasodilation.
Hypotension can occur with diuretic use, especially if the dose is too high or the patient is dehydrated, but it is not a specific condition caused by diuretics.
Choice C is wrong because hyperglycemia is not related to diuretics or heart failure.
Hyperglycemia is a condition of high blood sugar, which can be caused by diabetes or other factors.
Diuretics do not affect blood sugar levels directly, although some diuretics may interact with diabetes medications and affect their efficacy.
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