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
Simvastatin is a type of drug called a statin, which lowers cholesterol and triglycerides in the blood. Statins work by reducing the amount of cholesterol made by the liver, and the liver produces more cholesterol at night.Therefore, taking simvastatin in the evening can increase its effectiveness.
Choice A is wrong because changing position slowly when rising from a chair is not related to simvastatin use.
This advice is usually given to people who have low blood pressure or take medications that lower blood pressure, such as diuretics or beta blockers.
Choice B is wrong because maintaining a steady intake of green leafy vegetables is not specific to simvastatin use.
This advice is usually given to people who take anticoagulants, such as warfarin, because green leafy vegetables contain vitamin K, which can affect the blood clotting process.
Choice C is wrong because consuming no more than 1 L/day of fluid is not related to simvastatin use.
This advice is usually given to people who have fluid retention or heart failure, because excess fluid can put strain on the heart and lungs.
Correct Answer is C
Explanation
This is because elevating the legs can help reduce swelling and improve blood flow back to the heart by reducing the effects of gravity.Elevating the legs can also prevent blood from pooling in the veins and reduce the risk of blood clots.
Choice A is wrong because dangling the legs can increase swelling and pressure in the veins, which can worsen peripheral venous disease (PVD) symptoms and complications.
Choice B is wrong because sitting in one position for prolonged hours can impair blood circulation and increase the risk of blood clots, especially in the lower legs.People with PVD should avoid crossing their legs, wearing tight clothing, or sitting for long periods without moving.
Choice D is wrong because standing in one position can also increase swelling and pressure in the veins, which can lead to pain, ulcers, and skin changes.People with PVD should avoid standing for long periods without moving or changing positions.
Some additional information:
Peripheral venous disease (PVD) is a condition that affects blood flow in the veins and arteries outside of your heart and brain.
It can be caused by narrowing, blocking, or spasming of the blood vessels, or by blood clots in the veins.PVD can cause pain and fatigue, especially in the legs, and can lead to serious complications such as gangrene or amputation.
The most common cause of PVD is atherosclerosis, the buildup of plaque inside the artery wall.
Plaque reduces the amount of blood flow to the limbs and decreases the oxygen and nutrients available to the tissue.Other causes of PVD may include injury, infection, irregular anatomy of muscles or ligaments, or inflammation of the blood vessels.
The normal range of blood pressure in the veins is about 10 to 20 mmHg.
The normal range of oxygen saturation in the veins is about 60 to 80%.
The normal range of pulse rate in the veins is about 60 to 100 beats per minute.
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