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 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.

A. Take before starting daily activities. B. Take with a sedative. C. Take with grapefruit juice. D. Take with an NSAID such as ibuprofen.

Correct Answer is D

Explanation

Taking niacin with an NSAID such as ibuprofen can reduce flushing, the most common adverse effect of niacin therapy. Flushing is a side effect of taking large doses of niacin (vitamin B3) supplements.It happens when the niacin causes the small blood vessels in your skin to dilate so more blood can rush through.Flushing can cause skin redness, warmth, itching, tingling, or burning sensations.

Choice A is wrong because taking niacin before starting daily activities can increase the risk of flushing and interfere with your routine.Flushing usually occurs within 15 to 30 minutes of taking niacin and lasts for about an hour.

Choice B is wrong because taking niacin with a sedative can increase the risk of liver damage, especially if the sedative is acetaminophen (Tylenol).Niacin can also cause liver problems at high doses, so combining it with another liver-toxic drug is not advisable.

Choice C is wrong because taking niacin with grapefruit juice can increase the risk of side effects, such as low blood pressure, dizziness, or fainting.Grapefruit juice can interfere with the metabolism of some drugs, including niacin, and make them more potent or toxic.

Normal ranges for niacin intake vary depending on age and gender.The recommended dietary allowance (RDA) for adult males is 16 mg per day and for adult females is 14 mg per day.Higher doses of niacin may be prescribed by a doctor to treat high cholesterol or other conditions, but they should be taken under medical supervision and with caution.

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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

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?

Correct Answer is D

Explanation

Which administration strategy can a patient implement to reduce flushing, the most common adverse effect of niacin therapy?

Correct Answer is D

Explanation

If the patient PTT lab level is too long and greater than 80 seconds, the nurse should notify the doctor. Which doctor’s order should the nurse anticipate?

A patient with peripheral vascular disease has been on pentoxifylline (Trental) for 2 weeks. Which statements by the patient indicate no need for further patient teaching about the disease? Select all that apply.

The use of diuretics in the treatment of heart failure may lead to what condition?

Which drug class should not be used when a patient is taking nitrates?

The antagonistic agent to digoxin toxicity is what?

Patients taking which cholesterol-lowering agent may require supplements of fat-soluble vitamins A, D, E, and K?

The antagonistic agent to digoxin toxicity is what?

The greatest contributing factor that can lead to many diseases is what?

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?