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 ["A","B","D","E"]
Explanation
These are all modifiable risk factors for cardiovascular disease, meaning they can be changed through lifestyle choices or medication.Cholesterol level, blood pressure, weight, and smoking all affect the health of the heart and blood vessels, and can increase the risk of developing conditions such as atherosclerosis, hypertension, heart attack, or stroke.
Choice C, family history, is not a modifiable risk factor for cardiovascular disease.
It is a non-modifiable risk factor, meaning it cannot be changed and is determined by genetics.
Having a family history of cardiovascular disease can increase the risk of developing it, but it does not mean that it is inevitable.Other non-modifiable risk factors include sex, older age, race and ethnicity.
Some normal ranges for the modifiable risk factors are:
• Cholesterol level: total cholesterol should be less than 200 mg/dL; LDL cholesterol should be less than 100 mg/dL; HDL cholesterol should be more than 40 mg/dL for men and more than 50 mg/dL for women; triglycerides should be less than 150 mg/dL.
• Blood pressure: normal blood pressure is less than 120/80 mmHg; elevated blood pressure is 120-129/less than 80 mmHg; hypertension stage 1 is 130-139/80-89 mmHg; hypertension stage 2 is 140 or higher/90 or higher mmHg.
• Weight: body mass index (BMI) is a measure of weight relative to height; normal BMI is 18.5-24.9 kg/m2; overweight BMI is 25-29.9 kg/m2; obese BMI is 30 or higher kg/m2.
• Smoking: smoking any amount of tobacco products can harm the cardiovascular system; quitting smoking can lower the risk of cardiovascular disease and improve overall health.
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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