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
Explanation
Lisinopril belongs to the class of drugs calledangiotensin-converting enzyme (ACE) inhibitors.ACE inhibitors work by blocking the enzyme that converts angiotensin I to angiotensin II, a hormone that causes blood vessels to narrow and raise blood pressure.By inhibiting this enzyme, ACE inhibitors relax and widen the blood vessels, lower blood pressure, and improve blood flow to the heart and kidneys.
Choice B.Candesartan is wrong because it belongs to the class of drugs calledangiotensin II receptor blockers (ARBs).ARBs work by blocking the action of angiotensin II on its receptors, preventing it from causing blood vessel constriction and high blood pressure.ARBs are similar to ACE inhibitors in their effects, but they do not affect the enzyme or the level of bradykinin, a peptide that can cause cough and angioedema as side effects of ACE inhibitors.
Choice C.Metoprolol is wrong because it belongs to the class of drugs calledbeta blockers.Beta blockers work by blocking the effects of adrenaline and other hormones that stimulate the heart and blood vessels, causing them to beat slower and with less force.Beta blockers lower blood pressure and reduce the workload on the heart.
Choice D.Amlodipine is wrong because it belongs to the class of drugs calledcalcium channel blockers.Calcium channel blockers work by blocking the entry of calcium into the muscle cells of the heart and blood vessels, causing them to relax and dilate.Calcium channel blockers lower blood pressure and improve blood flow to the heart.
Normal ranges for blood pressure vary depending on age, gender, and other factors, but generally, a systolic blood pressure (the top number) of less than 120 mmHg and a diastolic blood pressure (the bottom number) of less than 80 mmHg are considered normal for adults.A blood pressure of 130/80 mmHg or higher is considered high and may require treatment with medication.
Correct Answer is D
Explanation
Taking a loop diuretic with supper is not advisable because it can cause nocturia, which is the need to urinate frequently at night. This can disrupt sleep and affect quality of life.Loop diuretics should be taken in the morning or early afternoon to avoid this problem.
Choice A is wrong because weighing oneself each day before breakfast is a good way to monitor fluid balance and detect any signs of fluid retention or dehydration.This can help adjust the dose of the loop diuretic as needed.
Choice B is wrong because contacting the healthcare provider if shortness of breath returns is a sensible precaution and indicates awareness of the symptoms of worsening heart failure.Shortness of breath is caused by fluid accumulation in the lungs, which loop diuretics help to prevent or reduce.
Choice C is wrong because having a banana with breakfast every morning is a good source of potassium, which can help prevent hypokalemia, a common side effect of loop diuretics.Loop diuretics increase the excretion of potassium in the urine, which can lead to low blood levels of potassium and cause muscle weakness, cramps, fatigue, arrhythmias, and increased sensitivity to digoxin.
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