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 C
Explanation
Digoxin is a cardiac glycoside that increases the force of heart contractions (positive inotropy) and decreases the heart rate (negative chronotropy) by inhibiting the sodium-potassium ATPase pump in the cardiac cell membranes and affecting the autonomic tone.This helps to improve the symptoms of heart failure and to control the ventricular rate in atrial fibrillation.
Choice A is wrong because positive chronotropy means increasing the heart rate, which is the opposite of what digoxin does.
Choice B is wrong because negative inotropy means decreasing the force of heart contractions, which is also the opposite of what digoxin does.
Choice D is wrong because positive inotropy and positive chronotropy would both increase the workload of the heart, which is not desirable in heart failure or atrial fibrillation.
Normal ranges for digoxin are 0.5 to 2 ng/mL for heart failure and 0.8 to 2 ng/mL for atrial fibrillation.Digoxin has a narrow therapeutic window and can cause serious side effects if overdosed or underdosed.
Correct Answer is D
Explanation
Report any muscle pain or weakness to the healthcare provider.This is because simvastatin This is because simvastatin can cause a rare but serious side effect of muscle damage (rhabdomyolysis), which can lead to kidney failure.Muscle pain or weakness can be signs of muscle breakdown and kidney damage, and should be reported to the healthcare provider as soon as possible.
Choice A is wrong because changing position slowly when rising from a chair is not related to simvastatin.This is a precaution for people who take medications that lower blood pressure, such as diuretics or beta blockers, to prevent dizziness or fainting.
Choice B is wrong because maintaining a steady intake of green leafy vegetables is not specific to simvastatin.This is a general dietary recommendation for people who take anticoagulants, such as warfarin, to prevent bleeding complications.
Choice C is wrong because consuming no more than 1 L/day of fluid is not advised for people who take simvastatin.This is a restriction for people who have heart failure or kidney disease, to prevent fluid overload.People who take simvastatin should drink enough fluids to stay hydrated and avoid dehydration, which can increase the risk of kidney damage.
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