A patient with ﬂuid overload is prescribed furosemide (Lasix) 20 mg by mouth each day. What should the nurse include when teaching the patient about this medication? (Select all that apply.)

Measure body weight every day.

Expect urination to increase.

Take the medication before going to sleep.

Report swelling of the face or hands.

Expect to feel weak and dizzy.

Answer and Explanation

Correct Answer : A,B,D,E

Choice A: Measure body weight every day is correct because body weight is an indicator of ﬂuid balance and can help monitor the eﬀectiveness of the medication. The nurse should instruct the patient to weigh themselves at the same time each day, preferably in the morning, and report any significant changes to the provider.

Choice B: Expect urination to increase is correct because furosemide is a diuretic that works by blocking the reabsorption of sodium and water in the kidneys, thus increasing urine output and reducing ﬂuid volume. The nurse should instruct the patient to drink enough ﬂuids to prevent dehydration and electrolyte imbalance and to avoid taking the medication at night to prevent nocturia and sleep disturbance.

Choice C: Taking the medication before going to sleep is incorrect because taking furosemide at night can cause nocturia and sleep disturbance, as well as increase the risk of falls. The nurse should instruct the patient to take the medication in the morning or early afternoon and to avoid caﬀeine and alcohol, which can also increase urination.

Choice D: Report swelling of the face or hands is correct because swelling of the face or hands can indicate an allergic reaction or angioedema, which are rare but serious side effects of furosemide. The nurse should instruct the patient to stop taking the medication and seek immediate medical attention if they experience swelling of the face or hands, as well as difficulty breathing, hives, or itching.

Choice E: Expecting to feel weak and dizzy is correct because weakness and dizziness are common side effects of furosemide, especially when starting or increasing the dose. The nurse should instruct the patient to rise slowly from a sitting or lying position and to use caution when driving or performing other activities that require alertness. The nurse should also instruct the patient to report any signs of hypotension, such as fainting, blurred vision, or chest pain.

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Correct Answer is B

Explanation

Choice A: Concentrated hemoglobin and hematocrit levels are not a sign of ﬂuid volume overload, but rather of ﬂuid volume deficit. This is a condition that occurs when the body loses more ﬂuid than it gains. This can happen in patients who have excessive bleeding, vomiting, diarrhea, or diaphoresis. Concentrated hemoglobin and hematocrit levels indicate hemoconcentration, which is an increase in the ratio of blood cells to plasma.

Choice B: Distended neck veins are a sign of ﬂuid volume overload, because this condition occurs when the body retains more ﬂuid than it excretes. This can happen in patients who have heart failure, kidney failure, or excessive ﬂuid intake. Distended neck veins indicate increased central venous pressure, which is a measure of the pressure in the right atrium of the heart.

Choice C: Decreased urine output is not a sign of ﬂuid volume overload, but rather of oliguria or anuria. These are conditions that occur when the urine output is less than 400 mL or 50 mL per day, respectively. These can happen in patients who have acute or chronic kidney injury, urinary obstruction, or shock. Decreased urine output indicates impaired renal function and decreased glomerular filtration rate.

Choice D: Poor skin turgor is not a sign of ﬂuid volume overload, but rather of dehydration. This is a condition that occurs when the body loses more water than it gains. This can happen in patients who have fever, diabetes insipidus, or hyperglycemia. Poor skin turgor indicates decreased skin elasticity and delayed return to normal shape after being pinched.

A. Calcium-containing antacids B. Increased vitamin D intake C. Potassium phosphate D. Additional milk intake E. IV normal saline

Correct Answer is ["A","E"]

Explanation

Choice A: Calcium-containing antacids are prescribed for patients with high serum phosphate levels, because calcium binds with phosphate and lowers its concentration in the blood. Calcium-containing antacids also help to prevent or treat hypocalcemia, which is a common complication of hyperphosphatemia.

Choice B: Increased vitamin D intake is not prescribed for patients with high serum phosphate levels, because vitamin D enhances the absorption of both calcium and phosphate from the intestines. Increased vitamin D intake can worsen hyperphosphatemia and hypocalcemia.

Choice C: Potassium phosphate is not prescribed for patients with high serum phosphate levels, because potassium phosphate is a source of phosphate that increases its concentration in the blood. Potassium phosphate can also cause hyperkalemia, which is a dangerous condition that aﬀects the heart rhythm.

Choice D: Additional milk intake is not prescribed for patients with high serum phosphate levels, because milk is rich in both calcium and phosphate. Additional milk intake can worsen hyperphosphatemia and hypocalcemia.

Choice E: IV normal saline is prescribed for patients with high serum phosphate levels, because normal saline helps to dilute the blood and lower the concentration of phosphate. Normal saline also helps to maintain ﬂuid and electrolyte balance in the body.

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A patient with ﬂuid overload is prescribed furosemide (Lasix) 20 mg by mouth each day. What should the nurse include when teaching the patient about this medication? (Select all that apply.)

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Correct Answer is ["A","E"]

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