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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason: This is correct because phosphorus is a mineral that is essential for bone health, energy metabolism, and acid-base balance. Hypophosphatemia is a low level of phosphorus in the blood, which can cause muscle weakness, bone pain, and confusion. The nurse should request a dietitian consult for selecting foods high in phosphorus, such as dairy products, meat, fish, eggs, nuts, and beans.
Choice B Reason: This is incorrect because poultry, peanuts, and seeds are foods that are high in phosphorus, not low. The nurse should not instruct the patient to avoid these foods, as they can help increase the serum phosphorus level and prevent further complications of hypophosphatemia.
Choice C Reason: This is incorrect because aluminum hydroxide antacids are medications that can lower the serum phosphorus level by binding to phosphorus in the gastrointestinal tract and preventing its absorption. The nurse should not provide aluminum hydroxide antacids as prescribed, as they can worsen the patient's condition and cause aluminum toxicity. The nurse should consult with the provider about alternative medications for treating stomach ulcers that do not affect phosphorus levels.
Choice D Reason: This is incorrect because sodium phosphate is a medication that can raise the serum phosphorus level by providing supplemental phosphorus. The nurse should not instruct the patient to avoid the intake of sodium phosphate, as it can help correct hypophosphatemia and restore normal phosphorus balance. The nurse should administer sodium phosphate as ordered and monitor the patient's serum phosphorus level and renal function.
Correct Answer is A
Explanation
Choice A: Widened QRS complexes is correct because it is a sign of cardiac dysrhythmias, which can occur in respiratory acidosis due to hyperkalemia, or high potassium level. Respiratory acidosis is a condition where the blood pH is low and the PaCO2 is high, indicating impaired gas exchange or hypoventilation. This can cause potassium to shift from the intracellular fluid to the extracellular fluid, thus raising the serum potassium level and affecting the cardiac conduction.
Choice B: Hyperactive deep tendon reflexes is incorrect because it is a sign of hypocalcemia, or low calcium level, which can occur in metabolic alkalosis, not respiratory acidosis. Metabolic alkalosis is a condition where the blood pH is high and the HCO3 is high, indicating a loss of metabolic acids or an excess of bicarbonate in the body. This can cause calcium to bind to albumin and lower its availability in the blood, thus increasing the neuromuscular excitability.
Choice C: Bounding peripheral pulses is incorrect because it is a sign of fluid overload, which can occur in heart failure, not respiratory acidosis. Fluid overload is a condition where the fluid volume in the body exceeds the normal range, causing edema, hypertension, and dyspnea. This can be caused by conditions such as kidney disease, liver disease, or excessive sodium intake.
Choice D: Warm, flushed skin is incorrect because it is a sign of vasodilation, which can occur in respiratory alkalosis, not respiratory acidosis. Respiratory alkalosis is a condition where the blood pH is high and the PaCO2 is low, indicating excessive loss of carbon dioxide through hyperventilation. This can cause the blood vessels to dilate and increase the blood flow to the skin, thus causing warmth and redness.
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