A patient with heart failure develops hyperaldosteronism and is prescribed spironolactone.

What instructions should the nurse include in the patient’s care plan?

Substitute salt with a salt substitute.

Protect your skin before going outside.

Limit intake of high-potassium foods.

Monitor skin for excessive bruising.

Answer and Explanation

The Correct Answer is C

Choice A rationale

While salt substitutes can be a good option for some patients with heart failure, they are often high in potassium. Because spironolactone is a potassium-sparing diuretic, using a salt substitute could lead to dangerously high levels of potassium.

Choice B rationale

Protecting your skin before going outside is generally good advice, but it’s not specifically related to the use of spironolactone.

Choice C rationale

Spironolactone is a potassium-sparing diuretic, which means it can cause the body to retain potassium. Therefore, patients taking spironolactone should limit their intake of high- potassium foods to prevent hyperkalemia.

Choice D rationale

While it’s always important to monitor for side effects when taking a new medication, excessive bruising is not a common side effect of spironolactone.

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Correct Answer is C

Explanation

Choice A rationale

Excessive bruising is not a typical side effect of atorvastatin, and it is not linked to increased CK levels. Excessive bruising can be caused by bleeding disorders, anticoagulant therapy, or trauma.

Choice B rationale

Peripheral edema is not a common side effect of atorvastatin, and it is not related to increased CK levels. CK is an enzyme that is released when muscle tissue is damaged. Peripheral edema is more likely to be caused by heart failure, kidney disease, or venous insufficiency.

Choice C rationale

Muscle tenderness is a sign of myopathy, which is a rare but serious adverse effect of atorvastatin. Myopathy is a condition where muscle fibers are damaged and inflamed, leading to muscle weakness and pain. Increased CK levels indicate muscle injury and can be a marker of myopathy. The nurse should monitor the client for muscle symptoms and report them to the prescriber.

Choice D rationale

Nausea and vomiting are common gastrointestinal side effects of atorvastatin, but they are not associated with increased CK levels. Nausea and vomiting can be managed by taking the medication with food or reducing the dose.

A. Patient on Vancomycin. B. Patient on Sucralfate. C. Patient on Lorazepam. D. Patient on Digoxin.

Correct Answer is A

Explanation

Choice A rationale

Vancomycin is known to potentially cause nephrotoxicity, which can lead to acute kidney injury.

Choice B rationale

Sucralfate is not typically associated with acute kidney injury.

Choice C rationale

Lorazepam is not typically associated with acute kidney injury.

Choice D rationale

While digoxin can have many side effects, it’s not typically associated with acute kidney injury.

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A patient with heart failure develops hyperaldosteronism and is prescribed spironolactone.What instructions should the nurse include in the patient’s care plan?

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A patient with heart failure develops hyperaldosteronism and is prescribed spironolactone.

What instructions should the nurse include in the patient’s care plan?