A patient with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in the patient's plan of care?

Limit the intake of foods high in potassium.

Cover your skin before going outside.

Replace salt with a salt substitute.

Monitor skin for excessive bruising.

Answer and Explanation

The Correct Answer is A

A. Limit the intake of foods high in potassium: Spironolactone is a potassium-sparing diuretic, which means it can cause potassium levels to rise. Therefore, the nurse should advise the patient to limit the intake of potassium-rich foods to avoid hyperkalemia.
B. Cover your skin before going outside: This instruction is not specifically related to the use of spironolactone. It is more relevant for medications that cause photosensitivity or skin reactions.
C. Replace salt with a salt substitute: Many salt substitutes contain potassium, which could increase the risk of hyperkalemia when taking spironolactone. Therefore, replacing salt with a potassium-containing salt substitute is not recommended.
D. Monitor skin for excessive bruising: While monitoring for bruising is important, it is more relevant for anticoagulants or medications that affect blood clotting, not specifically for spironolactone.

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Correct Answer is D

Explanation

A) Avoid the intake of dairy products while using the medication: There is no specific requirement to avoid dairy products when using bulk-forming laxatives. The primary concern with bulk-forming laxatives is to ensure they are taken with adequate fluids.
B) Take the medication one hour after meals and other medications: Bulk-forming laxatives should be taken with a meal or at a different time from other medications to prevent interactions, but the key aspect is to follow the medication with sufficient fluids rather than timing relative to meals.
C) Remain upright for thirty minutes following drug administration: While remaining upright can help prevent potential esophageal irritation, it is not the primary instruction for bulk-forming laxatives. The more critical instruction is related to fluid intake to ensure effectiveness and prevent complications.
D) Follow medication administration with an additional glass of water: Bulk-forming laxatives require adequate fluid intake to function properly. Following the medication with an additional glass of water helps the laxative form a gel-like substance in the intestines, which aids in bowel movement and prevents potential complications like obstruction.

A. Administer an oral analgesic and evaluate its effectiveness before applying the new patch. B. Apply the new patch in a different location after removing the original patch. C. Remove the patch and consult with the healthcare provider about the client's pain resolution. D. Place the patch on the client's shoulder and leave both patches in place for 12 hours.

Correct Answer is B

Explanation

A) Administer an oral analgesic and evaluate its effectiveness before applying the new patch: This action is unnecessary because the client reports no pain. Administering an oral analgesic would not be appropriate when the client denies pain and the previous fentanyl patch is intact.
B) Apply the new patch in a different location after removing the original patch: This is the correct action. Fentanyl patches should be replaced with new ones in a different location to prevent overdosing and ensure proper absorption. The old patch should be removed to avoid accumulation of excess medication.
C) Remove the patch and consult with the healthcare provider about the client's pain resolution: There is no need to consult the healthcare provider or remove the patch if the client denies pain and the patch is intact. The issue is with replacing the patch rather than evaluating pain.
D) Place the patch on the client's shoulder and leave both patches in place for 12 hours: This is unsafe. Applying a new patch without removing the old one can lead to overdose due to excessive fentanyl. The old patch must be removed before placing a new one.

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A patient with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in the patient's plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which instruction should the nurse include when teaching a client about self-administration of a bulk-forming laxative?

Correct Answer is D

Explanation

When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client's upper back and the client denies pain. Which action should the nurse take?

Correct Answer is B

Explanation

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A patient with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in the patient's plan of care?

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