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 B

Explanation

A. Assess the client for other indications of adverse effects of corticosteroid use: While important, this action does not address the immediate issue of stopping the medication safely.
B. Advise the client that the medication should be stopped gradually rather than abruptly: Corticosteroids should not be stopped suddenly due to the risk of adrenal insufficiency and withdrawal symptoms. Gradual tapering is necessary to safely discontinue the medication.
C. Encourage the client to take the medication with food to decrease GI distress: This can help manage GI symptoms but does not address the issue of safely discontinuing the medication.
D. Review the client's dosing schedule to ensure he is taking the prescribed amount: This is useful but does not resolve the problem of safely stopping the medication.

A. "I need to notify my healthcare provider if I lose my appetite or get nauseated." B. "I should take my furosemide only if I have shortness of breath or swelling in my feet." C. "I need to check my blood pressure three times a day." D. "If I lose more than one pound in a week, I should hold my next dose of furosemide."

Correct Answer is A

Explanation

A. "I need to notify my healthcare provider if I lose my appetite or get nauseated." This statement shows understanding because loss of appetite and nausea can be symptoms of digoxin toxicity or side effects, and it is important to report these symptoms to a healthcare provider. Monitoring for such side effects is crucial when taking digoxin.
B. "I should take my furosemide only if I have shortness of breath or swelling in my feet." This statement is incorrect because furosemide, a diuretic, should be taken according to the prescribed schedule, not based on symptoms. It is used to manage fluid retention and symptoms of heart failure, and its use should not be dependent solely on the presence of symptoms.
C. "I need to check my blood pressure three times a day." While monitoring blood pressure is important, it is not specifically required for patients on digoxin and furosemide unless instructed by a healthcare provider. The focus should be more on monitoring for symptoms of drug side effects and electrolyte imbalances.
D. "If I lose more than one pound in a week, I should hold my next dose of furosemide." Weight loss can be a normal effect of furosemide due to fluid loss, and the decision to hold a dose should be based on specific medical advice and not solely on weight change.

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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

A male client reports to the nurse that he is experiencing gastrointestinal (GI) distress from a high dose of a corticosteroid and is planning to stop taking the medication. In response to the client's statement, which nursing action is most important for the nurse to Implement?

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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