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

Monitor skin for excessive bruising.

Replace salt with a salt substitute.

Cover your skin before going outside.

Limit the intake of foods high in potassium.

Answer and Explanation

The Correct Answer is D

Choice A Reason:

Spironolactone is a potassium-sparing diuretic often prescribed for heart failure. While monitoring for side effects is important, excessive bruising is not a common side effect of spironolactone. Bruising might be more relevant for patients on anticoagulants or those with clotting disorders.

Choice B Reason:

Replacing salt with a salt substitute is not advisable for patients on spironolactone. Many salt substitutes contain potassium chloride, which can lead to hyperkalemia (high potassium levels) when combined with spironolactone. Hyperkalemia can cause serious cardiac issues, including arrhythmias.

Choice C Reason:

Covering the skin before going outside is not specifically related to the use of spironolactone. This advice might be more relevant for medications that cause photosensitivity, such as certain antibiotics or diuretics like hydrochlorothiazide, but not spironolactone.

Choice D Reason:

Limiting the intake of foods high in potassium is crucial for patients taking spironolactone. Spironolactone can increase potassium levels in the blood, and consuming high-potassium foods (like bananas, oranges, and potatoes) can exacerbate this effect, leading to hyperkalemia. Hyperkalemia can be dangerous and cause symptoms such as muscle weakness, fatigue, and cardiac arrhythmias.

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Correct Answer is A

Explanation

Choice A reason: Denying having coughing spells indicates that the antitussive medication benzonatate is effective. Benzonatate works by numbing the throat and lungs, reducing the cough reflex. This means that if the client is no longer experiencing coughing spells, the medication is performing its intended function.

Choice B reason: Being able to sleep through the night can be an indirect indicator of the medication’s effectiveness, but it is not as specific as denying coughing spells. While improved sleep might result from reduced coughing, it could also be influenced by other factors such as overall improvement in the client’s condition or the use of other medications.

Choice C reason: Expectorating bronchial secretions is not a direct indicator of the effectiveness of benzonatate. Benzonatate is an antitussive, meaning it suppresses the cough reflex rather than promoting the expulsion of mucus. Therefore, expectorating bronchial secretions would not be a primary measure of this medication’s effectiveness.

Choice D reason: Reporting reduced nasal discharge is also not a direct indicator of the effectiveness of benzonatate. This medication specifically targets the cough reflex and does not have a significant impact on nasal discharge. Reduced nasal discharge could be due to other factors or treatments.

A. Be aware that difficulty sleeping and weight loss may occur. B. Notify the healthcare provider if experiencing changes in taste. C. Administer each dose with at least 8 ounces of water. D. Consume tyramine-free foods while taking the medicine.

Correct Answer is A

Explanation

Choice A reason: Bupropion is known to cause side effects such as insomnia and weight loss. These side effects are due to its stimulant properties, which can interfere with sleep patterns and suppress appetite1. Patients should be informed about these potential side effects so they can monitor their symptoms and seek medical advice if necessary.

Choice B reason: While changes in taste can occur with some medications, it is not a common side effect of bupropion. Therefore, it is not necessary to specifically instruct patients to notify their healthcare provider about changes in taste when taking bupropion.

Choice C reason: There is no specific requirement to administer bupropion with 8 ounces of water. Bupropion can be taken with or without food, and the amount of water consumed with the medication does not impact its effectiveness.

Choice D reason: Consuming tyramine-free foods is crucial for patients taking monoamine oxidase inhibitors (MAOIs) due to the risk of hypertensive crisis. However, bupropion is not an MAOI, so this dietary restriction is not applicable.

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

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