The nurse is monitoring a client taking a potassium sparing diuretic. Which of the following findings would prompt the nurse to notify the health care provider?

Serum sodium level of 140 mEq/L

Blood pressure of 130/80 mmHg

Serum potassium level of 5.5 mEq/L

Serum potassium level of 3.5 mEq/L

Answer and Explanation

The Correct Answer is C

Choice A reason: Serum sodium level of 140 mEq/L is within the normal range of 135145 mEq/L. It does not indicate any adverse effect of the potassium sparing diuretic, which does not affect sodium excretion significantly. The nurse does not need to notify the health care provider about this finding.
Choice B reason: Blood pressure of 130/80 mmHg is slightly above the normal range of 120/80 mmHg, but it is not a cause for concern. The potassium sparing diuretic can lower the blood pressure by reducing the fluid volume and preventing sodium retention. The nurse should monitor the blood pressure regularly but does not need to notify the health care provider about this finding.
Choice C reason: Serum potassium level of 5.5 mEq/L is above the normal range of 3.55.0 mEq/L. It indicates hyperkalemia, which is a serious and potentially life-threatening complication of the potassium sparing diuretic. The potassium sparing diuretic can increase the potassium level by inhibiting its secretion in the distal tubule of the kidney. The nurse should notify the health care provider immediately and prepare to administer interventions such as calcium gluconate, insulin, or sodium bicarbonate to lower the potassium level and prevent cardiac arrhythmias.
Choice D reason: Serum potassium level of 3.5 mEq/L is at the lower end of the normal range of 3.55.0 mEq/L. It does not indicate any adverse effect of the potassium sparing diuretic, which does not cause potassium loss. The nurse does not need to notify the health care provider about this finding.

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Correct Answer is C

Explanation

Choice A reason: This is incorrect. Miosis is the constriction of the pupils, which can also be caused by morphine, but it is not a life-threatening side effect. Miosis occurs because morphine stimulates the parasympathetic nervous system, which controls the muscles that constrict the pupils¹.

Choice B reason: This is incorrect. Sedation is the state of being calm, relaxed, and sleepy, which can also be caused by morphine, but it is not a life-threatening side effect. Sedation occurs because morphine depresses the central nervous system, which reduces the activity of the brain and the body.

Choice C reason: This is correct. Respiratory depression is the slowing down of breathing, which can be a life-threatening side effect of morphine. Respiratory depression occurs because morphine depresses the respiratory center in the brainstem, which regulates the rate and depth of breathing. If the breathing becomes too slow or shallow, the patient may not get enough oxygen and may lose consciousness or die.

Choice D reason: This is incorrect. Euphoria is the feeling of intense happiness, pleasure, or wellbeing, which can also be caused by morphine, but it is not a life-threatening side effect. Euphoria occurs because morphine stimulates the reward system in the brain, which releases dopamine, a neurotransmitter that causes positive emotions.

A. Nausea, vomiting, diarrhea B. Palpitations C. Headaches D. Heartburn

Correct Answer is A

Explanation

Choice A reason: This is correct. Nausea, vomiting, and diarrhea are the most common side effects of metformin, especially when the drug is started or the dose is increased. These side effects occur because metformin can interfere with the absorption of glucose and other nutrients in the intestines, causing osmotic diarrhea. The nurse should advise the client to take metformin with food, start with a low dose and gradually increase it, and drink plenty of fluids to prevent dehydration. The nurse should also monitor the client for signs of lactic acidosis, a rare but serious complication of metformin that causes severe diarrhea, abdominal pain, muscle cramps, and difficulty breathing.

Choice B reason: This is incorrect. Palpitations are not a common side effect of metformin. Palpitations are the sensation of a rapid, irregular, or pounding heartbeat, which can be caused by various factors, such as stress, anxiety, caffeine, nicotine, or heart problems. Metformin does not affect the heart rate or rhythm directly, but it can lower the blood sugar levels, which can trigger the release of adrenaline, a hormone that can cause palpitations. The nurse should check the client's blood sugar levels and advise the client to eat regular meals and snacks, avoid alcohol and caffeine, and report any chest pain or shortness of breath.

Choice C reason: This is incorrect. Headaches are not a common side effect of metformin. Headaches are the pain or discomfort in the head, scalp, or neck, which can be caused by various factors, such as stress, dehydration, or sinus infection. Metformin does not cause headaches directly, but it can lower the blood sugar levels, which can cause headaches as a symptom of hypoglycemia. The nurse should check the client's blood sugar levels and advise the client to eat regular meals and snacks, drink plenty of water, and take painkillers as needed.

Choice D reason: This is incorrect. Heartburn is not a common side effect of metformin. Heartburn is the burning sensation in the chest or throat, which is caused by the reflux of stomach acid into the esophagus. Metformin does not cause heartburn directly, but it can worsen it if the client already has gastroesophageal reflux disease (GERD), a condition where the lower esophageal sphincter is weak or relaxed and allows the acid to flow back. The nurse should advise the client to take metformin with food, avoid spicy or fatty foods, elevate the head of the bed, and take antacids as needed.

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The nurse is monitoring a client taking a potassium sparing diuretic. Which of the following findings would prompt the nurse to notify the health care provider?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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