The nurse obtains a prescription for furosemide 40 mg IV for a client who has pulmonary congestion as the result of fluid volume overload. The nurse assesses the vital signs to be T-98.6, P-110, RR-24 and BP-90/60. What is the most appropriate action at this time?
Withhold the dose and reassess the blood pressure in 30 minutes.
Call the healthcare provider to obtain an order for oral furosemide.
Administer the medication and notify the healthcare provider of the blood pressure.
Administer the dose and continue to monitor the vital signs.
The nurse obtains a prescription for furosemide 40 mg IV for a client who has pulmonary congestion as the result of fluid volume overload. The nurse assesses the vital signs to be T-98.6, P-110, RR-24 and BP-90/60. What is the most appropriate action at this time?
The Correct Answer is C
Choice A reason: Withholding the dose and reassessing the blood pressure in 30 minutes is not the most appropriate action at this time. Furosemide is a drug that reduces fluid retention and swelling by increasing the urine output. ¹ The client has pulmonary congestion, which means that there is excess fluid in the lungs, causing difficulty breathing and low oxygen levels. ² Delaying the administration of furosemide may worsen the client's condition and increase the risk of complications, such as pulmonary edema or heart failure.
Choice B reason: Calling the healthcare provider to obtain an order for oral furosemide is not the most appropriate action at this time. Oral furosemide is a tablet that is swallowed and absorbed by the digestive system. ¹ It takes longer to act than intravenous (IV) furosemide, which is injected directly into the bloodstream. ¹ The client has pulmonary congestion, which requires immediate treatment to relieve the fluid accumulation in the lungs. Switching to oral furosemide may delay the therapeutic effect and compromise the client's outcome.
Choice C reason: Administering the medication and notifying the healthcare provider of the blood pressure is the most appropriate action at this time. Furosemide is a drug that reduces fluid retention and swelling by increasing the urine output. ¹ The client has pulmonary congestion, which means that there is excess fluid in the lungs, causing difficulty breathing and low oxygen levels. ² Administering IV furosemide can help remove the excess fluid from the lungs and improve the client's breathing and oxygenation. However, furosemide can also lower the blood pressure by reducing the volume of fluid in the blood vessels. ¹ The client already has low blood pressure, which can cause dizziness, fainting, or shock. The nurse should notify the healthcare provider of the blood pressure and monitor the client for any signs of hypotension or adverse reactions.
Choice D reason: Administering the dose and continuing to monitor the vital signs is not the most appropriate action at this time. Furosemide is a drug that reduces fluid retention and swelling by increasing the urine output. ¹ The client has pulmonary congestion, which means that there is excess fluid in the lungs, causing difficulty breathing and low oxygen levels. ² Administering IV furosemide can help remove the excess fluid from the lungs and improve the client's breathing and oxygenation. However, furosemide can also lower the blood pressure by reducing the volume of fluid in the blood vessels. ¹ The client already has low blood pressure, which can cause dizziness, fainting, or shock. The nurse should not only monitor the vital signs, but also notify the healthcare provider of the blood pressure and report any changes or concerns.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Cucumbers are not a good source of iron for the client with iron-deficiency anemia. Iron-deficiency anemia is a condition where the body does not have enough iron to produce hemoglobin, the protein that carries oxygen in the red blood cells. Cucumbers are mostly water and have very little iron content. The client should eat foods that are rich in iron, such as meat, poultry, fish, eggs, beans, and leafy green vegetables.
Choice B reason: Bran is not a good source of iron for the client with iron-deficiency anemia. Bran is the outer layer of cereal grains that contains fiber and some minerals, but not much iron. Bran can also interfere with the absorption of iron from other foods by binding to it and preventing it from entering the bloodstream. The client should avoid eating bran or other foods that contain phytates, oxalates, or tannins, which can reduce the bioavailability of iron.
Choice C reason: Celery is not a good source of iron for the client with iron-deficiency anemia. Celery is a low-calorie vegetable that has some vitamins and minerals, but very little iron. Celery also has a high water content and can fill up the stomach without providing much nutrition. The client should eat foods that are high in iron, such as meat, poultry, fish, eggs, beans, and leafy green vegetables.
Choice D reason: This is the correct answer. Spinach is a good source of iron for the client with iron-deficiency anemia. Spinach is a leafy green vegetable that has a high iron content and can help increase the hemoglobin level and the oxygen-carrying capacity of the blood. Spinach also has other nutrients, such as vitamin C, folate, and antioxidants, that can benefit the health of the client. The client should eat spinach and other foods that are high in iron, such as meat, poultry, fish, eggs, beans, and leafy green vegetables.
Correct Answer is A
Explanation
Choice A reason: Decreasing the incidence of tachycardia is not the main therapeutic effect of atenolol for coronary artery disease. Atenolol is a beta-blocker that lowers the heart rate, but this is not the primary goal of therapy for coronary artery disease. Coronary artery disease is caused by atherosclerosis, which is the buildup of plaque in the arteries that supply the heart. This reduces the blood flow and oxygen to the heart muscle and causes angina, or chest pain.
Choice B reason: Dilating the coronary arteries is not the therapeutic effect of atenolol for coronary artery disease. Atenolol does not directly affect the diameter of the coronary arteries. It works by blocking the beta receptors in the heart and reducing the response to adrenaline and other stress hormones. This lowers the blood pressure and the oxygen demand of the heart.
Choice C reason: This is the correct answer. Decreasing cardiac workload is the therapeutic effect of atenolol for coronary artery disease. Atenolol reduces the contractility and the excitability of the heart muscle, which lowers the force and the frequency of the heartbeats. This decreases the amount of work that the heart has to do and the amount of oxygen that it needs. This helps prevent or relieve anginal attacks and improve the quality of life of the client.
Choice D reason: Increasing the strength of myocardial contraction is not the therapeutic effect of atenolol for coronary artery disease. Atenolol does not increase the strength of myocardial contraction, but rather decreases it. Increasing the strength of myocardial contraction would increase the oxygen demand of the heart and worsen the angina. Atenolol aims to reduce the oxygen demand of the heart and improve the blood supply to the heart.
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