The prescriber orders furosemide 80 mg for a patient who has been retaining extra fluid after surgery. The nurse notes the following: BP of 142/88 (lying) and 108/60 (sitting); daily weight of 154 lb, a 1-lb drop from day before; serum potassium of 2.8 mEq/L.
What should the nurse do?
Administer medication.
Contact provider.
Hold medication
Give potassium supplement
The Correct Answer is B
The nurse should contact the provider before administering furosemide because the patient has a low serum potassium level of 2.8 mEq/L, which is below the normal range of 3.5 to 5.0 mEq/L. Furosemide is a diuretic that can cause potassium loss and worsen hypokalemia, which can lead to cardiac arrhythmias, muscle weakness, and fatigue. The nurse should also monitor the patient’s blood pressure, weight, and urine output, as furosemide can lower blood pressure and cause dehydration.
Choice A. Administer medication is wrong because the nurse should not give furosemide without checking with the provider first, as it could be harmful to the patient with low potassium.
Choice C. Hold medication is wrong because the nurse should not withhold furosemide without a valid reason or an order from the provider, as it could cause fluid overload and worsen the patient’s condition.
Choice D. Give potassium supplement is wrong because the nurse should not give potassium supplement without an order from the provider, as it could cause hyperkalemia or interact with other medications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Vitamin K is the antidote for warfarin toxicity because it can reverse the effects of warfarin by restoring the clotting factors.Warfarin is an oral anticoagulant that works by inhibiting vitamin K epoxide reductase, an enzyme that activates vitamin K in the body.Vitamin K is needed for the synthesis of active coagulation factors, such as II, VII, IX and X.By blocking vitamin K, warfarin reduces the blood’s clotting activity and prevents the formation of blood clots.
Choice A is wrong because vitamin B12 is not involved in the coagulation cascade.Vitamin B12 is mainly involved in DNA synthesis, red blood cell production and nerve function.
Choice C is wrong because calcium gluconate is not an antidote for warfarin toxicity.Calcium gluconate is used to treat low blood calcium levels or hypocalcemia.Calcium is also a cofactor for some coagulation factors, but it does not reverse the effects of warfarin.
Choice D is wrong because protamine sulfate is not an antidote for warfarin toxicity.
Protamine sulfate is used to reverse the effects of heparin, another type of anticoagulant that works by inhibiting thrombin and factor Xa.
Protamine sulfate does not affect the vitamin K-dependent coagulation factors that are inhibited by warfarin.
Normal ranges for coagulation tests that are affected by warfarin are:
• Prothrombin time (PT): 11 to 13.5 seconds
• International normalized ratio (INR): 0.8 to 1.2
• Activated partial thromboplastin time (aPTT): 25 to 35 seconds
Correct Answer is D
Explanation
Anticoagulant drugs are medicines that prevent blood clots from forming or growing larger.
They do not dissolve existing clots or transport platelets. They work by interfering with different steps of the blood coagulation pathway, which is the process that leads to clot formation.
Choice A is wrong because anticoagulant drugs do not dissolve existing clots.
To dissolve clots, you need fibrinolytic drugs, which break down the fibrin mesh that holds the clots together.
Choice B is wrong because anticoagulant drugs do not transport platelets.
Platelets are blood cells that stick together to form clots.
Anticoagulant drugs may affect the function of platelets, but they do not move them around.
Choice C is wrong because anticoagulant drugs do not act as fibrinolytic agents.
Fibrinolytic agents are drugs that activate plasmin, an enzyme that breaks down fibrin.
Anticoagulant drugs may inhibit the formation of fibrin, but they do not break it down.
Some examples of anticoagulant drugs are warfarin, heparin, and factor Xa inhibitors.
The normal ranges for some blood tests that measure the effects of anticoagulants are:
• Prothrombin time (PT): 11 to 13.5 seconds
• International normalized ratio (INR): 0.8 to 1.2
• Activated partial thromboplastin time (aPTT): 25 to 35 seconds
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