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 A
Explanation
Food high in potassium should be avoided for clients taking ACE inhibitors. ACE inhibitors are drugs that block the conversion of angiotensin I to angiotensin II, which is a potent vasoconstrictor and also stimulates the secretion of aldosterone. Aldosterone is a hormone that increases the reabsorption of sodium and water and the excretion of potassium in the kidneys. By inhibiting angiotensin II, ACE inhibitors lower blood pressure and reduce the loss of potassium. However, this can also lead to hyperkalemia, which is a high level of potassium in the blood that can cause cardiac arrhythmias and muscle weakness.Therefore, clients taking ACE inhibitors should limit their intake of foods that are rich in potassium, such as bananas, oranges, tomatoes, potatoes, spinach, beans, nuts, and salt substitutes.
Choice B is wrong because a low sodium diet is recommended for clients taking ACE inhibitors.
A low sodium diet can help lower blood pressure and reduce fluid retention, which are beneficial effects for clients with hypertension, heart failure, or chronic kidney disease.A low-potassium diet should aim for potassium intake of less than 50 or 75 mmol/day and sodium intake of less than 60 mmol/day for hypertensive patients with chronic kidney disease.
Choice C is wrong because adequate fluid intake is not contraindicated for clients taking ACE inhibitors.
Adequate fluid intake can help prevent dehydration and maintain kidney function, especially in patients with diabetes or nephropathy.However, excessive fluid intake may worsen heart failure or edema in some patients, so fluid intake should be individualized and monitored according to the patient’s condition and response to therapy.
Choice D is wrong because foods low in potassium are not harmful for clients taking ACE inhibitors.
Foods low in potassium do not affect the serum potassium level or the risk of hyperkalemia in clients taking ACE inhibitors.However, foods low in potassium may not provide enough dietary potassium for normal cellular functions, so a balanced diet that includes moderate amounts of potassium-rich foods is advisable.
Correct Answer is ["A","B","D","E"]
Explanation
These are all modifiable risk factors for cardiovascular disease, meaning they can be changed through lifestyle choices or medication.Cholesterol level, blood pressure, weight, and smoking all affect the health of the heart and blood vessels, and can increase the risk of developing conditions such as atherosclerosis, hypertension, heart attack, or stroke.
Choice C, family history, is not a modifiable risk factor for cardiovascular disease.
It is a non-modifiable risk factor, meaning it cannot be changed and is determined by genetics.
Having a family history of cardiovascular disease can increase the risk of developing it, but it does not mean that it is inevitable.Other non-modifiable risk factors include sex, older age, race and ethnicity.
Some normal ranges for the modifiable risk factors are:
• Cholesterol level: total cholesterol should be less than 200 mg/dL; LDL cholesterol should be less than 100 mg/dL; HDL cholesterol should be more than 40 mg/dL for men and more than 50 mg/dL for women; triglycerides should be less than 150 mg/dL.
• Blood pressure: normal blood pressure is less than 120/80 mmHg; elevated blood pressure is 120-129/less than 80 mmHg; hypertension stage 1 is 130-139/80-89 mmHg; hypertension stage 2 is 140 or higher/90 or higher mmHg.
• Weight: body mass index (BMI) is a measure of weight relative to height; normal BMI is 18.5-24.9 kg/m2; overweight BMI is 25-29.9 kg/m2; obese BMI is 30 or higher kg/m2.
• Smoking: smoking any amount of tobacco products can harm the cardiovascular system; quitting smoking can lower the risk of cardiovascular disease and improve overall health.
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