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 C
Explanation
This is because elevating the legs can help reduce swelling and improve blood flow back to the heart by reducing the effects of gravity.Elevating the legs can also prevent blood from pooling in the veins and reduce the risk of blood clots.
Choice A is wrong because dangling the legs can increase swelling and pressure in the veins, which can worsen peripheral venous disease (PVD) symptoms and complications.
Choice B is wrong because sitting in one position for prolonged hours can impair blood circulation and increase the risk of blood clots, especially in the lower legs.People with PVD should avoid crossing their legs, wearing tight clothing, or sitting for long periods without moving.
Choice D is wrong because standing in one position can also increase swelling and pressure in the veins, which can lead to pain, ulcers, and skin changes.People with PVD should avoid standing for long periods without moving or changing positions.
Some additional information:
Peripheral venous disease (PVD) is a condition that affects blood flow in the veins and arteries outside of your heart and brain.
It can be caused by narrowing, blocking, or spasming of the blood vessels, or by blood clots in the veins.PVD can cause pain and fatigue, especially in the legs, and can lead to serious complications such as gangrene or amputation.
The most common cause of PVD is atherosclerosis, the buildup of plaque inside the artery wall.
Plaque reduces the amount of blood flow to the limbs and decreases the oxygen and nutrients available to the tissue.Other causes of PVD may include injury, infection, irregular anatomy of muscles or ligaments, or inflammation of the blood vessels.
The normal range of blood pressure in the veins is about 10 to 20 mmHg.
The normal range of oxygen saturation in the veins is about 60 to 80%.
The normal range of pulse rate in the veins is about 60 to 100 beats per minute.
Correct Answer is A
Explanation
This is because low potassium levels (hypokalemia) increase the sensitivity of the heart to digoxin and can lead to toxicity even with normal serum digoxin levels. Digoxin inhibits the sodium-potassium pump on the cardiac cells, which causes potassium to accumulate outside the cells.Low potassium levels in the blood create a larger gradient for potassium to move out of the cells, which enhances the effect of digoxin and can cause arrhythmias.
Choice B is wrong because calcium 9.2 mg/dL is within the normal range (8.5 to 10.2 mg/dL) and does not increase the risk of digoxin toxicity.However, high calcium levels (hypercalcemia) can potentiate the effects of digoxin and cause toxicity.
Choice C is wrong because sodium 140 mEq/L is within the normal range (135 to 145 mEq/L) and does not increase the risk of digoxin toxicity.However, high sodium levels (hypernatremia) can reduce the binding of digoxin to the sodium-potassium pump and decrease its efficacy.
Choice D is wrong because magnesium 2.2 mg/dL is within the normal range (1.7 to 2.4 mg/dL) and does not increase the risk of digoxin toxicity.However, low magnesium levels (hypomagnesemia) can increase the sensitivity of the heart to digoxin and cause toxicity.
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