Which lab results should be monitored for a patient on furosemide?

Creatinine

Platelets

Chloride

RBC

Answer and Explanation

The Correct Answer is A

Choice A reason: Furosemide, a loop diuretic, increases renal workload, risking kidney injury. Creatinine rises (>1.2 mg/dL) with reduced glomerular filtration, a critical marker to monitor for nephrotoxicity or dehydration in heart failure patients.

Choice B reason: Platelets (150,000-450,000/µL) assess clotting, unaffected by furosemide directly. Diuretics alter volume, not hematopoiesis, so monitoring platelets is irrelevant unless bleeding or unrelated conditions complicate the patient’s status.

Choice C reason: Chloride may drop with furosemide, but it’s less critical than creatinine. Hypochloremia affects acid-base balance, yet renal function takes priority, as kidney damage has broader, immediate implications in therapy.

Choice D reason: RBC count reflects anemia, not furosemide’s primary effects. Diuretics cause hemoconcentration if overused, but creatinine better captures renal impact, making red cell monitoring secondary in this context.

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Correct Answer is C

Explanation

Choice A reason: Respiratory rate dropping to 18 breaths/min may suggest improvement or fatigue, not worsening, in respiratory status. Normal range (12-20) makes this less alarming than signs of increased breathing effort.

Choice B reason: Oxygen saturation rising to 90% on 2 L indicates better oxygenation, not worsening. It reflects treatment response, improving gas exchange, so this finding contradicts a decline in respiratory status.

Choice C reason: Increased accessory muscle use signals worsening respiratory distress, as it compensates for airway resistance or fatigue. It reflects higher work of breathing, a critical sign of decompensation needing intervention.

Choice D reason: Productive cough with yellowish sputum suggests infection, not immediate worsening of respiratory mechanics. It’s a chronic sign, less urgent than accessory muscle use indicating acute respiratory effort escalation.

A. Ask the Health Care Provider to order a sweat chloride test. B. Coordinate with the dietitian to place the patient on a low-sodium diet. C. Coordinate with respiratory therapy to perform chest physiotherapy D. Coordinate with the case manager to arrange for a hospice nurse visit.

Correct Answer is C

Explanation

Choice A reason: Sweat chloride tests diagnose CF, not manage dyspnea in a known patient. It’s irrelevant here, as the focus is treating acute respiratory symptoms, not reconfirming an established diagnosis in this scenario.

Choice B reason: Low-sodium diets aren’t indicated for CF; patients need high salt due to losses. Dyspnea stems from mucus obstruction, not fluid, so this intervention contradicts CF physiology and symptom management.

Choice C reason: Chest physiotherapy clears mucus in CF, improving airflow and reducing dyspnea. It targets the primary cause—thick secretions—enhancing lung function, a standard intervention coordinated with respiratory therapy for acute exacerbations.

Choice D reason: Hospice is premature for dyspnea in CF without end-stage decline. It’s inappropriate now, as active interventions like physiotherapy address reversible symptoms, prioritizing treatment over palliative care planning.

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Which lab results should be monitored for a patient on furosemide?

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