Which patient assessment would alert the nurse to withhold a loop diuretic?

Choice A reason: Bronchoconstriction refers to the narrowing of the airways in the lungs due to the contraction of the surrounding smooth muscle. This condition is typically associated with asthma or allergic reactions and is not directly related to Virchow's triad, which concerns factors leading to thrombosis (formation of blood clots).

Choice B reason: Pulmonary embolus is a blockage in one of the pulmonary arteries in the lungs, usually caused by blood clots that travel to the lungs from the legs or other parts of the body (deep vein thrombosis). Virchow's triad describes the three primary factors that predispose individuals to thrombosis: hypercoagulability (increased tendency of blood to clot), stasis of blood flow, and endothelial injury (damage to the blood vessel wall). These factors contribute to the formation of blood clots, which can ultimately result in a pulmonary embolus if they dislodge and travel to the lungs.

Choice C reason: Decreased pulmonary arterial pressure is not a consequence of the factors described in Virchow's triad. In fact, a pulmonary embolus can lead to increased pulmonary arterial pressure due to the obstruction of blood flow in the pulmonary arteries, which can strain the right side of the heart and lead to complications.

Choice D reason: Alveolar collapse, also known as atelectasis, occurs when the tiny air sacs in the lungs (alveoli) deflate or fill with fluid. This condition is typically due to reasons such as airway obstruction, surfactant deficiency, or lung compression, and is not directly related to the formation of blood clots described by Virchow's triad.

Choice A reason: Dry mouth is a relatively minor side effect of statin medications and is generally not a cause for significant concern. While it can be uncomfortable and may affect oral health if persistent, it does not typically indicate a serious underlying condition.

Choice B reason: Diarrhea can be an inconvenient and uncomfortable side effect of statins, but it is not usually considered dangerous. It is important to manage it to prevent dehydration and electrolyte imbalances, but it is not as concerning as some other side effects.

Choice C reason: Muscle pain, also known as myalgia, is the most concerning side effect of statin medications like simvastatin. In rare cases, muscle pain can progress to a more serious condition called rhabdomyolysis, where muscle tissue breaks down rapidly, releasing a protein called myoglobin into the bloodstream. This can lead to kidney damage and, in severe cases, kidney failure. Therefore, any new or unexplained muscle pain should be promptly reported to a healthcare provider for evaluation.

Choice D reason: Headache is a common and generally mild side effect of many medications, including statins. While it can be bothersome, it is not typically indicative of a serious problem and is not considered as concerning as muscle pain related to statin use.