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A patient is admitted with heart failure. The morning laboratory results reveal a serum
potassium level of 2.9 mEq/L. Which classification of medication would the nurse hold
until the health care provider is consulted?
A. Antibiotics
B. Loop diuretics
C. Bronchodilators
D. Antihypertensives
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, B. Loop diuretics
Loop diuretics are contraindicated during episodes of hypokalemia
because these medications cause the kidneys to excrete sodium and
potassium. Thus, administration of this type of medication at this time would
worsen the hypokalemia, putting the patient at risk for dysrhythmias. The
prescribing physician should be consulted for potassium replacement
therapy, and the drug should be withheld until the potassium has returned
to normal range.
The nurse is providing discharge instructions to a patient with diabetes insipidus.
Which instruction about desmopressin acetate would be most appropriate?
A. Expect to have some nasal irritation while using this drug.
B. Monitor for symptoms of hypernatremia as a drug side effect.
C. Report any decrease in urinary output to the health care provider.
D. Drink at least 3000 mL of water per day while taking this medication.
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A. Expect to have some nasal irritation while using this drug.
Desmopressin acetate is used to treat diabetes insipidus by replacing the
antidiuretic hormone that the patient is lacking. Diuresis will be decreased
and is expected. Inhaled desmopressin can cause nasal irritation,
headache, nausea, and other signs of hyponatremia, not hypernatremia.
Drinking too much water or other fluids increases the risk of hyponatremia.
The patient should follow the provider's directions for limiting fluids and be
taught to seek medical attention if they have severe nausea; vomiting;
severe headache; muscle weakness, spasms, or cramps; sudden weight
gain; unusual tiredness; mental/mood changes; seizures; and slow or
shallow breathing.
,A nurse is making a home visit to a client who receives diuretics daily for heart failure.
Which of the following signs would the client manifest with hypokalemia?
A. Pitting edema
B. Fatigue
C. Dyspnea
D. Oliguria
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B. Fatigue
he nurse should expect to find the client with fatigue due to muscle
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weakness with hypokalemia.
While caring for a patient with metastatic bone cancer, which clinical manifestations
would alert the nurse to the possibility of hypercalcemia? (Select all that apply.)
A. Weakness
B. Paresthesia
C. Facial spasms
D. Muscle tremors
E. Depressed reflexes
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A. weakness
E. Depressed reflexes
Signs of hypercalcemia are lethargy, fatigue, weakness, depressed reflexes,
muscle flaccidity, heart block, anorexia, nausea, and vomiting. Paresthesia,
facial spasms, and muscle tremors are symptoms of hypocalcemia.
, A nurse is reviewing the arterial blood gas lab report for a client who has chronic
renal failure. Which of the following is an expected finding?
A. pH 7.25, HCO3 19 mEq/L, PaCO2 30 mm Hg
B. pH 7.30, HCO3 26 mEq/L, PaCO2 50 mm Hg
C. pH 7.50, HCO3 20 mEq/L, PaCO2 32 mm Hg
D. pH 7.55, HCO3 30 mEq/L, PaCO2 31 mm Hg
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A. pH 7.25, HCO3 19 mEq/L, PaCO2 30 mm Hg
he client with renal failure would be in metabolic acidosis (low HCO3, low
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pH, and low or normal PaCO2. Normal lab values include pH 7.35-7.45,
HCO3 21-28 mEq/L, and PaCO2 35-45 mm HG.
A patient was admitted with epigastric pain from a gastric ulcer. Which assessment
finding warrants an urgent change in the plan of care?
A. Back pain 3 or 4 hours after eating a meal
B. Chest pain relieved with eating or drinking water
C. Burning epigastric pain 90 minutes after breakfast
D. Rigid abdomen and vomiting following indigestion
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D. Rigid abdomen and vomiting following indigestion
A rigid abdomen with vomiting in a patient who has a gastric ulcer indicates
a perforation of the ulcer, especially if the manifestations of perforation
appear suddenly. Midepigastric pain is relieved by eating, drinking water,
or antacids with duodenal ulcers, not gastric ulcers. Back pain 3 to 4 hours
after a meal is more likely to occur with a duodenal ulcer. Burning
epigastric pain 1 to 2 hours after a meal is an expected manifestation of a