NURSING 112-Chapter 28: Diuretic Drugs Lilley: Pharmacology and the Nursing Process, 8th Edition

NURSING 112-Chapter 28: Diuretic Drugs Lilley: Pharmacology and the Nursing Process, 8th Edition Chapter 28: Diuretic Drugs Lilley: Pharmacology and the Nursing Process, 8th Edition MULTIPLE CHOICE 1. When monitoring a patient who has diabetes and is receiving a carbonic anhydrase inhibitor for edema, the nurse will monitor for which possible adverse effect? a. Metabolic alkalosis b. Elevated blood glucose c. Hyperkalemia d. Mental alertness ANS: B An undesirable effect of carbonic anhydrase inhibitors is that they elevate the blood glucose level and cause glycosuria in diabetic patients. They induce metabolic acidosis, making their usefulness limited. In addition, hypokalemia and drowsiness may occur. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 453 TOP: NURSING PROCESS: Evaluation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 2. The nurse will monitor a patient for signs and symptoms of hyperkalemia if the patient is taking which of these diuretics? a. Hydrochlorothiazide (HydroDIURIL) b. Furosemide (Lasix) c. Acetazolamide (Diamox) d. Spironolactone (Aldactone) ANS: D Spironolactone (Aldactone) is a potassium-sparing diuretic, and patients taking this drug must be monitored for signs of hyperkalemia. The other drugs do not cause hyperkalemia but instead cause hypokalemia. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 457 TOP: NURSING PROCESS: Evaluation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 3. Mannitol (Osmitrol) has been ordered for a patient with acute renal failure. The nurse will administer this drug using which procedure? a. Intravenously, through a filter b. By rapid intravenous bolus c. By mouth in a single morning dose d. Through a gravity intravenous drip with standard tubing ANS: A Mannitol is administered via intravenous infusion through a filter because of possible crystallization. It is not available in oral form. The other options are incorrect. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 456 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 4. Furosemide (Lasix) is prescribed for a patient who is about to be discharged, and the nurse provides instructions to the patient about the medication. Which statement by the nurse is correct? a. “Take this medication in the evening.” b. “Avoid foods high in potassium, such as bananas, oranges, fresh vegetables, and dates.” c. “If you experience weight gain, such as 5 pounds or more per week, be sure to tell your physician during your next routine visit.” d. “Be sure to change positions slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes.” ANS: D Orthostatic hypotension is a possible problem with diuretic therapy. Foods high in potassium should be eaten more often, and the drug needs to be taken in the morning so that the diuretic effects do not interfere with sleep. A weight gain of 5 pounds or more per week must be reported immediately. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 459 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 5. When reviewing the mechanisms of action of diuretics, the nurse knows that which statement is true about loop diuretics? a. They work by inhibiting aldosterone. b. They are very potent, having a diuretic effect that lasts at least 6 hours. c. They have a rapid onset of action and cause rapid diuresis. d. They are not effective when the creatinine clearance decreases below 25 mL/min. ANS: C The loop diuretics have a rapid onset of action; therefore, they are useful when rapid onset is desired. Their effect lasts for about 2 hours, and a distinct advantage they have over thiazide diuretics is that their diuretic action continues even when creatinine clearance decreases below 25 mL/min. DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 454 TOP: NURSING PROCESS: Assessment MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 6. When monitoring a patient who is taking hydrochlorothiazide (HydroDIURIL), the nurse notes that which drug is most likely to cause a severe interaction with the diuretic? a. Digitalis b. Penicillin c. Potassium supplements d. Aspirin ANS: A There is an increased risk for digitalis toxicity in the presence of hypokalemia, which may develop with hydrochlorothiazide therapy. Potassium supplements are often prescribed with hydrochlorothiazide therapy to prevent hypokalemia. The other options do not have interactions with hydrochlorothiazide. DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 458 TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 7. When a patient is receiving