Question 1

Several clients have been seen in the acute -care clinic. The nurse will plan to administer diuretic therapy to which clients? Select all that apply.&#10;A) The client experiencing visual and auditory hallucinations.&#10;B) The client with a blood pressure of 200/98 mm/Hg.&#10;C) The client with confusion and ataxia.&#10;D) The client with generalized edema and decreased urine output.&#10;E) The client with pinpoint pupils and extreme paranoia.

Accepted Answer

Diuretic therapy is indicated for clients with hypertension (B) and generalized edema with decreased urine output (D). Clients experiencing hallucinations (A), confusion and ataxia (C), and pinpoint pupils with extreme paranoia (E) have different underlying conditions that do not warrant diuretic therapy.

Question 2

The client is receiving spironolactone (Aldactone). The nurse has completed dietary education and evaluates that the client needs additional education when the client makes which statement?&#10;A) &#34;I am German, so I could not give up my cabbage and mushrooms.&#34;&#10;B) &#34;I need an apple a day to stay regular; I'm glad I can still have this.&#34;&#10;C) &#34;I am really happy that I can have my cranberry juice.&#34;&#10;D) &#34;Thank goodness I can still have my orange juice and bananas for breakfast.&#34;

Accepted Answer

Spironolactone is a potassium-sparing diuretic, which means it can cause potassium levels in the blood to increase. Foods high in potassium, such as orange juice and bananas, should be consumed with caution to avoid hyperkalemia (high potassium levels). The client's statement about continuing to consume orange juice and bananas indicates a misunderstanding of dietary restrictions related to spironolactone therapy.

Question 3

The client is receiving chlorothiazide (Diuril). The nurse assesses the client for hypokalemia. What does the best assessment include?&#10;A) confusion and decreased urine output.&#10;B) muscle weakness or cramps.&#10;C) general irritability and increased urine output.&#10;D) diarrhea and projectile vomiting.

Accepted Answer

Hypokalemia, or low potassium levels, can be a side effect of diuretic medications like chlorothiazide. Muscle weakness or cramps are common symptoms of hypokalemia. Confusion and decreased urine output may be indicative of other issues, while general irritability and increased urine output may be expected with the use of a diuretic. Diarrhea and projectile vomiting may cause dehydration and electrolyte imbalances, but are not specifically related to hypokalemia.

Question 4

The physician has ordered hydrochlorothiazide (HCTZ) for the client in chronic renal failure. The nurse suspects the client is experiencing an ineffective response to the medication. Which assessment is a priority for this client?

A) auscultating breath sounds for wheezes
B) assessing the skin for moisture and turgor
C) reviewing the lab work for hypokalemia and hyponatremia
D) assessing the vital signs for hypertension

Accepted Answer

The answer of The physician has ordered hydrochlorothiazide (HCTZ) for...

Question 5

Four clients arrive at the emergency department. All have attempted suicide by overdosing on medication. Which client will the nurse plan to transfer to the renal failure unit?&#10;A) the client who overdosed on amitriptyline (Elavil)&#10;B) the client who overdosed on ibuprofen (Advil)&#10;C) the client who overdosed on quetiapine (Seroquel)&#10;D) the client who overdosed on lorazepam (Ativan)

Accepted Answer

Ibuprofen overdose can lead to acute kidney injury (AKI) or renal failure, necessitating specialized care in a renal unit.

Question 6

The elderly client is receiving chlorothiazide (Diuril). What does the best teaching of the nurse include with this medication?&#10;A) &#34;Avoid foods that are high in potassium.&#34;&#10;B) &#34;Take the medication on an empty stomach.&#34;&#10;C) &#34;It is alright to have a glass of wine with this medication.&#34;&#10;D) &#34;Take the medication early in the morning.&#34;

Accepted Answer

Chlorothiazide is a diuretic medication and should be taken early in the morning to prevent interference with sleep. It can also cause increased urination, so taking it later in the day may interfere with sleep. The medication does not interact with potassium or alcohol intake, nor does it need to be taken on an empty stomach.

Question 7

The client is receiving bumetanide (Burinex) and asks the nurse, &#34;What is all this about 'loops' in my medicine&#34;? What is the best response by the nurse?&#10;A) &#34;This is a loop diuretic, which refers to where it acts in your kidney. Not all diuretics work the same way.&#34;&#10;B) &#34;This medication reabsorbs potassium in the loop of Henle in your kidney. It is safer than other diuretics.&#34;&#10;C) &#34;This medication blocks sodium reabsorption in what is known as Bowman's Capsule. Not all diuretics work the same way.&#34;&#10;D) &#34;This is a loop diuretic, which means it works in the proximal loop of your kidney. Not all diuretics work the same way.&#34;

Accepted Answer

This response correctly explains that bumetanide is a loop diuretic, meaning it acts on a specific part of the kidney called the loop of Henle to increase urine output. It also acknowledges that not all diuretics work the same way, emphasizing the importance of understanding the specific medication being prescribed. Option B incorrectly suggests that bumetanide reabsorbs potassium, when in fact it promotes potassium excretion. Option C incorrectly describes the site of action as Bowman's Capsule, while that is more relevant to thiazide diuretics. Option D incorrectly refers to the proximal loop of the kidney, which is actually the proximal tubule where different diuretics act.

Question 8

The elderly client is receiving ethacrynic acid (Edecrin) and tells the nurse he doesn't hear as well as he used to. What is the best response by the nurse?&#10;A) &#34;How long have you been having difficulty hearing?&#34;&#10;B) &#34;I will let your doctor know about this; it could be a side effect of your medication.&#34;&#10;C) &#34;You may be dehydrated; are you drinking enough fluid?&#34;&#10;D) &#34;I will schedule a hearing exam; this could be a side effect of your medication.&#34;

Accepted Answer

The best response is to inform the client that this could be a side effect of medication and that the doctor will be notified. Option A is not as appropriate because it does not address the potential cause. Option C is also not as appropriate because dehydration is not a known side effect of ethacrynic acid. Option D is not as appropriate because scheduling a hearing exam would not address the potential cause.

Question 9

The client is receiving hydrochlorothiazide (HCTZ). The client asks the nurse what the best fluid to drink to avoid dehydration is. What is the best response by the nurse?&#10;A) &#34;Electrolyte -replacement drinks like Gatorade&#34;.&#10;B) &#34;Any kind of fluid is okay, but avoid alcohol.&#34;&#10;C) &#34;Iced teas, especially the green teas&#34;.&#10;D) &#34;Plain water is really the best&#34;.

Accepted Answer

HCTZ is a diuretic medication that increases urination and can lead to dehydration. The best fluid to drink to avoid dehydration is plain water as it is free of caffeine and sugar, which can further dehydrate the body. Electrolyte-replacement drinks like Gatorade can be helpful for those engaging in intense physical activity or experiencing excessive sweating, but they are not necessary for the average person taking HCTZ. Iced teas, especially those that contain caffeine, can actually have a diuretic effect and worsen dehydration. Avoiding alcohol is also important as it can further dehydrate the body.

Question 10

The client has a routine urinalysis done, and the results show protein in the urine. What does the nurse correctly conclude about this result?&#10;A) The client is in acute renal failure, and needs to be hospitalized.&#10;B) The client probably has kidney damage; protein should not be present in the urine.&#10;C) There could be a mistake with the results; the client should have another test done.&#10;D) This results probably mean nothing, if the amount of protein is very small.

Accepted Answer

The presence of protein in the urine is abnormal and can indicate kidney damage or other underlying health issues. The nurse should further assess the client's medical history and symptoms, and possibly recommend further testing or referral to a healthcare provider for further evaluation.

Question 11

The client is receiving chlorothiazide (Diuril). The nurse suspects the client is exhibiting side effects to the medication. What will the best assessment of the nurse include?&#10;A) mental confusion and dependent edema&#10;B) serum potassium level of 3.0, and low blood pressure&#10;C) serum sodium level of 160, and headaches&#10;D) ataxia and frequent diarrhea

Accepted Answer

The answer of The client is receiving chlorothiazide (Diuril). The...

Question 12

The hospitalized client is receiving spironolactone (Aldactone). A consulting physician sees the client and orders lisinopril (Zestril). What will be the primary assessment of the nurse?&#10;A) hypokalemia&#10;B) decreased effect of spironolactone (Aldactone)&#10;C) hyperkalemia&#10;D) decreased effect of lisinopril (Zestril)

Accepted Answer

The answer of The hospitalized client is receiving spironolactone (Aldactone)....

Question 13

The client is receiving chlorothiazide (Diuril). What is the best medication education by the nurse?&#10;A) &#34;Report signs of hypokalemia, such as vomiting and diarrhea.&#34;&#10;B) &#34;Weigh yourself and report a gain of more than 0.25 kilogram in 24 hours.&#34;&#10;C) &#34;Avoid foods high in potassium, such as bananas.&#34;&#10;D) &#34;Weigh yourself, and report a gain of more than 1 kilogram in 24 hours.&#34;

Accepted Answer

The answer of The client is receiving chlorothiazide (Diuril). What...

Question 14

The nurse is managing care for a group of clients on a renal failure unit. What does the nurse recognize as the most important client safety precaution with regard to medication administration?&#10;A) Know that clients will require less -than -average doses of medications.&#10;B) Ensure that each client's intake and output is measured precisely.&#10;C) Know which drugs will increase fluid retention.&#10;D) Be aware of what drugs are nephrotoxic.

Accepted Answer

The answer of The nurse is managing care for a...

Question 15

The client has been diagnosed with chronic renal failure and is receiving hydrochlorothiazide (HCTZ). The nurse has taught the client about the importance of kidney function, and evaluates that learning has occurred when the client makes which statements? Select all that apply.

A) "Kidneys help regulate the oxygen levels in my blood."
B) "Kidneys help my heart by balancing potassium."
C) "Kidneys keep blood pressure from getting too low."
D) "Kidneys help decrease infections by excreting bacteria."
E) "Kidneys balance the fluid and electrolytes in my body."

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Accepted Answer

The answer of The client has been diagnosed with chronic...

Deck 43: Drugs for Renal Disorders and Diuretic Therapy