Question 1

The nurse administers a dose of hydrochlorothiazide (HCTZ) to a client on a medical floor. When does the nurse expect to see action from this drug?

Accepted Answer

The answer of The nurse administers a dose of hydrochlorothiazide...

Question 2

The nurse is preparing to discharge a client who is prescribed a loop diuretic for the treatment of congestive heart failure. Which foods should the nurse encourage the client to consume to prevent serious adverse effects associated with the medication? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse is preparing to discharge a...

Question 3

A client diagnosed with chronic renal failure is prescribed hydrochlorothiazide (HCTZ). The client asks the nurse which is the best fluid to drink to avoid dehydration. Which is the best response by the nurse?

Accepted Answer

Plain water is the best fluid for a client with chronic renal failure, as it does not contain added sugars or electrolytes that may further burden the kidneys. Iced tea or coffee contains caffeine, which can potentially worsen dehydration. Alcohol should be avoided as it can further damage the kidneys. Electrolyte-replacement fluids like Gatorade are not necessary unless the client is experiencing significant fluid and electrolyte imbalances.

Question 4

An older adult reports ringing in the ears while the nurse is administering a dose of ethacrynic acid (Edecrin) intravenously. Which intervention is the priority for the nurse?

Accepted Answer

Ringing in the ears (tinnitus) is a potential adverse reaction to ethacrynic acid, indicating ototoxicity. It is important for the nurse to immediately stop the infusion and notify the prescriber to prevent further damage to the client's hearing. Scheduling a hearing test or assessing fluid intake are not the priority interventions in this situation. Questioning the client about recent history of hearing loss may be helpful in determining the underlying cause of the tinnitus, but the priority is to address the immediate concern.

Question 5

A home care nurse is instructing a client diagnosed with congestive heart failure on daily self-monitoring between home care visits. The nurse should instruct the client to monitor and record which items? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of A home care nurse is instructing a...

Question 6

Student nurses are writing their final exam on diuretic therapy. There are asked to identify the mechanism of action of chlorothiazide (Diuril). Which is the correct response?

Accepted Answer

Chlorothiazide (Diuril) acts on the early distal tubule to block the reabsorption of sodium, chloride, and water. It is a thiazide diuretic that inhibits the sodium-chloride symporter, leading to decreased sodium and chloride reabsorption and increased urine output. This results in decreased blood volume and blood pressure.

Question 7

The nurse is preparing to administer furosemide (Lasix) 40 mg IV to a client on complete bed rest who has renal failure and pulmonary edema. Which action is most appropriate prior to administering furosemide (Lasix) to this client?

Accepted Answer

Furosemide (Lasix) is a loop diuretic that can cause electrolyte imbalances and may also cause ototoxicity, so it is important to monitor the client's heart rate and rhythm prior to administration. Additionally, this medication can cause hypotension, so it is also important to ensure that the client is not in a position that could cause a drop in blood pressure, such as having the bed lowered. While monitoring urinary output is important in clients with renal failure, it would not necessarily be the most appropriate action prior to administering furosemide. Auscultating bowel sounds is not directly related to the administration of furosemide.

Question 8

A client is prescribed Furosemide (Lasix)for heart failure. He is currently on prednisone as well for exacerbation of his COPD. Which finding indicates that the next dose of Lasix should be withheld?

Accepted Answer

Furosemide is a loop diuretic that promotes the excretion of fluid and electrolytes, including potassium. The combination of furosemide and prednisone can increase the risk of hypokalemia, which can cause adverse effects such as cardiac arrhythmias. A potassium level of 3.0 mmol/L indicates hypokalemia and is a reason to withhold the next dose of furosemide. A potassium level of 5.5 mmol/L is within the normal range and does not require the drug to be held. Blood pressure of 166/88 is elevated, but it is not a reason to withhold furosemide. Urine output of 900 ml/24 hrs is low, but not a reason to withhold furosemide.

Question 9

What teaching will the nurse include for the client taking acetazolamide (Diamox)?

Accepted Answer

Acetazolamide makes the body excrete more fluids and electrolytes, putting the client at risk for dehydration. Therefore, the client needs to increase fluid intake to prevent dehydration. A is incorrect because acetazolamide is a potassium-sparing diuretic, so it does not cause hypokalemia. C and D are incorrect because they do not relate to the specific medication acetazolamide.

Question 10

The nurse caring for a client prescribed chlorothiazide (Diuril). Which assessment findings indicate that the client is experiencing side effects of this medication?

Accepted Answer

The answer of The nurse caring for a client prescribed...

Question 11

A client has a severe fluid and electrolyte imbalance. The nurse is aware that in order for the body to move large molecules and molecules with electrical charges, which two processes are required?

Accepted Answer

The answer of A client has a severe fluid and...

Question 12

The nurse is caring for a client who was admitted to the hospital for the treatment of dehydration. The nurse is discussing the difference between intracellular fluid and extracellular fluid. What fraction of total body water does intracellular fluid account for?

Accepted Answer

Intracellular fluid accounts for approximately 2/3 of total body water, while extracellular fluid accounts for the remaining 1/3. This is an important concept to understand when assessing and treating dehydration or fluid imbalances in clients.

Question 13

When treating fluid imbalances, which is the ultimate goal of care?

Accepted Answer

The ultimate goal of care when treating fluid imbalances is to diagnose and correct the underlying cause of the disorder. This will not only address the immediate problem, but also prevent future occurrences. Simply maintaining normal vital signs or administering intravenous fluids may temporarily alleviate symptoms but does not address the root cause of the imbalance. Normothermia, or maintaining normal body temperature, is important but is not the ultimate goal when treating fluid imbalances.

Question 14

When planning care, the nurse anticipates that which client will most likely require intravenous fluid replacement?

Accepted Answer

Shock is a condition that results in insufficient perfusion and oxygenation of tissues and organs. IV fluid replacement therapy is a common intervention used to restore intravascular volume and improve tissue perfusion in shock. Clients with minor burns, congestive heart failure, or SIADH are unlikely to require IV fluid replacement therapy to the same degree as a client with shock.

Question 15

Which instruction will the nurse include when teaching a client newly prescribed chlorothiazide (Diuril)?

Accepted Answer

The nurse would instruct the client to take chlorothiazide early in the morning. This medication is a diuretic and can cause the need to urinate frequently, so taking it in the morning can help avoid disruptions to sleep patterns. The nurse would also advise the client to avoid alcohol, foods high in potassium, and excessive salt intake.

Question 16

The health care provider prescribes hydrochlorothiazide (HCTZ) for a client in chronic renal failure. The nurse suspects the client is experiencing an ineffective response to the medication. Which clinical manifestation would be the most significant?

Accepted Answer

The answer of The health care provider prescribes hydrochlorothiazide (HCTZ)...

Question 17

A client diagnosed with chronic renal failure and has gained 4 pounds in the past 24 hours. Which diuretic does the nurse anticipate the client will receive?

Accepted Answer

Ethacrynic acid (Edecrin) is a loop diuretic that is often used in cases of chronic renal failure. It has been shown to be effective in reducing fluid accumulation and improving symptoms associated with this condition. It is also considered to be a more potent diuretic than other loop diuretics, such as furosemide (Lasix), which may be beneficial in cases where other diuretics have not been effective. Amiloride (Midamor) is a potassium-sparing diuretic that is typically used in combination with other diuretics. Mannitol (Osmitrol) is an osmotic diuretic that is primarily used to reduce intracranial pressure or promote diuresis during certain medical procedures. Hydrochlorothiazide (HCTZ) is a thiazide diuretic that is often used to treat hypertension, but may not be effective in cases of chronic renal failure.

Question 18

The nurse is assessing a client prior to the administration of a diuretic. The nurse knows it is essential to assess which vital signs at this time? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The nurse should assess pulse and blood pressure prior to the administration of a diuretic, as they can both be affected by the medication. The other options, temperature, respirations, and pain, are not directly affected by the diuretic and do not need to be assessed prior to administration.

Question 19

The nurse is assessing a client prescribed chlorothiazide (Diuril). Which clinical manifestation found upon assessment is an indication of hypokalemia?

Accepted Answer

Hypokalemia, or low potassium levels, can lead to muscle weakness and cramps. Confusion and decreased urine output are not specific signs of hypokalemia. General irritability and increased urine output are not typical signs of hypokalemia either. Diarrhea and projectile vomiting can lead to dehydration and electrolyte imbalances, but are not specific signs of hypokalemia.

Question 20

The nurse is aware that body fluids are exchanged between which compartments?

Accepted Answer

Body fluids are exchanged between the intracellular (within cells) and extracellular (outside cells, including interstitial fluid and blood plasma) compartments. This exchange is crucial for maintaining homeostasis in the body.

Quiz 11: Pharmacology of Alterations in the Cardiovascular System

The nurse administers a dose of hydrochlorothiazide (HCTZ) to a client on a medical floor. When does the nurse expect to see action from this drug?

A client diagnosed with chronic renal failure is prescribed hydrochlorothiazide (HCTZ) . The client asks the nurse which is the best fluid to drink to avoid dehydration. Which is the best response by the nurse?

An older adult reports ringing in the ears while the nurse is administering a dose of ethacrynic acid (Edecrin) intravenously. Which intervention is the priority for the nurse?

Student nurses are writing their final exam on diuretic therapy. There are asked to identify the mechanism of action of chlorothiazide (Diuril) . Which is the correct response?

The nurse is preparing to administer furosemide (Lasix) 40 mg IV to a client on complete bed rest who has renal failure and pulmonary edema. Which action is most appropriate prior to administering furosemide (Lasix) to this client?

A client is prescribed Furosemide (Lasix) for heart failure. He is currently on prednisone as well for exacerbation of his COPD. Which finding indicates that the next dose of Lasix should be withheld?

What teaching will the nurse include for the client taking acetazolamide (Diamox) ?

The nurse caring for a client prescribed chlorothiazide (Diuril) . Which assessment findings indicate that the client is experiencing side effects of this medication?