1. A patient is brought to the emergency department with shortness of breath, a
respiratory rate of 30 breaths per minute, intercostal retractions, and
... [Show More] frothy, pink
sputum. The nurse caring for this patient will expect to administer which drug?
a.
Furosemide [Lasix]
b.
Hydrochlorothiazide [HydroDIURIL]
c.
Mannitol [Osmitrol]
d.
Spironolactone [Aldactone] - ANS: A
Furosemide, a potent diuretic, is used when rapid or massive mobilization of fluids
is needed. This patient shows severe signs of congestive heart failure with
respiratory distress and pulmonary edema and needs immediate mobilization of
fluid. Hydrochlorothiazide and spironolactone are not indicated for pulmonary
edema, because their diuretic effects are less rapid. Mannitol is indicated for
patients with increased intracranial pressure and must be discontinued immediately
if signs of pulmonary congestion or heart failure occur.
PTS: 1 DIF: Cognitive Level: Application
REF: pp. 450-452 | pp. 452-453 | pp. 452-454
2. A patient who is taking digoxin is admitted to the hospital for treatment of
congestive heart failure. The prescriber has ordered furosemide [Lasix]. The nurse
notes an irregular heart rate of 86 beats per minute, a respiratory rate of 22 breaths
per minute, and a blood pressure of 130/82 mm Hg. The nurse auscultates crackles
in both lungs. Which laboratory value causes the nurse the most concern?
a.
Blood glucose level of 120 mg/dL
b.
Oxygen saturation of 90%
c.
Potassium level of 3.5 mEq/L
d.
Sodium level of 140 mEq/L - ANS: C
This patient has an irregular, rapid heartbeat that might be caused by a
dysrhythmia. This patient's serum potassium level is low, which can trigger fatal
dysrhythmias, especially in patients taking digoxin. Furosemide contributes to lossof potassium through its effects on the distal nephron. Potassium-sparing diuretics
often are used in conjunction with furosemide to prevent this complication. This
patient's serum glucose and sodium levels are normal and of no concern at this
point, although they can be affected by furosemide. The oxygen saturation is
somewhat low and needs to be monitored, although it may improve with diuresis.
PTS: 1 DIF: Cognitive Level: Application REF: pp. 450-451 [Show Less]