NSG 232 EXAM STUDY QUESTIONS AND
100% CORECT ANSWERS!!
What is the recommended dose of furosemide?
PO: 20 - 80 mg single dose/d
max: 600 mg/d
IV: 20 - 40 mg over 1-2 hr; repeat 20 mg in 2 h
What nursing dx are associated w/ furosemide? (2)
- Risk for deficient fluid volume r/t fluid loss w/ excessive use of loops.
- Risk for K deficit r/t excessive use of loops.
Furosemide can be given more than once/day b/c:
t1/2 of 30 to 50 minutes
If furosemide is given IV, urine output should increase how quickly?
5 to 10 minutes
* if not, contact hcp. Severe renal disorder may be present.
Urinary output should be at least:
30 mL/hr or 600 mL/24 hr
What can happen if furosemide is too rapidly injected?
Hearing loss
Monitor what serum levels w/ a pt on fursoemide? Especially if they're taking digoxin.
Potassium - hypokalmeia enhances the effects of digitalis, causing toxicity
When should furosemide be taken? (2) Why?
AM - prevent sleep disturbance and nocturia
With food - avoid nausea
Why should a patient taking furosemide rise from a seated position w/ caution?
,Prevent dizziness from fluid loss.
What are signs that furosemide is effective (3)?
- decreased fluid retention or overload
- decreased respiratory distress
- ^ cardiac output
Osmotic diuretics are used to: (3)
- prevent kidney failure
- decrease ICP
- decrease intraocular pressure
How does mannitol (Osmitrol) work? What is lost? (4)
- increases concentration in the proximal
- leading to...loss of Na, Cl, and K (to a lesser degree), and water (follows Na)
Mannitol is frequently used in emergency situations, such as:
ICP and IOP
Diuresis occurs w/in own long of IV mannitol administration?
1 to 3 hours
Heparin is indicated for what?
Rapid anticoagulant effect:
Thrombosis b/c of DVT, PE, or evolving stroke.
The main use for heparin is?
To prevent DVTs.
What lab tests are used to monitor heparin tx? (detect deficiencies of certain clotting
factors) (2)
- PTT (partial thromboplastin time)
- aPTT (activated partial thromboplastin time)
, Heparin can decrease the platelet count causing:
Thrombocytopenia
If hemorrhage occurs during heparin tx, what is administered? What is its effect?
Protamine sulfate:
binds to heparin
What are SE of heparin? (2) ARs? (2)
itching, burning
- ARs: bleeding, ecchymosis
What are SE of warfarin? (4)
- a/n/v/d
- abd cramps
- rash
- fever
What labs are affected by heparin?
Increases AST, ALT
What test should be done before administering heparin? Warfarin?
- Heparin - aPTT
- Warfarin - PT or INR
The PT should be in what range? INR?
PT: 1.25 to 2.5 times the control level (11 to 15 seconds)
INR: 2 to 3
What anticoagulant antagonsists should be kept available when drug dose is increased or
there are any indications of frank bleeding?
- protamine for heparin
- vit K for warfarin
100% CORECT ANSWERS!!
What is the recommended dose of furosemide?
PO: 20 - 80 mg single dose/d
max: 600 mg/d
IV: 20 - 40 mg over 1-2 hr; repeat 20 mg in 2 h
What nursing dx are associated w/ furosemide? (2)
- Risk for deficient fluid volume r/t fluid loss w/ excessive use of loops.
- Risk for K deficit r/t excessive use of loops.
Furosemide can be given more than once/day b/c:
t1/2 of 30 to 50 minutes
If furosemide is given IV, urine output should increase how quickly?
5 to 10 minutes
* if not, contact hcp. Severe renal disorder may be present.
Urinary output should be at least:
30 mL/hr or 600 mL/24 hr
What can happen if furosemide is too rapidly injected?
Hearing loss
Monitor what serum levels w/ a pt on fursoemide? Especially if they're taking digoxin.
Potassium - hypokalmeia enhances the effects of digitalis, causing toxicity
When should furosemide be taken? (2) Why?
AM - prevent sleep disturbance and nocturia
With food - avoid nausea
Why should a patient taking furosemide rise from a seated position w/ caution?
,Prevent dizziness from fluid loss.
What are signs that furosemide is effective (3)?
- decreased fluid retention or overload
- decreased respiratory distress
- ^ cardiac output
Osmotic diuretics are used to: (3)
- prevent kidney failure
- decrease ICP
- decrease intraocular pressure
How does mannitol (Osmitrol) work? What is lost? (4)
- increases concentration in the proximal
- leading to...loss of Na, Cl, and K (to a lesser degree), and water (follows Na)
Mannitol is frequently used in emergency situations, such as:
ICP and IOP
Diuresis occurs w/in own long of IV mannitol administration?
1 to 3 hours
Heparin is indicated for what?
Rapid anticoagulant effect:
Thrombosis b/c of DVT, PE, or evolving stroke.
The main use for heparin is?
To prevent DVTs.
What lab tests are used to monitor heparin tx? (detect deficiencies of certain clotting
factors) (2)
- PTT (partial thromboplastin time)
- aPTT (activated partial thromboplastin time)
, Heparin can decrease the platelet count causing:
Thrombocytopenia
If hemorrhage occurs during heparin tx, what is administered? What is its effect?
Protamine sulfate:
binds to heparin
What are SE of heparin? (2) ARs? (2)
itching, burning
- ARs: bleeding, ecchymosis
What are SE of warfarin? (4)
- a/n/v/d
- abd cramps
- rash
- fever
What labs are affected by heparin?
Increases AST, ALT
What test should be done before administering heparin? Warfarin?
- Heparin - aPTT
- Warfarin - PT or INR
The PT should be in what range? INR?
PT: 1.25 to 2.5 times the control level (11 to 15 seconds)
INR: 2 to 3
What anticoagulant antagonsists should be kept available when drug dose is increased or
there are any indications of frank bleeding?
- protamine for heparin
- vit K for warfarin
