Chapter 28: Drugs Used for Diuresis
Clayton/Willihnganz: Basic Pharmacology for Nurses, 17th Edition
MULTIPLE CHOICE
1.What would the nurse anticipate if a patient with a history of type 2 diabetes is prescribed a thiazide diuretic?
a.No change in the antidiabetic regimen
b.Decreased need for antidiabetic medication
c.Increased blood sugar levels
d.Less frequent monitoring of blood sugar level
ANS:C
The thiazides may induce hyperglycemia and aggravate cases of preexisting diabetes mellitus.
Regular assessment for glycosuria is indicated. Dosages of oral hypoglycemics and insulin may need adjustment in patients with diabetes mellitus. Thiazides affect glucose metabolism, and the patient should change her regimen to accommodate this. Thiazides have the opposite effect on glucose metabolism. More frequent monitoring is warranted when the patient is being treated with thiazide diuretics.
DIF:Cognitive Level: Application REF:Page 440OBJ:5
TOP:Nursing Process Step: Assessment
MSC:NCLEX Client Needs Category: Physiological Integrity
NOT:CONCEPT(S): Clinical Judgment
2.When teaching a patient who is taking thiazide diuretics, the nurse will encourage the patient to increase the intake of which electrolyte?
a.Calcium
b.Sodium
c.Potassium
d.Magnesium
ANS:C
Thiazide diuretics cause a decrease in the level of potassium. The patient taking thiazide diuretics does not need to increase calcium or magnesium intake. Although sodium levels are altered in patients taking thiazide diuretics, patients do not need to increase sodium intake.
DIF:Cognitive Level: Comprehension REF:Page 440OBJ:5
TOP:Nursing Process Step: Implementation
MSC:NCLEX Client Needs Category: Health Promotion and Maintenance
NOT:CONCEPT(S): Clinical Judgment; Nutrition; Health Promotion
3.On admission, a patient with a history of cardiac insufficiency complains of shortness of breath. The nurse auscultates the lungs and notes bilateral crackles throughout both fields. In addition, there is bilateral +2 edema of the lower extremities. Which medication does the nurse anticipate that the health care provider will prescribe?
a.Allopurinol (Zyloprim)This study source was downloaded by 100000812546443 from CourseHero.com on 07-21-2023 03:41:10 GMT -05:00
https://www.coursehero.com/file/36142046/c28rtf/ b.Diphenhydramine (Benadryl)
c.Mannitol
d.Furosemide (Lasix)
ANS:D
Diuretics, such as furosemide, are the mainstays of treatment in heart failure and hypertension.
Allopurinol is used to treat gout. Diphenhydramine is an antihistamine and is not used for diuresis. Mannitol is used mainly to treat cerebral edema.
DIF:Cognitive Level: Application REF:Page 436OBJ:1 | 2
TOP:Nursing Process Step: Planning
MSC:NCLEX Client Needs Category: Physiological Integrity
NOT:CONCEPT(S): Clinical Judgment; Gas Exchange; Perfusion
4.Which medication is a potassium sparing diuretic?
a.Acetazolamide (Diamox)
b.Spironolactone (Aldactone)
c.Furosemide (Lasix)
d.Bumetanide (Bumex)
ANS:B
Spironolactone is a potassium sparing diuretic that blocks the sodium retaining and potassium and magnesium excreting properties of aldosterone. This results in loss of water, with increased sodium excretion and retention of potassium. Acetazolamide is a carbonic anhydrase
inhibitor and does not spare potassium. Furosemide is a loop diuretic. Bumetanide is a loop diuretic and does not spare potassium.
DIF:Cognitive Level: Knowledge REF:Page 442OBJ:2
TOP:Nursing Process Step: Implementation
MSC:NCLEX Client Needs Category: Physiological Integrity
NOT:CONCEPT(S): Clinical Judgment; Nutrition
5.How soon will diuresis be expected to occur after the nurse has administered 20 mg of furosemide (Lasix) intravenously (IV) to a patient with heart failure?
a.As soon as injected
b.Within 10 minutes
c.After 2 hours
d.After 4 hours
ANS:B
The onset of diuresis following IV furosemide administration is 5 to 10 minutes after administration. The diuretic effect peaks within 30 minutes and lasts approximately 2 hours.
DIF:Cognitive Level: Comprehension REF:Page 436OBJ:5
TOP:Nursing Process Step: Assessment
MSC:NCLEX Client Needs Category: Physiological IntegrityThis study source was downloaded by 100000812546443 from CourseHero.com on 07-21-2023 03:41:10 GMT -05:00
https://www.coursehero.com/file/36142046/c28rtf/
Clayton/Willihnganz: Basic Pharmacology for Nurses, 17th Edition
MULTIPLE CHOICE
1.What would the nurse anticipate if a patient with a history of type 2 diabetes is prescribed a thiazide diuretic?
a.No change in the antidiabetic regimen
b.Decreased need for antidiabetic medication
c.Increased blood sugar levels
d.Less frequent monitoring of blood sugar level
ANS:C
The thiazides may induce hyperglycemia and aggravate cases of preexisting diabetes mellitus.
Regular assessment for glycosuria is indicated. Dosages of oral hypoglycemics and insulin may need adjustment in patients with diabetes mellitus. Thiazides affect glucose metabolism, and the patient should change her regimen to accommodate this. Thiazides have the opposite effect on glucose metabolism. More frequent monitoring is warranted when the patient is being treated with thiazide diuretics.
DIF:Cognitive Level: Application REF:Page 440OBJ:5
TOP:Nursing Process Step: Assessment
MSC:NCLEX Client Needs Category: Physiological Integrity
NOT:CONCEPT(S): Clinical Judgment
2.When teaching a patient who is taking thiazide diuretics, the nurse will encourage the patient to increase the intake of which electrolyte?
a.Calcium
b.Sodium
c.Potassium
d.Magnesium
ANS:C
Thiazide diuretics cause a decrease in the level of potassium. The patient taking thiazide diuretics does not need to increase calcium or magnesium intake. Although sodium levels are altered in patients taking thiazide diuretics, patients do not need to increase sodium intake.
DIF:Cognitive Level: Comprehension REF:Page 440OBJ:5
TOP:Nursing Process Step: Implementation
MSC:NCLEX Client Needs Category: Health Promotion and Maintenance
NOT:CONCEPT(S): Clinical Judgment; Nutrition; Health Promotion
3.On admission, a patient with a history of cardiac insufficiency complains of shortness of breath. The nurse auscultates the lungs and notes bilateral crackles throughout both fields. In addition, there is bilateral +2 edema of the lower extremities. Which medication does the nurse anticipate that the health care provider will prescribe?
a.Allopurinol (Zyloprim)This study source was downloaded by 100000812546443 from CourseHero.com on 07-21-2023 03:41:10 GMT -05:00
https://www.coursehero.com/file/36142046/c28rtf/ b.Diphenhydramine (Benadryl)
c.Mannitol
d.Furosemide (Lasix)
ANS:D
Diuretics, such as furosemide, are the mainstays of treatment in heart failure and hypertension.
Allopurinol is used to treat gout. Diphenhydramine is an antihistamine and is not used for diuresis. Mannitol is used mainly to treat cerebral edema.
DIF:Cognitive Level: Application REF:Page 436OBJ:1 | 2
TOP:Nursing Process Step: Planning
MSC:NCLEX Client Needs Category: Physiological Integrity
NOT:CONCEPT(S): Clinical Judgment; Gas Exchange; Perfusion
4.Which medication is a potassium sparing diuretic?
a.Acetazolamide (Diamox)
b.Spironolactone (Aldactone)
c.Furosemide (Lasix)
d.Bumetanide (Bumex)
ANS:B
Spironolactone is a potassium sparing diuretic that blocks the sodium retaining and potassium and magnesium excreting properties of aldosterone. This results in loss of water, with increased sodium excretion and retention of potassium. Acetazolamide is a carbonic anhydrase
inhibitor and does not spare potassium. Furosemide is a loop diuretic. Bumetanide is a loop diuretic and does not spare potassium.
DIF:Cognitive Level: Knowledge REF:Page 442OBJ:2
TOP:Nursing Process Step: Implementation
MSC:NCLEX Client Needs Category: Physiological Integrity
NOT:CONCEPT(S): Clinical Judgment; Nutrition
5.How soon will diuresis be expected to occur after the nurse has administered 20 mg of furosemide (Lasix) intravenously (IV) to a patient with heart failure?
a.As soon as injected
b.Within 10 minutes
c.After 2 hours
d.After 4 hours
ANS:B
The onset of diuresis following IV furosemide administration is 5 to 10 minutes after administration. The diuretic effect peaks within 30 minutes and lasts approximately 2 hours.
DIF:Cognitive Level: Comprehension REF:Page 436OBJ:5
TOP:Nursing Process Step: Assessment
MSC:NCLEX Client Needs Category: Physiological IntegrityThis study source was downloaded by 100000812546443 from CourseHero.com on 07-21-2023 03:41:10 GMT -05:00
https://www.coursehero.com/file/36142046/c28rtf/
