A female patient who begins taking spironolactone (Aldactone) as ...

[Bernana]

A female patient who begins taking spironolactone (Aldactone) as an adjunct to furosemide (Lasix) complains that her voice is deepening. What will the nurse do?
 
  a. Contact the provider to obtain an order for a complete blood count (CBC) and liver function tests.
  b. Explain that this drug binds with receptors for steroid hormones, causing this effect.
  c. Report this side effect to the provider and request another medication for this patient.
  d. Teach the patient to report any associated cough, which may indicate a more severe side effect.

Question 2

A female patient taking an ACE inhibitor learns that she is pregnant. What will the nurse tell this patient?
 
  a. The fetus most likely will have serious congenital defects.
  b. The fetus must be monitored closely while the patient is taking this drug.
  c. The patient's prescriber probably will change her medication to an ARB.
  d. The patient should stop taking the medication and contact her provider immediately.

[juicepod]

Answer to Question 1

ANS: B
Spironolactone binds with receptors for aldosterone and with other steroid hormones, causing side effects such as gynecomastia, menstrual irregularities, impotence, hirsutism, and deepening of the voice. There is no indication for a CBC or for liver function tests in this patient with this side effect. Deepening of the voice is not an indication for withdrawal of the drug. This side effect is not associated with cough.

Answer to Question 2

ANS: D
ACE inhibitors are known to cause serious fetal injury during the second and third trimesters of pregnancy. Whether injury occurs earlier in pregnancy is unknown, and the incidence probably is low. However, women should be counseled to stop taking the drug if they become pregnant, and they should not take it if they are contemplating becoming pregnant. Women who take ACE inhibitors in the first trimester should be counseled that the risk to the fetus is probably low. Women should stop taking the drug when pregnant. ARBs carry the same risk as ACE inhibitors.