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

[saraeharris]

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?
  1. Hyponatremia
  2. Excessive skin moisture
  3. Rales
  4. Hypertension

Question 2

A client is prescribed acetazolamide (Diamox) to treat absence seizures. Which finding indicates that the next dose of this drug should be withheld?
 
  1. Elevated serum pH
  2. Decreased serum potassium
  3. Increased seizure frequency
  4. Nausea and dizziness

[kiamars2010]

Answer to Question 1

Correct Answer: 3
Rationale 1: Hyponatremia is an adverse effect associated with this medication, but it is not the most significant adverse effect noted.
Rationale 2: Excessive skin moisture is not an adverse effect associated with this medication.
Rationale 3: Rales can represent pulmonary edema, which is a life-threatening complication of chronic renal failure and fluid retention.
Rationale 4: Hypertension is not an adverse effect associated with this medication. Hypertension is the reason the medication is given.
Global Rationale: Rales can represent pulmonary edema, which is a life-threatening complication of chronic renal failure and fluid retention. Hyponatremia is an adverse effect associated with this medication, but it is not the most significant adverse effect noted. Excessive skin moisture is not an adverse effect associated with this medication. Hypertension is not an adverse effect associated with this medication. Hypertension is the reason the medication is given.

Answer to Question 2

Correct Answer: 2
Rationale 1: A serious adverse effect of acetazolamide (Diamox) is metabolic alkalosis, not metabolic acidosis.
Rationale 2: Hypokalemia is a serious adverse effect of acetazolamide (Diamox).
Rationale 3: Increased seizure frequency would represent a decreased therapeutic effect of the drug for this client.
Rationale 4: Nausea and dizziness can occur as adverse effects of acetazolamide (Diamox) but are not indications to discontinue therapy.
Global Rationale: Hypokalemia is a serious adverse effect of acetazolamide (Diamox). A serious adverse effect of acetazolamide (Diamox) is metabolic alkalosis, not metabolic acidosis. Increased seizure frequency would represent a decreased therapeutic effect of the drug for this client. Nausea and dizziness can occur as adverse effects of acetazolamide (Diamox) but are not indications to discontinue therapy.

[saraeharris]

TY

[kiamars2010]

You're welcome