A nurse is preparing to administer morning medications. The nurse ...

[itsmyluck]

A nurse is preparing to administer morning medications. The nurse notes that a patient with a history of hypertension is taking captopril (Capoten) concurrently with spironolactone (Aldac-tone).
 
  Morning laboratory results reveal a serum sodium level of 144 mg/dL, a serum potassium level of 4.5 mEq/L, and a blood glucose level of 128 mg/dL. Which of the following interven-tions should the nurse use? a. Administer the medications as ordered.
  b. Clarify the order with the prescriber.
  c. Confer with the prescriber about increasing the captopril dose.
  d. Request that the spironolactone be changed to mannitol (Osmitrol).

Question 2

The nurse is caring for a premature infant with respiratory distress syndrome (RDS). The nurse is preparing to administer surfactant to the infant.
 
  By which route would the nurse administer the surfactant to achieve the desired response? The drug would be given a. intravenously to reduce the risk of alveolar collapse.
  b. by inhalation to promote bronchodilation of the lungs.
  c. intrathecally to prevent hyperventilation.
  d. by intratracheal instillation to lower surface tension in the lungs.

[nanny]

Answer to Question 1

B
Spironolactone should not be administered with angiotensin-converting enzyme (ACE) inhibitors, which can also elevate potassium levels. Because the potassium level is on the high end of the spectrum, the nurse should not administer the medication and should obtain clarification of the order.
Conferring with the prescriber about increasing the captopril dosage is not indicated or appropri-ate.
Requesting that spironolactone be changed to mannitol is unmerited, because indications for mannitol include prophylaxis of renal failure, reduction of intracranial pressure, and reduction of intraocular pressure, not the management of hypertension.
The medications should not be administered as ordered. Spironolactone should not be adminis-tered with captopril.

Answer to Question 2

D
Surfactant lowers the surface tension forces that cause alveolar collapse and improves oxygena-tion and lung compliance. It is administered by direct intratracheal instillation.
Surfactant cannot be administered intravenously, by inhalation, or intrathecally. In addition, sur-factant does not promote bronchodilation of the lungs or prevent hyperventilation.

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