The hospitalized patient is receiving spironolactone (Aldactone). ...

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The hospitalized patient is receiving spironolactone (Aldactone). A consulting physician sees the patient and orders lisinopril (Prinivil). What will be the primary assessment by the nurse?
 
  1. Decreased effect of spironolactone (Aldactone)
  2. Hypokalemia
  3. Hyperkalemia
  4. Decreased effect of lisinopril (Prinivil)

Question 2

The elderly patient is receiving ethacrynic acid (Edecrin) and tells the nurse he doesn't hear as well as he used to. What is the best response by the nurse?
 
  1. You may be dehydrated; are you drinking enough fluid?
  2. I will let your doctor know about this; it could be a side effect of your medication.
  3. How long have you been having difficulty hearing?
  4. I will schedule a hearing exam; this could be a side effect of your medication.

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Answer to Question 1

Correct Answer: 3
Rationale: Concurrent use of spironolactone (Aldactone) and ACE inhibitors such as lisinopril (Prinivil), may predispose the patient to hyperkalemia. The patient will be at risk for hyperkalemia, not hypokalemia. Lisinopril (Prinivil) does not decrease the effect of spironolactone (Aldactone). Spironolactone (Aldactone) does not decrease the effect of spironolactone (Aldactone).

Answer to Question 2

Correct Answer: 2
Rationale: Loop diuretics are ototoxic. Instruct the patient to report ringing in the ears or becoming hard of hearing and notify the physician. It is inappropriate to schedule a hearing exam unless drug toxicity has been ruled out. Asking the patient about how long he has had the hearing loss is a good question, but the nurse must always report suspected side effects to the physician. Ototoxicity is not related to dehydration.