Author Question: The physician has ordered hydrochlorothiazide (HCTZ) for the patient in chronic renal failure. The ... (Read 41 times)

sabina · **on:** Jul 23, 2018

The physician has ordered hydrochlorothiazide (HCTZ) for the patient in chronic renal failure. The nurse suspects the patient is experiencing an ineffective response to the medication. Which assessment is a priority for this patient?

1. Reviewing the lab work for hypokalemia and hyponatremia
2. Assessing the vital signs for hypertension
3. Assessing the skin for moisture and turgor
4. Auscultating breath sounds for wheezes

Question 2

The patient is receiving bumetanide (Bumex) and asks the nurse, What is all this about 'loops' in my medicine? What is the best response by the nurse?

1. This medication reabsorbs potassium in the loop of Henle in your kidney. It is safer than other diuretics.
2. This is a loop diuretic, which means it works in the proximal loop of your kidney. Not all diuretics work the same way.
3. This is a loop diuretic, which refers to where it acts in your kidney. Not all diuretics work the same way.
4. This medication blocks sodium reabsorption in what is known as Bowman's capsule. Not all diuretics work the same way.

akudia · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 4
Rationale: Wheezes are commonly auscultated with pulmonary edema, which can occur with chronic renal failure and fluid retention. This is a priority because pulmonary edema affects the patient's oxygenation. Skin assessment is important, but is not the priority here. Vital sign assessment is important, but is not the priority here. Reviewing lab work is important, but is not the priority here.

Answer to Question 2

Correct Answer: 3
Rationale: Bumetanide (Bumex) is called a loop diuretic because it acts by preventing the reabsorption of sodium in the loop of Henle. Bumetanide (Bumex) blocks reabsorption of sodium in the loop of Henle, not in Bowman's capsule. Bumetanide (Bumex) is a potassium-excreting drug; it does not reabsorb potassium. Bumetanide (Bumex) works in the loop of Henle, not the proximal loop.