When evaluating an 82-year-old patient receiving ...

[RYAN BANYAN]

When evaluating an 82-year-old patient receiving hydrochlorothiazide (HydroDIURIL), what laboratory value deviations may be related to the medication?
 
  A) Elevated uric acid levels
  B) Reduced blood urea nitrogen (BUN) levels
  C) A serum potassium level of 4.7 mEq/L
  D) A hemoglobin A1C of 4.8

Question 2

A 68-year-old patient, who has type 1 diabetes, is to receive hydrochlorothiazide (HydroDIURIL). Before administration of this medication, what information is most important for the nurse to communicate to the patient?
 
  A) His or her insulin dose may need to be increased.
  B) His or he insulin dose may need to be decreased.
  C) He or she will need to have him or her urine checked for ketones four times a day.
  D) He or she will need to have a creatinine clearance done once a month.

[LP]

Answer to Question 1

A
Feedback:
Uric acid excretion is decreased because thiazides interfere with its secretory mechanism. High levels of uric acid can result in a condition called gout. Hydrochlorothiazide does not reduce BUN levels. Thiazide diuretics may lead to hypokalemia and increase blood glucose levels. The potassium and hemoglobin A1C levels are normal and not affected by the medication.

Answer to Question 2

A
Feedback:
Caution should be used with the following conditions, which include systemic lupus erythematosus (SLE), which frequently causes glomerular changes and renal dysfunction that could precipitate renal failure in some cases; glucose tolerance abnormalities or diabetes mellitus, which is worsened by the glucose-elevating effects of many diuretics; and gout, which reflects an abnormality in normal tubule reabsorption and secretion. There would be no reason to check ketones four times daily or to have a creatinine clearance once a month.

[RYAN BANYAN]

Thanks for the timely response, appreciate it

[bblaney]

Gracias!