A nurse administers a thiazide diuretic to a client with renal ...

[mwit1967]

A nurse administers a thiazide diuretic to a client with renal compromise as prescribed by the primary health care provider. Which action by the nurse would be most appropriate if the client's blood urea nitrogen level increases?
 
  A) Give prescribed magnesium supplements.
  B) Withhold the next dose of the drug.
  C) Administer the drug in a diluted form.
  D) Increase the fluid intake for the client.

Question 2

A nurse is caring for a client with edema due to congestive heart failure (CHF). The primary health care provider has prescribed indapamide. The client is also receiving digoxin. Which intervention would be most appropriate for the nurse to implement?
 
  A) Encourage oral fluids at frequent intervals during waking hours.
  B) Encourage the client to eat or drink between meals and in the evening.
  C) Frequently monitor the client's pulse rate and rhythm.
  D) Closely monitor the client for signs of hyperkalemia.

[Cnarkel]

Answer to Question 1

Ans: B
Feedback:
The nurse should withhold the drug or discontinue its use if the blood urea nitrogen (BUN) rises in the client with renal compromise who is receiving a thiazide diuretic. Magnesium supplements or add-ons may be provided to clients taking loop diuretics as they are prone to magnesium deficiency. The nurse should encourage fluid intake to prevent a fluid volume deficit in elderly clients who are particularly prone to fluid volume deficit and electrolyte imbalances when taking a diuretic. The nurse need not administer the drug in a diluted form since doing so will not have an effect on the blood urea nitrogen level.

Answer to Question 2

Ans: C
Feedback:
Clients receiving a diuretic, particularly a loop or thiazide diuretic such as indapamide, and a digitalis glycoside concurrently require frequent monitoring of the pulse rate and rhythm because of the possibility of cardiac arrhythmias. Any significant changes in the pulse rate and rhythm are immediately reported to the primary health care provider. The nurse should encourage oral fluids at frequent intervals during waking hours when caring for older clients to prevent a fluid volume deficit. In such cases the nurse should also encourage elderly clients to eat or drink between meals and in the evening. The nurse must closely observe clients receiving a potassium-sparing diuretic for signs of hyperkalemia, a serious and potentially fatal electrolyte imbalance.

[mwit1967]

TY

[Cnarkel]

You're welcome