An older adult patient with congestive heart failure develops ...

[BrownTown3]

An older adult patient with congestive heart failure develops crackles in both lungs and pitting edema of all extremities.
 
  The physician orders hydrochlorothiazide (HydroDIURIL). Before administering this medication, the nurse reviews the patient's chart. Which laboratory value causes the nurse the most concern?
  a. Elevated creatinine clearance
  b. Elevated serum potassium level
  c. Normal blood glucose level
  d. Low levels of low-density lipoprotein (LDL) cholesterol

Question 2

A patient is taking gentamicin (Garamycin) and furosemide (Lasix). The nurse should counsel this patient to report which symptom?
 
  a. Frequent nocturia
  b. Headaches
  c. Ringing in the ears
  d. Urinary retention

[jsm54321]

Answer to Question 1

ANS: A
Hydrochlorothiazide should not be given to patients with severe renal impairment; therefore, an elevated creatinine clearance would cause the most concern. Thiazide diuretics are potassium-wasting drugs and thus may actually improve the patient's potassium level. Thiazides may elevate the serum glucose level in diabetic patients. Thiazides increase LDL cholesterol; however, this patient's levels are low, so this is not a risk.

Answer to Question 2

ANS: C
Patients taking furosemide should be advised that the risk of furosemide-induced hearing loss can be increased when other ototoxic drugs, such as gentamicin, are also taken. Patients should be told to report tinnitus or dizziness or hearing loss. Nocturia may be an expected effect of furosemide. Headaches are not likely to occur with concomitant use of gentamicin and furosemide. Urinary retention is not an expected side effect.

[BrownTown3]

Thanks

[jsm54321]

Welcome