A patient is taking a thiazide diuretic for hypertension and ...

[mspears3]

A patient is taking a thiazide diuretic for hypertension and quinidine to treat a dysrhythmia. The prescriber orders digoxin 0.125 mg to improve this patient's cardiac output. The nurse should contact the provider to request:
 
  a. adding spironolactone Aldactone.
  b. reducing the dose of digoxin.
  c. discontinuing the quinidine.
  d. giving potassium supplements.

Question 2

A nurse is caring for a patient infected with the human immunodeficiency virus (HIV). Which finding would most concern the nurse?
 
  a. High level of macrophages
  b. Low neutrophil count
  c. Low red blood cell (RBC) count
  d. Very low helper T lymphocyte count

[Shshxj]

Answer to Question 1

C
Quinidine can cause plasma levels of digoxin to rise; concurrent use of quinidine and digoxin is contraindicated. There is no indication for adding spironolactone unless this patient's potassium level is elevated. The dose of digoxin ordered is a low dose. Potassium supplements are con-traindicated with digoxin.

Answer to Question 2

D
The nurse understands that this patient may be vulnerable to opportunistic infections, especially if there were an indication of the HIV conversion to acquired immunodeficiency syndrome (AIDS). A very low helper T lymphocyte count would most concern the nurse, because the helper T cells are essential to the immune system, and people with AIDS have a low or deficient count. A high level of macrophages could indicate an inflammatory response. A low RBC count may indicate anemia. A low neutrophil count can be caused by multiple conditions, but a high count most likely indicates an infection.

[mspears3]

Thanks for the timely response, appreciate it

[Alyson.hiatt@yahoo.com]

Great answer, keep it coming