A client is taking spironolactone (Aldactone) but continues to ...

[mpobi80]

A client is taking spironolactone (Aldactone) but continues to have peripheral edema. Which question by the nurse is the most appropriate?
 
  1. Are you taking potassium supplements?
  2. Are you taking corticosteroids?
  3. Are you taking digoxin (Lanoxin)?
  4. Are you taking aspirin (ASA)?

Question 2

Why would a client benefit from a thiazide diuretic over a loop diuretic?
 
  1. They can be taken on an as-needed basis.
  2. They do not cause electrolyte imbalance.
  3. Possible dehydration is not a factor.
  4. The frequency of adverse effects is much lower.

[al]

Answer to Question 1

Correct Answer: 4

Rationale 1: Hyperkalemia may occur if the client is also taking a potassium supplement.
Rationale 2: The effects of corticosteroids are increased with thiazides.
Rationale 3: Spironolactone decreases the effects of digoxin, which would not cause peripheral edema.
Rationale 4: Aspirin and other salicylates can decrease the diuretic effect of spironolactone.

Global Rationale: Aspirin and other salicylates can decrease the diuretic effect of spironolactone. Hyperkalemia may occur if the client is also taking a potassium supplement. The effects of corticosteroids are increased with thiazides. Spironolactone decreases the effects of digoxin, which would not cause peripheral edema.

Answer to Question 2

Correct Answer: 4

Rationale 1: They can be taken on an as-needed basis is incorrect because all diuretics can cause dehydration and electrolyte imbalance, and should be taken on a regular schedule to monitor effectiveness.
Rationale 2: They do not cause electrolyte imbalance is incorrect because all diuretics can cause dehydration and electrolyte imbalance, and should be taken on a regular schedule to monitor effectiveness.
Rationale 3: Possible dehydration is not a factor is incorrect because all diuretics can cause dehydration and electrolyte imbalance, and should be taken on a regular schedule to monitor effectiveness.
Rationale 4: Side effects from thiazides are generally minor, and rarely cause discontinuation of therapy.

Global Rationale: Side effects from thiazides are generally minor, and rarely cause discontinuation of therapy. They can be taken on an as-needed basis is incorrect because all diuretics can cause dehydration and electrolyte imbalance, and should be taken on a regular schedule to monitor effectiveness. They do not cause electrolyte imbalance is incorrect because all diuretics can cause dehydration and electrolyte imbalance, and should be taken on a regular schedule to monitor effectiveness. Possible dehydration is not a factor is incorrect because all diuretics can cause dehydration and electrolyte imbalance, and should be taken on a regular schedule to monitor effectiveness.

[mpobi80]

Excellent

[bulacsom]

Gracias!