chapter 38 diuretics mccuistion pharmacology a patient centered nursing process approach
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TEST
TEST BANK FORPHARMACOLOGY
BANK FOR PHARMACOLOGY10TH10TH EDITION
EDITION BY MCCUSTION
BY MCCUISTION
Chapter 38: Diuretics
McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 10th
Edition
MULTIPLE CHOICE
1. The Clinical Officer is preparing to administer the first dose of hydrochlorothiazide
(HydroDIURIL) 50mg to a patient who has a blood pressure of 160/95 mm Hg. The Clinical
Officer notes that the patient had a urine output of 200 mL in the past 12 hours. The Clinical
Officer will perform which action?
a. Administer the medication as ordered.
b. Encourage the patient to drink more fluids.
c. Hold the medication and request an order for serum BUN (blood urea nitrogen)
and creatinine.
d. Request an order for serum electrolytes and administer the medication.
ANSWER: C
Thiazide diuretics are contraindicated in renal failure. This patient has oliguria and should be
evaluated for renal failure prior to administration of the diuretic—especially in the absence of
known renal failure for this patient. Drinking more fluids will not increase urine output in
patients with renal failure.
2. The Clinical Officer is preparing to administer doses of hydrochlorothiazide (HydroDIURIL)
N
and digoxin (Lanoxin) to a patient who has heart failure. The patient reports having blurred
vision.The Clinical Officer notes a heart rate of 60 beats per minute and a blood pressure of
140/78 mm Hg. Which action will the Clinical Officer take?
a. Administer the medications and request an order for serum electrolytes.
b. Give both medications and evaluate serum blood glucose frequently.
c. Hold the digoxin and notify the provider.
d. Hold the hydrochlorothiazide and notify the provider.
ANSWER: C
When thiazide diuretics are taken with digoxin, patients are at risk of digoxin toxicity because
thiazides can cause hypokalemia. The patient has bradycardia and blurred vision, which are
both signs of digoxin toxicity. The Clinical Officer should hold the digoxin and notify the
provider.
Serum electrolytes may be ordered, but the digoxin should not be given.
3. The Clinical Officer is teaching a patient about taking hydrochlorothiazide. Which
statement by the patient indicates a need for further teaching?
a. “I may need extra sodium and calcium while taking this drug.”
b. “I should eat plenty of fruits and vegetables while taking this medication.”
c. “I should take care when rising from a bed or chair when I’m starting this
medication.”
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