A 70-year-old male receiving high-dose IV furosemide for heart failure complains of ringing in his ears and dizziness. His current labs show normal potassium and sodium levels. What is the nurse's most appropriate intervention?
Increase the infusion rate and check the patient's sodium levels again in 2 hours
Administer potassium supplements and continue the infusion
Reassure the patient that the symptoms are temporary and continue monitoring
Stop the furosemide infusion and notify the provider
The Correct Answer is D
A. Increasing the infusion rate may exacerbate the patient's symptoms and does not address the potential toxicity from the furosemide.
B. Normal potassium levels indicate that potassium supplementation is unnecessary and does not address the dizziness and ringing in the ears, which could suggest ototoxicity from furosemide.
C. While reassurance can help, the patient's symptoms indicate a potential adverse reaction to the medication that should not be ignored.
D. Stopping the furosemide infusion and notifying the provider is the most appropriate action due to the risk of ototoxicity and the need for further evaluation of the patient's symptoms.
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Correct Answer is B
Explanation
A. Fluid overload is not an allergic reaction but rather a complication of transfusion related to the volume of fluid administered, thus diphenhydramine would not be appropriate.
B. Urticaria, or hives, is a common mild allergic reaction that can occur during blood transfusions. Administering diphenhydramine can help prevent or treat this response.
C. Hemolysis is a serious reaction involving the destruction of red blood cells, often due to blood type incompatibility; it is not alleviated by antihistamines.
D. Fever can occur during transfusions but is typically due to non-specific immune reactions and does not respond to diphenhydramine.
Correct Answer is A
Explanation
A. A phlebotomist collecting blood from clients who have HIV is at the greatest risk due to the potential for exposure to infected blood, especially if safety precautions are not properly followed.
B. A nurse working for an insurance company collecting urine samples is at a lower risk, as urine is not a primary mode of HIV transmission.
C. A personal trainer working with a client who has HIV may be at risk if there are open wounds, but the risk is less compared to healthcare workers directly handling blood.
D. An occupational therapist working with a client who has HIV may have some exposure risk, but it is significantly lower than that of a phlebotomist who handles blood samples.