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 A
Explanation
A. Respiratory acidosis is characterized by a low pH (7.32) and an elevated PaCO2 (48 mm Hg), indicating that the body is unable to eliminate CO2 effectively, leading to acid retention. The HCO3 level is within normal limits, suggesting that there is not a metabolic compensation occurring yet.
B. Metabolic alkalosis would present with a high pH and elevated bicarbonate levels, which is not the case here.
C. Respiratory alkalosis typically shows a high pH and low PaCO2, indicating hyperventilation, which does not align with the current findings.
D. Metabolic acidosis would show a low pH with a low HCO3, which is not supported by the HCO3 level of 23 mEq/L in this case.
Correct Answer is C
Explanation
A. Pneumocystis lung infection is an opportunistic infection that typically occurs in later stages of HIV/AIDS when the immune system is significantly weakened, not during the initial phase of infection.
B. Fungal and bacterial infections are also associated with advanced HIV/AIDS due to immunosuppression and not seen in the initial phase of infection.
C. Flu-like symptoms and night sweats are common initial symptoms of HIV infection, often occurring 2-4 weeks after exposure during the acute retroviral syndrome phase.
D. Kaposi's sarcoma is a cancer associated with advanced HIV/AIDS and does not manifest during the initial symptoms of infection.