A nurse is administering bumetanide to a client who has ascites. The nurse should recognize that which of the following findings is an expected therapeutic effect of this medication?
Decreased excretion of urine sodium.
Increased urinary output.
Decreased serum glucose.
Increased blood pressure.
The Correct Answer is B
Choice A rationale
Decreased excretion of urine sodium is not an expected therapeutic effect of bumetanide. Bumetanide is a loop diuretic that works by inhibiting the reabsorption of sodium and chloride in the ascending loop of Henle, leading to increased excretion of sodium and water.
Choice B rationale
Increased urinary output is the expected therapeutic effect of bumetanide. As a potent loop diuretic, bumetanide increases the excretion of water and electrolytes, which helps reduce fluid accumulation in conditions like ascites.
Choice C rationale
Decreased serum glucose is not associated with bumetanide. Bumetanide primarily affects fluid and electrolyte balance and does not have a significant impact on blood glucose levels.
Choice D rationale
Increased blood pressure is not an expected effect of bumetanide. On the contrary, bumetanide can help lower blood pressure by reducing fluid volume and decreasing the workload on the heart.
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Correct Answer is A
Explanation
Choice A rationale
A neutrophil count of 650/mm³ is significantly lower than the normal range (2,500 to 8,000/mm³) and indicates neutropenia, which is a known adverse effect of zidovudine. Neutropenia increases the risk of infections and requires close monitoring and potential dose adjustment or discontinuation of the medication.
Choice B rationale
A platelet count of 450,000/mm³ is slightly above the normal range (150,000 to 400,000/mm³) but is not typically associated with zidovudine toxicity. Zidovudine is more commonly associated with bone marrow suppression leading to anemia and neutropenia rather than thrombocytosis.
Choice C rationale
An Hgb level of 17 g/dL is above the normal range for females (12 to 16 g/dL) but is not a common adverse effect of zidovudine. Zidovudine is more likely to cause anemia, leading to lower hemoglobin levels rather than elevated levels.
Choice D rationale
A creatinine level of 1.5 mg/dL is within the upper limit of the normal range (0.5 to 1 mg/dL) and is not a typical adverse effect of zidovudine. Zidovudine primarily affects the bone marrow and does not have a significant impact on renal function.
Correct Answer is A
Explanation
Choice A rationale
Gargling with water after using a beclomethasone inhaler helps prevent oral candidiasis (thrush), a common side effect of inhaled corticosteroids.
Choice B rationale
Using a spacer with a beclomethasone inhaler can help improve drug delivery to the lungs and reduce the risk of side effects. It is generally recommended to use a spacer with inhaled corticosteroids.
Choice C rationale
Beclomethasone is not a rescue inhaler and should not be used for acute incidents of shortness of breath. It is a maintenance medication used to control chronic asthma symptoms.
Choice D rationale
Albuterol should be used before beclomethasone to open the airways and enhance the absorption of the corticosteroid. Using beclomethasone first does not increase absorption and is not the recommended practice.