A nurse is administering furosemide 80 mg PO twice daily to a client who has pulmonary edema. Which of the following assessment findings indicates to the nurse that the medication is effective?
Elevation in blood pressure
Respiratory rate of 24/min
Adventitious breath sounds
Weight loss of 1.8 kg (4 lb) in the past 24 hr
The Correct Answer is D
A) Elevation in blood pressure: An elevation in blood pressure is not an indicator of the effectiveness of furosemide. In fact, effective diuresis would typically lead to a reduction in blood pressure, especially in cases of pulmonary edema related to heart failure.
B) Respiratory rate of 24/min: A respiratory rate of 24/min indicates tachypnea, which is often associated with respiratory distress or ongoing pulmonary congestion. This finding does not suggest that the furosemide is effective; instead, it may indicate that further intervention is needed.
C) Adventitious breath sounds: The presence of adventitious breath sounds, such as wheezing or crackles, suggests ongoing fluid accumulation in the lungs and is not an indicator of effective diuresis. Effective treatment should lead to clearer breath sounds as fluid is removed.
D) Weight loss of 1.8 kg (4 lb) in the past 24 hr: This finding is a strong indicator of the effectiveness of furosemide. A significant weight loss, especially in a client with pulmonary edema, reflects a reduction in fluid overload. Since furosemide works by promoting diuresis, this weight loss suggests that the medication is effectively reducing excess fluid in the body.
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Correct Answer is A
Explanation
A) Assess urine output hourly. Monitoring urine output hourly is critical in the postoperative care of a client following a kidney transplant. It helps assess kidney function and detect any potential complications such as acute rejection or acute tubular necrosis early. Changes in urine output can provide important information about the client's fluid status and renal perfusion.
B) Check the client's blood pressure every 8 hr. While monitoring blood pressure is important, it is not sufficient to check it only every 8 hours in the immediate postoperative period. Blood pressure can fluctuate significantly due to factors such as fluid status, medication effects, and potential complications. More frequent monitoring, especially in the first 24 hours, is essential for timely intervention.
C) Monitor for hypokalemia as a manifestation of acute rejection. Hypokalemia is not typically a manifestation of acute rejection following a kidney transplant; rather, hyperkalemia is more commonly observed due to impaired kidney function. Therefore, focusing on monitoring for signs of hyperkalemia would be more relevant in this context.
D) Administer opioids PO. While pain management is crucial after surgery, opioids are often administered intravenously in the immediate postoperative period for better control and quicker action. Oral administration may be appropriate later when the client is stable and can tolerate oral medications.
Correct Answer is A
Explanation
A)"Yourproviderwouldn'tprescribethismedicationifitweren'tnecessary.":Thisresponsereassurestheclientthatthemedicationisprescribedbasedonaprofessionalevaluationoftheirhealthneeds.Itemphasizestheimportanceofthemedicationwhilevalidatingtheprovider'sexpertiseanddecision-making.
B)"Iwilltellyourproviderthatyoudonotwanttotakethismedication.":Whileit'sessentialtocommunicatetheclient'sconcernstotheprovider,thisresponsemightsuggestthatthenurseisdismissingtheimportanceofthemedicationratherthanaddressingtheclient'sapprehensions.
C)"Ifyoudon'ttakethismedication,youwillfeelworse.":Thisstatementcancomeacrossasconfrontationalandmaynoteffectivelyaddresstheclient'sconcernsorhelpthemunderstandtheimportanceoftakingthemedication.
D)"Mostclientsfeelbetteraftertakingtheantibiotic.":Whilethisstatementmightbetrue,itissomewhatgenericanddoesn'tdirectlyaddresstheclient'sspecificconcernsortherationalebehindtheprescription.