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 D
Explanation
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B) "I will drink whole milk with my cereal.": Whole milk is higher in saturated fat and cholesterol, which can contribute to cardiovascular issues. Low-fat or non-fat milk would be a more appropriate choice for someone with cardiovascular disease.
C) "I will limit my portions of meat to 8 ounces.": While portion control is important, this statement does not reflect an understanding of the type of meat to consume. It’s not just about the portion size but also about choosing lean meats and limiting red and processed meats.
D) "I will use canola oil when making salad dressing.": This statement shows an understanding of dietary recommendations for cardiovascular health. Canola oil is a healthier choice due to its lower saturated fat content and higher levels of heart-healthy monounsaturated fats, making it a better option for someone managing cardiovascular disease.
Correct Answer is B
Explanation
A) Chloride level: Chloride levels are generally not affected by gout. While electrolyte imbalances can occur in various conditions, they are not specifically associated with acute gout attacks.
B) Uric acid: An increase in uric acid levels is expected in clients with acute gout. Gout is caused by the accumulation of uric acid crystals in the joints, leading to inflammation and pain. Monitoring uric acid levels is crucial for diagnosing and managing this condition.
C) Creatinine kinase: Creatinine kinase levels are typically elevated in conditions related to muscle damage or injury, rather than gout. While some muscle soreness may occur during a gout flare, it is not a primary indicator for this condition.
D) Intrinsic factor: Intrinsic factor is related to vitamin B12 absorption and is not relevant to gout. It is primarily associated with conditions like pernicious anemia rather than gout or uric acid metabolism.