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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View Related questions
Correct Answer is A
Explanation
A) "Your breathing pattern causes this.": This statement accurately explains the phenomenon known as "tidaling." The rise and fall of fluid in the water-seal chamber is a normal response to the client’s breathing. As the client inhales, the negative pressure in the pleural space increases, causing the fluid level to rise, and it falls during exhalation. This indicates that the chest tube is functioning properly.
B) "This indicates a possible air leak.": An air leak would typically manifest as continuous bubbling in the water-seal chamber, not as tidaling. Tidaling is a normal finding, so this statement is misleading and does not accurately describe the situation.
C) "This means your lung is fully re-expanded.": While tidaling can be a sign of lung re-expansion, it does not definitively indicate that the lung is fully re-expanded. The presence of tidaling alone does not confirm complete re-expansion of the lung.
D) "Suction pressure that is too high causes this.": Suction pressure relates to the amount of suction applied to the drainage system, but it does not cause the normal rise and fall of fluid in the water-seal chamber. This statement is incorrect in the context of explaining the observed phenomenon.
Correct Answer is A
Explanation
A) Glycosylated hemoglobin level: The glycosylated hemoglobin (HbA1c) level is the most reliable indicator of long-term glycemic control in clients with diabetes mellitus. It reflects average blood glucose levels over the past 2 to 3 months, allowing healthcare providers to assess how well the treatment plan is working over time.
B) Oral glucose tolerance test results: The oral glucose tolerance test (OGTT) is primarily used for diagnosing diabetes rather than monitoring long-term control. It assesses how well the body processes glucose but does not provide an ongoing measure of glycemic control.
C) Postprandial blood glucose level: While monitoring postprandial blood glucose (the blood glucose level after meals) is important for managing daily glucose levels, it does not give a long-term perspective on glycemic control. This measurement can fluctuate significantly based on diet and activity levels.
D) Fasting blood glucose level: The fasting blood glucose level is useful for assessing daily glucose control, but it does not provide a comprehensive view of long-term glycemic management over months like the HbA1c level does.