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 C
Explanation
A) Lidocaine: Lidocaine is primarily used for the management of ventricular arrhythmias, particularly in cases of ventricular tachycardia or ventricular fibrillation. It is not indicated for treating sinus bradycardia and ST segment elevation.
B) Digoxin: Digoxin is used to treat atrial fibrillation and heart failure but is not appropriate for acute management of sinus bradycardia. In fact, digoxin can potentially worsen bradycardia by increasing vagal tone.
C) Atropine: Atropine is the drug of choice for acute management of symptomatic bradycardia. It works by blocking the effects of the vagus nerve on the heart, which can increase heart rate. Given the client's symptoms of shortness of breath and dizziness, atropine is appropriate to help stabilize their condition.
D) Sotalol: Sotalol is an antiarrhythmic medication used primarily for atrial fibrillation and ventricular arrhythmias. It is not indicated for the treatment of bradycardia and may even exacerbate the condition.
Correct Answer is A
Explanation
A) "Apply a second pair of gloves before touching the client's implant if it dislodges.": This is the correct action. If a sealed radiation implant dislodges, the nurse should wear a second pair of gloves to minimize exposure to radiation while handling the implant. This is a crucial safety measure to protect both the nurse and others in the environment.
B) "Limit family member visits to 30 min per day.": While it is important to limit the time family members spend with a patient who has a sealed radiation implant, the specific duration can vary based on institutional policies and the level of radiation. It may not be necessary to restrict visits to exactly 30 minutes.
C) "Give the dosimeter badge to the oncoming nurse at the end of the shift.": The dosimeter badge should not be passed to another nurse. Each nurse should wear their own badge to accurately measure their individual exposure to radiation. It should be kept by the individual nurse throughout their shifts.
D) "Remove soiled linens from the room after each change.": This statement is misleading. Soiled linens should be handled with care and may need to be treated as radioactive waste depending on the facility's protocols. They should not be removed without following proper safety and disposal guidelines.