A nurse is caring for a client who is being administered spironolactone (Aldactone). Which of the following laboratory values should be monitored due to taking this medication?
Troponins
Potassium
Albumin
Bicarbonate
The Correct Answer is B
A) Troponins: These are primarily used to assess for cardiac damage, such as in myocardial infarction. They are not directly related to the effects of spironolactone, so monitoring troponins is not necessary in this context.
B) Potassium: Spironolactone is a potassium-sparing diuretic, which can lead to elevated potassium levels (hyperkalemia). This can have serious implications, including cardiac arrhythmias. Therefore, it is crucial to monitor potassium levels regularly in clients taking
spironolactone to prevent potential complications.
C) Albumin: While albumin levels can provide information about the client's nutritional status and liver function, they are not specifically affected by spironolactone. Monitoring albumin is not a priority when considering the use of this medication.
D) Bicarbonate: Bicarbonate levels are important for assessing acid-base balance. Although spironolactone may have some impact on acid-base status, monitoring bicarbonate is not as critical as monitoring potassium levels, which are directly affected by the medication's action.
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View Related questions
Correct Answer is C
Explanation
A) Apply cold therapy to the affected leg: Cold therapy may be used for certain conditions to reduce swelling and pain, but in the case of suspected deep vein thrombosis (DVT) indicated by redness, warmth, tenderness, and pain in the calf, cold therapy is not appropriate. Instead, the focus should be on confirming the diagnosis before applying any treatment.
B) Monitor Homan's sign: Homan's sign involves dorsiflexion of the foot to assess for pain in the calf, which can suggest DVT. However, it is no longer considered a reliable diagnostic tool. Instead, confirmation through imaging or other diagnostic measures is preferred, so simply monitoring this sign would not be sufficient in this situation.
C) Obtain a venous duplex ultrasound: A venous duplex ultrasound is the gold standard for
diagnosing DVT. Given the client’s symptoms—redness, warmth, tenderness, and pain in the calf—the appropriate order is to obtain this ultrasound to confirm the presence of a thrombus. This imaging study provides critical information for diagnosis and subsequent management.
D) Obtain impedance plethysmography: While impedance plethysmography can assess venous flow and help diagnose DVT, it is less commonly used than venous duplex ultrasound. The more direct and widely accepted method for diagnosing DVT in this scenario is the ultrasound, making this option less suitable as the initial order.
Correct Answer is A
Explanation
A) Intermittent claudication: This term describes the leg pain and cramping that occurs during physical activity, such as walking, and is relieved by rest. It is a classic symptom of peripheral arterial disease (PAD) and results from insufficient blood flow to the muscles due to narrowed or blocked arteries. The client's description aligns perfectly with this definition.
B) Neuropathy: While neuropathy can cause leg pain, it typically presents differently, often with sensations like tingling, numbness, or burning rather than cramping during activity. Neuropathy does not specifically correlate with the pattern of pain relief upon resting, which is characteristic of intermittent claudication.
C) Deep vein thrombosis (DVT): DVT generally presents with symptoms like swelling, warmth, and tenderness in the affected leg, rather than cramping pain that is related to activity. The pain associated with DVT is not typically relieved by rest, making this option inconsistent with the client’s symptoms.
D) Venous insufficiency: This condition is characterized by symptoms such as swelling, varicosities, and skin changes, primarily in the lower extremities. Pain related to venous insufficiency tends to occur after prolonged standing or sitting and is not typically relieved by rest in the same way as intermittent claudication. Therefore, this option does not accurately describe the client’s experience.