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","B","C","D"]
Explanation
A) "I will apply my compression stockings." Compression stockings are a standard recommendation for clients with peripheral venous disease (PVD). They help improve venous return and reduce symptoms like swelling and discomfort, indicating that the client understands the importance of managing their condition.
B) "I will limit long periods of standing." This statement reflects an understanding of the need to avoid activities that can exacerbate venous stasis and contribute to worsening symptoms in PVD. Limiting long periods of standing helps promote better blood flow and reduces the risk of complications.
C) "I may develop a brownish discoloration to my lower extremities." This statement indicates an awareness of a potential complication of PVD, often caused by venous stasis and pooling of blood. Brownish discoloration, or stasis dermatitis, can occur in the lower extremities, showing the client’s understanding of the condition.
D) "With this problem, I may have lower extremity hair loss." This statement is accurate as well; hair loss on the lower extremities can occur with PVD due to reduced blood flow and oxygen supply to the tissues. This recognition indicates that the client understands the potential effects of their diagnosis.
E) "I will only take my cholesterol lowering medication every other day in the afternoon." This statement reflects a misunderstanding of medication management. Clients with PVD should take prescribed medications as directed to manage their condition effectively, and altering the dosing schedule without consulting a healthcare provider can lead to adverse outcomes.