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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Correct Answer is D
Explanation
A) Tachycardia: Propranolol is often used to manage tachycardia by reducing heart rate and controlling excessive adrenergic activity. Therefore, this diagnosis would not warrant clarification of the order; it is an appropriate use of the medication.
B) End-stage kidney failure: While caution is necessary when administering medications in clients with renal impairment, propranolol is primarily metabolized by the liver, and its use is not contraindicated in end-stage kidney failure. However, renal function can affect dosing, so monitoring would be important, but this diagnosis alone wouldn't require clarification.
C) Hypertension: Propranolol is commonly prescribed to manage hypertension, making this diagnosis a valid reason for the medication order. The use of propranolol in this context would not need clarification.
D) Asthma: Propranolol is a non-selective beta-blocker, which can cause bronchoconstriction and exacerbate asthma symptoms. This diagnosis would require the nurse to clarify the order, as beta-blockers are generally contraindicated in clients with asthma due to the risk of respiratory complications. If the client has reactive airway disease, an alternative medication should be considered.
Correct Answer is B
Explanation
A. Within the expected reference range: While a blood pressure of 130/82 mm Hg is close to normal, it is not considered fully within the expected reference range. The normal range is typically defined as less than 120/80 mm Hg.
B. Elevated: The reading of 130/82 mm Hg falls into the "elevated" category, which is defined as systolic blood pressure between 120-129 mm Hg and diastolic pressure less than 80 mm Hg. This indicates that while the client is not hypertensive, they are at increased risk for developing hypertension in the future.
C. Stage 2 hypertension: This category is defined by a systolic reading of 140 mm Hg or higher, or a diastolic reading of 90 mm Hg or higher. The client’s reading does not meet these criteria, so this option is not applicable.
D. Stage 1 hypertension: Stage 1 hypertension is characterized by systolic readings between 130-139 mm Hg and diastolic readings between 80-89 mm Hg. Although the systolic reading is in the Stage 1 range, the diastolic reading of 82 mm Hg places the overall reading in the "elevated" category, rather than Stage 1 hypertension.