A nurse is caring for a client who receives furosemide to treat heart failure. Which of the following laboratory values should the nurse monitor for this client due to this medication?
Cortisol
Bicarbonate
Albumin
Potassium
The Correct Answer is D
A. Cortisol levels are not directly affected by furosemide; monitoring for adrenal function is not a priority.
B. Bicarbonate levels are not specifically monitored for clients on furosemide; this medication's main effect does not relate directly to bicarbonate balance.
C. Albumin levels are not primarily affected by furosemide; although low albumin can affect fluid status, it is not the critical monitoring focus.
D. Potassium levels should be monitored because furosemide is a loop diuretic that can lead to hypokalemia, which is a common and significant side effect due to increased renal excretion of potassium.
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Correct Answer is A
Explanation
A. A phlebotomist collecting blood from clients who have HIV is at the greatest risk due to the potential for exposure to infected blood, especially if safety precautions are not properly followed.
B. A nurse working for an insurance company collecting urine samples is at a lower risk, as urine is not a primary mode of HIV transmission.
C. A personal trainer working with a client who has HIV may be at risk if there are open wounds, but the risk is less compared to healthcare workers directly handling blood.
D. An occupational therapist working with a client who has HIV may have some exposure risk, but it is significantly lower than that of a phlebotomist who handles blood samples.
Correct Answer is D
Explanation
A. Encouraging oral intake may not be effective due to the patient's likely need for more rapid rehydration given his low blood pressure and heart rate.
B. A potassium-sparing diuretic is inappropriate in this situation, as the patient is already experiencing fluid loss and requires rehydration, not diuresis.
C. Restricting fluid intake would be contraindicated as the patient is in a state of dehydration and hypotension.
D. Administering an IV bolus of normal saline is the priority intervention to quickly restore fluid volume and improve blood pressure and hydration status.