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A nurse is caring for a group of clients. The nurse should monitor which of the following clients for manifestations of hypokalemia? (Select all that apply.)

A.

A client taking prednisone.

B.

A client taking torsemide.

C.

A client taking polystyrene sulfonate.

D.

A client taking spironolactone.

E.

A client taking hydrochlorothiazide.

Question Solution

Correct Answer : A,B,C,E

Choice A rationale


Prednisone, a corticosteroid, can cause hypokalemia by increasing renal potassium excretion.


Choice B rationale


Torsemide, a loop diuretic, can lead to hypokalemia by promoting potassium loss through urine.


Choice C rationale


Polystyrene sulfonate is used to treat hyperkalemia, but it can cause hypokalemia as it removes potassium from the body.


Choice D rationale


A client taking spironolactone does not require monitoring for hypokalemia because spironolactone is a potassium-sparing diuretic. It helps the body retain potassium, so it is more likely to cause hyperkalemia (high potassium levels) than hypokalemia.


Choice E rationale


Hydrochlorothiazide, a thiazide diuretic, can cause hypokalemia by increasing potassium excretion in the urine.


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Correct Answer is B

Explanation

Choice A rationale

Monitoring for weight gain is not a primary concern with pramlintide. Pramlintide is an amylin analog used to control postprandial blood glucose levels. Weight gain is not a typical side effect of pramlintide; instead, it may cause weight loss due to its effects on appetite suppression and delayed gastric emptying.

Choice B rationale

Monitoring for hypoglycemia for 3 hours after pramlintide administration is crucial. Pramlintide can increase the risk of insulin-induced hypoglycemia, especially in patients with type 1 diabetes. This is because pramlintide slows gastric emptying and suppresses glucagon secretion, which can lead to lower blood glucose levels.

Choice C rationale

Injecting pramlintide in the upper arm is not recommended. Pramlintide should be administered subcutaneously in the abdomen or thigh, not the upper arm, to ensure proper absorption and effectiveness.

Choice D rationale

Administering pramlintide 30 minutes prior to a meal is incorrect. Pramlintide should be administered immediately before meals to help control postprandial blood glucose levels effectively.

Correct Answer is C

Explanation

Choice A rationale

Mannitol is an osmotic diuretic used primarily to reduce intracranial pressure (ICP) and treat cerebral edema. It does not affect thyroxine levels, which are related to thyroid function. Thyroxine levels are regulated by the thyroid gland and are not influenced by mannitol administration.

Choice B rationale

Mannitol is not used to correct atrial flutter. Atrial flutter is a type of arrhythmia that requires specific antiarrhythmic medications or procedures such as cardioversion. Mannitol’s primary action is to increase osmotic pressure in the kidneys, leading to diuresis and reduction of fluid in tissues, including the brain.

Choice C rationale

Mannitol is effective in reducing intracranial pressure by creating an osmotic gradient that draws fluid from the brain tissue into the bloodstream, which is then excreted by the kidneys. This reduction in intracranial pressure is a desired therapeutic outcome when treating conditions like cerebral edema.

Choice D rationale

Mannitol does not increase hemoglobin levels. Hemoglobin levels are influenced by factors such as red blood cell production and destruction, iron levels, and overall health status. Mannitol’s mechanism of action is related to fluid balance and diuresis, not hematopoiesis.

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