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 client taking prednisone.
A client taking torsemide.
A client taking polystyrene sulfonate.
A client taking spironolactone.
A client taking hydrochlorothiazide.
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 A
Explanation
Choice A rationale
Elevated alanine aminotransferase (ALT) is an adverse effect of simvastatin therapy. Statins, including simvastatin, can cause liver damage, which is indicated by elevated liver enzymes such as ALT2.
Choice B rationale
Elevated troponin T is not typically associated with simvastatin therapy. Troponin T is a marker for cardiac muscle damage, not a common adverse effect of statins.
Choice C rationale
Elevated WBC count is not a known adverse effect of simvastatin therapy. An elevated WBC count usually indicates an infection or inflammation.
Choice D rationale
Elevated thyroid-stimulating hormone (TSH) is not associated with simvastatin therapy. TSH levels are related to thyroid function, not the effects of statins.
Correct Answer is A
Explanation
Choice A rationale
Gargling with water after using a beclomethasone inhaler helps prevent oral candidiasis (thrush), a common side effect of inhaled corticosteroids.
Choice B rationale
Using a spacer with a beclomethasone inhaler can help improve drug delivery to the lungs and reduce the risk of side effects. It is generally recommended to use a spacer with inhaled corticosteroids.
Choice C rationale
Beclomethasone is not a rescue inhaler and should not be used for acute incidents of shortness of breath. It is a maintenance medication used to control chronic asthma symptoms.
Choice D rationale
Albuterol should be used before beclomethasone to open the airways and enhance the absorption of the corticosteroid. Using beclomethasone first does not increase absorption and is not the recommended practice.