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 C
Explanation
Choice A rationale
Crushing hydroxychloroquine tablets can alter the drug’s release and absorption, potentially leading to suboptimal therapeutic effects or increased side effects.
Choice B rationale
Discontinuing hydroxychloroquine when symptoms subside can lead to a flare-up of rheumatoid arthritis symptoms. It is important to continue the medication as prescribed to maintain disease control.
Choice C rationale
Regular eye exams are necessary while taking hydroxychloroquine because the medication can cause retinal toxicity, which can lead to vision changes or loss if not monitored and managed appropriately.
Choice D rationale
Taking a double dose of hydroxychloroquine can increase the risk of side effects and toxicity. It is important to take the medication as prescribed and not to double up on doses.
Correct Answer is B
Explanation
Choice A rationale
Repeating up to four doses until pain is relieved is incorrect. The correct instruction is to take one tablet at the onset of pain and repeat every 5 minutes if needed, up to a maximum of three tablets in 15 minutes.
Choice B rationale
Storing unused tablets at room temperature is correct. Nitroglycerin tablets should be stored in their original container at room temperature, away from moisture and heat.
Choice C rationale
Taking two tablets at the onset of pain is incorrect. The correct instruction is to take one tablet at the onset of pain and repeat every 5 minutes if needed, up to a maximum of three tablets in 15 minutes.
Choice D rationale
Taking the medication two hours prior to exercise is incorrect. Nitroglycerin should be taken 5 to 10 minutes before an activity that may cause chest pain.