The nurse is admitting an older adult with decompensated congestive heart failure. The nursing assessment reveals adventitious lung sounds, dyspnea, and orthopnea. The nurse should question which doctor's order?
a. Intravenous (IV) 500 mL of 0.9% NaCl at 125 mL/hr
b. Furosemide (Lasix) 20 mg PO now
c. Oxygen via face mask at 8 L/min
d. KCl 20 mEq PO two times per day
ANS: A
A patient with decompensated heart failure has extracellular fluid volume (ECV) excess. The IV of 0.9% NaCl is normal saline, which should be questioned because it would expand ECV and place an additional load on the failing heart. Diuretics such as furosemide are appropriate to decrease the ECV during heart failure. Increasing the potassium intake with KCl is appropriate, because furosemide increases potassium excretion. Oxygen administration is appropriate in this situation of near pulmonary edema from ECV excess.
You might also like to view...
A nurse is facilitating a social skills group on the inpatient unit for nursing assistants. Which comment would the nurse identify as assertive?
a. "I enjoy my work. I do all my own work, and so I seldom have time to help others. I would if I had the time.". b. "I love my work. I try to help others whenever they ask because on our unit it's certainly a team effort.". c. "I enjoy my work. I always try to be helpful, but I am careful not to help those who aren't willing to help others.". d. "I enjoy my work. I help others after I have spent sufficient time with my patients and feel my assistance is needed.".
A client is taking a diuretic such as Lasix. When implementing client teaching, what information should be included?
A) Increased sodium levels B) Increased potassium levels C) Decreased potassium levels D) Decreased oxygen levels
Dense bands of connective tissue that connect bones to bones at the joints are called ________.
Fill in the blank(s) with the appropriate word(s).
The use of which of the following medication can precipitate acute renal failure in a patient with bilateral renal artery stenosis?
A. corticosteroids B. Angiotensin II receptor antagonists C. beta-adrenergic antagonists D. Cephalosporins