The nurse is preparing to administer the third dose of aldactone (Spironolactone) to a patient with cirrhosis and ascites. What would cause the nurse to question the administration of this medication?
1. Serum creatinine of 1.6 mg/dL
2. Serum sodium of 130 mEq/L
3. Serum potassium of 5.7 mEq/L
4. Weight gain of 0.2 kg
3
Rationale 1: The serum creatinine of 1.6 mmol/L is within normal limits.
Rationale 2: The serum sodium of 130 mEq/l, even though it is low, does not meet the criteria to hold the medication.
Rationale 3: The nurse anticipates this potassium-sparing diuretic may be discontinued if the potassium level is greater than 5.3 mEq/L. This medication needs to be held or discontinued as this patient's potassium level is 5.7 mEq/L.
Rationale 4: A weight gain of 0.2 kg is not an indication to hold diuretics. The objective of diuretics is to reduce the ascites and peripheral edema.
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