Spironolactone (Aldactone) is prescribed for a client diagnosed with hypertension. The nurse recognizes which information as providing the most support for the use of this drug?
1. Diagnosis of hepatic failure
2. Insufficient therapeutic response to hydrochlorothiazide
3. Insufficient therapeutic response to furosemide (Lasix)
4. Diagnosis of renal failure
Correct Answer: 1
Rationale 1: Hepatic failure is accompanied by increased production of aldosterone, which increases reabsorption of sodium and water in the distal tubule and collecting ducts. Spironolactone (Aldactone) achieves a diuretic effect by blocking the effects of aldosterone.
Rationale 2: The diuretic effect of spironolactone (Aldactone) is weaker than the effect of thiazides.
Rationale 3: The diuretic effect of spironolactone (Aldactone) is weaker than that of loop diuretics.
Rationale 4: Diagnosis of renal failure might represent renal disease, which could be an indication for diuretic therapy, but it is not a specific indicator for use of spironolactone (Aldactone).
Global Rationale: Hepatic failure is accompanied by increased production of aldosterone, which increases reabsorption of sodium and water in the distal tubule and collecting ducts. Spironolactone (Aldactone) achieves a diuretic effect by blocking the effects of aldosterone. The diuretic effect of spironolactone (Aldactone) is weaker than the effect of thiazides or loop diuretics. Diagnosis of renal failure might represent renal disease, which could be an indication for diuretic therapy, but it is not a specific indicator for use of spironolactone (Aldactone).
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