A patient has 2+ pitting edema of the lower extremities bilaterally. Auscultation of the lungs reveals crackles bilaterally, and the serum potassium level is 6 mEq/L. Which diuretic agent ordered by the prescriber should the nurse question?
a. Bumetanide (Bumex)
b. Furosemide (Lasix)
c. Spironolactone (Aldactone)
d. Hydrochlorothiazide (HydroDIURIL)
ANS: C
Spironolactone is a non–potassium-wasting diuretic; therefore, if the patient has a serum potassium level of 6 mEq/L, indicating hyperkalemia, an order for this drug should be questioned. Bumetanide, furosemide, and hydrochlorothiazide are potassium-wasting diuretics and would be appropriate to administer in a patient with hyperkalemia.
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