A patient with chronic congestive heart failure has repeated hospitalizations in spite of ongoing treatment with hydrochlorothiazide (HydroDIURIL) and digoxin
The prescriber has ordered spironolactone (Aldactone) to be added to this patient's drug regimen, and the nurse provides education about this medication. Which statement by the patient indicates understanding of the teaching?
a. "I can expect improvement within a few hours after taking this drug."
b. "I need to stop taking potassium supplements."
c. "I should use salt substitutes to prevent toxic side effects."
d. "I should watch closely for dehydration."
ANS: B
Spironolactone is a potassium-sparing diuretic used to counter the potassium-wasting effects of hydrochlorothiazides. Patients taking potassium supplements are at risk for hyperkalemia when taking this medication, so they should be advised to stop the supplements. Spironolactone takes up to 48 hours to have effects. Salt substitutes contain high levels of potassium and are contraindicated. Spironolactone is a weak diuretic, so the risk of dehydration is not increased.
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