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 or-dered by the prescriber should the nurse question?
a. Bumetanide (Bumex)
b. Furosemide (Lasix)
c. Spironolactone (Aldactone)
d. Hydrochlorothiazide (HydroDIURIL)
C
Spironolactone is a non-potassium-wasting diuretic; therefore, if the patient has a serum potas-sium level of 6 mEq/L, indicating hyperkalemia, an order for this drug should be questioned.
Bumetanide and furosemide are potassium-wasting diuretics and would be appropriate to admi-nister in a patient with hyperkalemia.
Hydrochlorothiazide is a partially potassium-sparing diuretic and would not be contraindicated in this patient.
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