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STUVIA 2024/2025Chapter 38: Diuretics
1. The nurse is preparing to administer the first dose of hydrochlorothiazide (HydroDIURIL) 50 mg to
a patient who has a blood pressure of 160/95 mm Hg. The nurse notes that the patient had a urine
output of 200 mL in the past 12 hours. The nurse will perform which action?
a. Administer the medication as ordered.
b. Encourage the patient to drink more fluids.
c. Hold the medication and request an order for serum BUN (blood urea nitrogen) and creatinine.
d. Request an order for serum electrolytes and administer the medication. - ✔✔ANS: C
Thiazide diuretics are contraindicated in renal failure. This patient has oliguria and should be
evaluated for renal failure prior to administration of the diuretic—especially in the absence of known
renal failure for this patient. Drinking more fluids will not increase urine output in patients with renal
failure.
A patient has been taking spironolactone (Aldactone) to treat heart failure. The nurse will monitor for
which of the following electrolyte abnormalities?
a. hyperkalemia.
b. hypermagnesemia.
c. hypocalcemia.
%
d. hypoglycemia. - ✔✔ANS: A
Spironolactone is a potassium-sparing diuretic and can induce hyperkalemia.
A patient has begun taking spironolactone (Aldactone) in addition to a thiazide diuretic. With the
addition of the spironolactone, the nurse will counsel this patient to do which of the following?
a. continue taking a potassium supplement daily.
b. recognize that abdominal cramping is a transient side effect.
c. report decreased urine output to the provider.
d. take these medications at bedtime. - ✔✔ANS: C
Caution must be used when giving potassium-sparing diuretics to patients with poor renal function, so
patients should be taught to report a decrease in urine output. Patients taking potassium-sparing
diuretics are at risk for hyperkalemia, so they should not take potassium supplements. Abdominal
cramping should be reported to the provider. The medications should be taken in the morning for
patients who sleep during the night.
The nurse is caring for a patient who develops marked edema and a low urine output as a result of
heart failure. Which medication will the nurse expect the provider to order for this patient?
a. Digoxin (Lanoxin)
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