A patient is scheduled to receive high-dose cyclophosphamide via an intravenous infusion as treatment for cancer. Which will be most important for the nurse to include when teaching the patient about cyclophosphamide?

Correct Answer: B

Rationale: Cyclophosphamide can cause hemorrhagic cystitis, a serious side effect resulting from the irritation of the bladder lining by its metabolites. To prevent this, patients must maintain high fluid intake (at least 2 liters per day) to dilute the urine and flush out the bladder. While emptying the bladder regularly is important, it is secondary to ensuring adequate hydration. Limiting fluid intake is contraindicated, as it increases the risk of bladder toxicity. An indwelling urinary catheter is not routinely required unless the patient has urinary retention.

Correct Answer: D

Rationale: Nesiritide, also known as Natrecor, is a medication commonly used in the treatment of acute decompensated heart failure (ADHF) with dyspnea at rest. It is a recombinant form of B-type natriuretic peptide (BNP) which helps to improve cardiac function and alleviate symptoms of heart failure, such as dyspnea. Nesiritide works by promoting vasodilation and increasing diuresis, which can help reduce the workload on the heart and improve cardiac output. Therefore, in the case of a patient with acute decompensated heart failure and dyspnea at rest, the nurse would anticipate the administration of Nesiritide to help improve the patient's condition.

Correct Answer: A

Rationale: Spironolactone is a potassium-sparing diuretic, which belongs to the aldosterone receptor antagonists. It works by inhibiting aldosterone activity in the distal convoluted tubule and collecting ducts of the kidney. Aldosterone promotes sodium reabsorption in exchange for potassium and hydrogen ions. By blocking aldosterone, Spironolactone allows for increased excretion of sodium while retaining potassium and hydrogen ions, making it a suitable choice for patients who need to maintain potassium levels or are at risk for hypokalemia.

Correct Answer: C

Rationale: Morphine is an opioid analgesic that can cause respiratory depression as a serious side effect. Decreased respirations are a critical finding because they indicate that the patient may not be receiving adequate oxygenation, which can lead to hypoxia, brain damage, or even death. Increased temperature, decreased bowel sounds, and increased red blood cell count are less concerning in this context. Nurses must monitor respiratory rates closely in patients receiving morphine and be prepared to intervene with naloxone if respiratory depression occurs.

Correct Answer: B

Rationale: Spironolactone is a potassium-sparing diuretic, which means that it helps the body get rid of excess sodium and water while retaining potassium. This is accomplished by blocking the action of aldosterone, a hormone that normally causes the kidneys to retain sodium and water and excrete potassium. Potassium-sparing diuretics like spironolactone are often used in conjunction with other diuretics to prevent potassium loss and maintain electrolyte balance. In contrast, options A, C, and D (Furosemide, Hydrochlorothiazide, Bumetanide) are loop diuretics or thiazide diuretics which promote the excretion of both sodium and potassium.