The client with a diagnosis of heart failure is receiving furosemide (Lasix). Which laboratory value is most important for the nurse to monitor?

Correct Answer: C

Rationale: In the context of a client with heart failure receiving furosemide (Lasix), the most important laboratory value for the nurse to monitor is serum potassium (Option C). Furosemide is a loop diuretic that works by promoting the excretion of water and electrolytes, including potassium, from the body. Hypokalemia (low potassium levels) is a common side effect of furosemide therapy and can lead to serious cardiac complications, especially in patients with heart failure. Monitoring serum potassium levels is crucial to prevent adverse effects such as cardiac dysrhythmias, muscle weakness, and potential worsening of heart failure symptoms. Therefore, regular assessment of potassium levels allows for prompt intervention, such as potassium supplementation or adjusting the dosage of furosemide, to maintain electrolyte balance and optimize the client's cardiac function. Regarding the other options: - Blood glucose (Option A) is not directly related to furosemide therapy in heart failure. - Serum sodium (Option B) may be affected by furosemide but is not as critical as monitoring potassium levels in this context. - Blood urea nitrogen (BUN) (Option D) is an indicator of kidney function but is not the most crucial parameter to monitor when assessing the impact of furosemide on a client with heart failure. Understanding the rationale behind prioritizing serum potassium monitoring in this scenario is essential for nurses caring for clients with heart failure receiving diuretic therapy. It emphasizes the significance of anticipating and managing potential electrolyte imbalances to promote positive patient outcomes and prevent complications related to medication therapy.

Correct Answer: B

Rationale: In the case of a suspected myocardial infarction (MI), the immediate diagnostic test that the nurse should prepare the client for is an Electrocardiogram (ECG). This is the correct answer because an ECG is a quick and effective way to assess the electrical activity of the heart. In the context of a suspected MI, an ECG can quickly identify abnormal heart rhythms, ischemia, and areas of infarction, guiding immediate treatment decisions. The other options can be ruled out with the following explanations: A) Chest x-ray: While a chest x-ray can provide information about the size and shape of the heart and the presence of fluid in the lungs, it is not the most immediate or specific test for diagnosing an MI. C) Echocardiogram: An echocardiogram is a valuable test for assessing heart structure and function, but it is not typically the first-line diagnostic test in the acute setting of a suspected MI. D) Coronary angiography: Coronary angiography is an invasive procedure used to visualize the coronary arteries and is not typically performed as an initial diagnostic test in the emergency setting of a suspected MI. Educationally, understanding the rationale behind selecting the correct diagnostic test in a time-sensitive situation like a suspected MI is crucial for nurses to provide prompt and effective care. By knowing the appropriate diagnostic tests and their implications, nurses can intervene quickly to improve patient outcomes and collaborate effectively with the healthcare team.

Correct Answer: C

Rationale: In the context of pharmacology and the management of COPD, it is essential for nurses to understand the signs of theophylline toxicity. The correct answer is C) Nausea. Theophylline is a medication commonly used in COPD to help dilate the airways. However, it has a narrow therapeutic window, meaning that it can easily lead to toxicity if the levels in the body become too high. Nausea is a common early sign of theophylline toxicity and should prompt immediate intervention to prevent further complications. Option A) Drowsiness is a common side effect of theophylline but is not specific to toxicity. Bradycardia (Option B) is not typically associated with theophylline toxicity; in fact, theophylline is more likely to cause tachycardia. Constipation (Option D) is also not a typical sign of theophylline toxicity. Educationally, understanding the signs of theophylline toxicity is crucial for nurses managing patients with COPD. Monitoring for early signs like nausea can help prevent serious complications and guide appropriate interventions, such as dose adjustments or discontinuation of the medication. Nurses must be vigilant in monitoring for adverse effects of medications to ensure patient safety and optimal outcomes.

Correct Answer: B

Rationale: Nitroglycerin is a rapid-acting medication used to relieve angina pain by dilating blood vessels. The correct administration is to take one tablet every 5 minutes as needed, up to three doses. If chest pain persists after three doses, the client should seek emergency medical attention as it can indicate a more serious cardiac issue.

Correct Answer: C

Rationale: In the context of pharmacology and the use of digoxin in a client with heart failure, understanding the relationship between electrolyte imbalances and digoxin toxicity is crucial. The correct answer is C) Hypokalemia. Hypokalemia increases the risk of digoxin toxicity because digoxin competes with potassium for binding sites on the sodium-potassium ATPase pump in cardiac cells. When potassium levels are low, digoxin can exert its toxic effects more strongly, leading to serious cardiac complications. Option A) Hypernatremia is incorrect because high sodium levels do not directly impact digoxin toxicity. Option B) Hypercalcemia is also incorrect as elevated calcium levels do not increase the risk of digoxin toxicity. Option D) Hypomagnesemia is a close contender, as low magnesium levels can also contribute to digoxin toxicity, but hypokalemia is the primary electrolyte imbalance to be concerned about in this scenario. Educationally, this question highlights the importance of monitoring electrolyte levels in patients receiving digoxin therapy, especially potassium. It emphasizes the need for nurses to recognize the potential interactions between medications and electrolyte imbalances to prevent adverse drug events and ensure safe patient care.