The patient is discharged home and returns to the emergency department 4 days later. The patient is admitted to the ICU with acute decompensated HF with dyspnea at rest. The nurse anticipates administration of which medication?

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: Levothyroxine is a synthetic form of the thyroid hormone thyroxine and is commonly used for the treatment of hypothyroidism. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone to meet the body's needs, leading to various symptoms such as fatigue, weight gain, cold intolerance, and depression. By providing exogenous levothyroxine, the medication helps restore normal thyroid hormone levels in the body, thereby alleviating the symptoms of hypothyroidism and restoring normal hormonal balance. It is important to monitor thyroid hormone levels regularly when on levothyroxine therapy to ensure optimal dosing and maintenance of normal thyroid function.

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.

Correct Answer: C

Rationale: Levothyroxine is a synthetic form of the thyroid hormone thyroxine (T4). It is primarily used for the treatment of hypothyroidism, a condition in which the thyroid gland does not produce enough thyroid hormone. By providing exogenous levothyroxine, the medication helps to restore the normal hormonal balance in the body. This can alleviate symptoms such as fatigue, weight gain, cold intolerance, and other issues related to an underactive thyroid gland. Levothyroxine is not used for the suppression of seizure activity, decreased frequency of migraines, or treatment of ulcers.