Question

The physician has ordered hydrochlorothiazide (HCTZ) for the patient in chronic renal failure. The nurse suspects the patient is experiencing an ineffective response to the medication. Which assessment is a priority for this patient?

1. Reviewing the lab work for hypokalemia and hyponatremia
2. Assessing the vital signs for hypertension
3. Assessing the skin for moisture and turgor
4. Auscultating breath sounds for wheezes

Answer 1

The priority assessment for a patient in chronic renal failure taking hydrochlorothiazide (HCTZ) is reviewing lab work for hypokalemia and hyponatremia.

Step-by-step explanation:

The nurse should prioritize reviewing the lab work for hypokalemia and hyponatremia for the patient in chronic renal failure who is taking hydrochlorothiazide (HCTZ). HCTZ is a diuretic medication that works on the distal convoluted tubule, increasing the excretion of sodium and water. However, one of the side effects of HCTZ is the loss of potassium and sodium, which can lead to hypokalemia (low potassium levels) and hyponatremia (low sodium levels).

Monitoring lab values is essential to assess the patient's electrolyte balance and ensure an adequate response to the medication. Hypokalemia can cause muscle weakness, irregular heartbeat, and fatigue, while hyponatremia can lead to confusion, seizures, and fluid imbalances.