When there are 2 meds ordered....

[NCINDASUN]

Greetings!

I took a NCLEX prep class last week and there was one area that we were given conflicting information on. It was about questions with orders for multiple meds. One time the instructor told us that if there were 2 meds you either gave both or held both. Another time she said hold one if contraindicated.

For example: The physician orders furosemide (Lasix) and spironolactone (Aldactone). Prior to administering Lasix and Aldactone, the nurse determines that the patient's potassium level is 3.2. The nurse should.....

I know there is no true decision tree to taking the NCLEX, but does anyone have any thoughts on this?

[nursingone]

Hi,

Because furosemide (Lasix) is potassium wasting diuretic and the patient is losing potassium. You would administer the spironolactone(Aldactone) because it is a potassium sparing diuretic. Remember your normal levels with potassium 3.5-5.0 mEq/l. Lack of potassium can cause cardiac dysrhythmias and potassium is the most important electrolyte and mineral for the heart. I hope this helps.

Good luck

nursingone

[suzanne4, RN]

As stated above, you never hold all medications, unless all are contra-indicated for that patient.

Aldactone spares potassium, so it is okay to give. Lasix would be safe after the potassium was replaced.