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A client with heart failure is prescribed digoxin (Lanoxin). Which instruction should the nurse include in the client's teaching plan?
- A. Take your pulse before each dose and hold the medication if your pulse is below 60 beats per minute.
- B. Increase your intake of foods high in potassium.
- C. Take the medication with a high-fiber meal to enhance absorption.
- D. Skip a dose if you feel dizzy or lightheaded.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Digoxin is a medication that can cause bradycardia as a side effect.
2. Instructing the client to take their pulse before each dose is crucial to monitor for bradycardia.
3. Holding the medication if the pulse is below 60 beats per minute helps prevent potential adverse effects.
4. This instruction ensures the client's safety and adherence to the prescribed regimen.
Summary:
- Choice B is incorrect because increasing potassium intake can lead to hyperkalemia when taking digoxin.
- Choice C is incorrect as taking digoxin with a high-fiber meal may affect absorption negatively.
- Choice D is incorrect because skipping a dose based on dizziness or lightheadedness may lead to suboptimal treatment outcomes.
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A patient with schizophrenia is prescribed olanzapine. What is an important side effect for the healthcare provider to monitor?
- A. Hypertension
- B. Weight gain
- C. Hypoglycemia
- D. Bradycardia
Correct Answer: B
Rationale: The correct answer is B: Weight gain. Olanzapine is known to cause metabolic side effects, including weight gain. This is important to monitor as it can lead to various health issues such as diabetes and cardiovascular problems. Hypertension (A), hypoglycemia (C), and bradycardia (D) are not commonly associated with olanzapine use, making them less likely side effects to monitor in this case.
A patient with depression is prescribed fluoxetine. What is an important side effect for the nurse to monitor?
- A. Weight gain
- B. Bradycardia
- C. Dry mouth
- D. Suicidal thoughts
Correct Answer: D
Rationale: The correct answer is D: Suicidal thoughts. When a patient with depression is prescribed fluoxetine, there is a risk of increased suicidal thoughts, especially in the initial weeks of treatment. This is important for the nurse to monitor because it can lead to serious consequences. Weight gain (A) is a common side effect of fluoxetine but not as critical to monitor as suicidal thoughts. Bradycardia (B) and dry mouth (C) are not common side effects of fluoxetine and are less relevant to monitor in this scenario. Monitoring for suicidal thoughts is crucial for patient safety.
A client with heart failure is receiving intravenous furosemide (Lasix). Which assessment finding indicates that the medication is having the desired effect?
- A. Decreased peripheral edema.
- B. Elevated blood pressure.
- C. Increased heart rate.
- D. Decreased urine output.
Correct Answer: A
Rationale: The correct answer is A: Decreased peripheral edema. Furosemide is a diuretic that helps to remove excess fluid from the body, which can reduce peripheral edema in patients with heart failure. This indicates that the medication is effectively reducing fluid overload in the body. Elevated blood pressure (choice B) would not be an expected outcome of furosemide use. Increased heart rate (choice C) is not a direct effect of furosemide and can indicate worsening heart failure. Decreased urine output (choice D) would be an adverse effect of furosemide and would indicate the medication is not working as intended.
A patient with chronic heart failure is prescribed carvedilol. What is the primary purpose of this medication?
- A. Increase cardiac output
- B. Reduce fluid retention
- C. Decrease heart rate
- D. Lower blood pressure
Correct Answer: C
Rationale: The correct answer is C: Decrease heart rate. Carvedilol is a beta-blocker that works by blocking the beta-adrenergic receptors in the heart, leading to a decrease in heart rate. This helps reduce the workload of the heart and improve its efficiency in patients with heart failure. Choice A is incorrect because carvedilol may not necessarily increase cardiac output directly. Choice B is incorrect because carvedilol focuses more on improving heart function rather than directly reducing fluid retention. Choice D is incorrect because while carvedilol may lower blood pressure as a secondary effect, its primary purpose in heart failure is to improve cardiac function by decreasing heart rate.
A client with heart failure is prescribed furosemide (Lasix). Which instruction should the nurse include in the client's teaching plan?
- A. Take the medication before bedtime.
- B. Report any weight gain of more than 2 pounds in a day.
- C. Increase your intake of high-sodium foods.
- D. Limit your fluid intake to less than 1 liter per day.
Correct Answer: B
Rationale: The correct answer is B: Report any weight gain of more than 2 pounds in a day. This instruction is crucial for a client with heart failure taking furosemide as sudden weight gain can indicate fluid retention, which can worsen heart failure. Monitoring weight daily can help detect early signs of fluid overload.
A: Taking the medication before bedtime is not a critical instruction for furosemide as it is usually taken in the morning to prevent nocturia.
C: Increasing intake of high-sodium foods contradicts the purpose of furosemide, which is a diuretic used to reduce fluid retention by promoting diuresis.
D: Limiting fluid intake to less than 1 liter per day can lead to dehydration and electrolyte imbalances, which can be harmful for a client with heart failure.