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A client with heart failure is prescribed furosemide (Lasix) and digoxin (Lanoxin). Which instruction should the nurse include in the client's teaching plan?
- A. Avoid foods high in potassium.
- B. Report a pulse rate less than 60 beats per minute.
- C. Take the medications in the morning.
- D. Weigh yourself daily.
Correct Answer: B
Rationale: The nurse should instruct the client to report a pulse rate less than 60 beats per minute, as it could indicate digoxin toxicity. Consuming potassium-rich foods is encouraged due to the potential for furosemide (Lasix) to cause hypokalemia. The medications should be taken in the morning to prevent nocturia. Additionally, the client should weigh themselves daily to monitor for fluid retention, which is crucial in managing heart failure.
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A postoperative client has received a dose of naloxone hydrochloride for respiratory depression shortly after transfer to the nursing unit from the postanesthesia care unit. After administration of the medication, the nurse checks the client for:
- A. Pupillary changes
- B. Scattered lung wheezes
- C. Sudden increase in pain
- D. Sudden episodes of diarrhea
Correct Answer: C
Rationale: Naloxone hydrochloride is an antidote to opioids and may be administered to postoperative clients to address respiratory depression. This medication can also reverse the effects of analgesics, potentially leading to a sudden increase in pain. Therefore, the nurse must assess the client for any unexpected rise in pain levels after naloxone administration.
The healthcare provider prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. What is the appropriate intervention for the nurse?
- A. Administer the medication within 60 minutes before the morning and evening meal.
- B. Withhold the medication and question the prescription with the healthcare provider.
- C. Monitor the client for gastrointestinal side effects after administration of the medication.
- D. Withdraw the insulin from the Penlet into an insulin syringe to prepare for administration.
Correct Answer: B
Rationale: Exenatide (Byetta) is specifically indicated for the treatment of type 2 diabetes mellitus and is not recommended for clients with type 1 diabetes mellitus who are taking insulin. Therefore, the appropriate intervention for the nurse is to withhold the medication and question the prescription with the healthcare provider to ensure the safety and appropriateness of the treatment plan for the client.
A healthcare professional is monitoring a client who is receiving intravenous amphotericin B. Which of the following should prompt the healthcare professional to notify the healthcare provider immediately?
- A. Fever
- B. Headache
- C. Nausea
- D. Oliguria
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The client has a new prescription for metoclopramide (Reglan). On review of the chart, the nurse identifies that this medication can be safely administered with which condition?
- A. Intestinal obstruction
- B. Peptic ulcer with melena
- C. Diverticulitis with perforation
- D. Vomiting following cancer chemotherapy
Correct Answer: D
Rationale: Metoclopramide, also known as Reglan, is commonly used to manage vomiting following cancer chemotherapy. It acts as a gastrointestinal stimulant and antiemetic, aiding in relieving nausea and vomiting associated with chemotherapy. Metoclopramide should be avoided in conditions like intestinal obstruction, peptic ulcer with melena, and diverticulitis with perforation due to its prokinetic properties that can worsen these conditions. Therefore, the correct answer is D: Vomiting following cancer chemotherapy.
A client is prescribed nitroglycerin (Nitro-Dur) transdermal patch for angina. Which instruction should the nurse include in the client's teaching plan?
- A. Apply the patch to a hairless area of skin.
- B. Leave the patch on for 24 hours.
- C. Apply the patch at the same time each day.
- D. You can keep the patch on while taking a shower.
Correct Answer: C
Rationale: The nurse should instruct the client to apply the nitroglycerin (Nitro-Dur) transdermal patch at the same time each day to ensure consistent blood levels. It is essential to apply the patch to a hairless area of the skin for proper absorption. The patch can generally be left on during a shower. The patch is usually worn for 12-14 hours to allow for a nitrate-free period, which helps reduce tolerance to the medication.