A healthcare professional is preparing to initiate IV therapy for an older adult client. Which of the following actions should the professional plan to take?
- A. Use a blood pressure cuff to distend the veins.
- B. Select the antecubital area to insert the IV catheter.
- C. Distend the veins by using a blood pressure cuff.
- D. Direct the client to lower his arm below his heart.
Correct Answer: C
Rationale: The correct answer is C. The healthcare professional should distend the veins using a blood pressure cuff to make the veins more visible and accessible for IV catheter insertion. This technique helps reduce the risk of overfilling the vein, which can lead to complications such as hematoma formation. Choices A, B, and D are incorrect because while selecting the antecubital area is often appropriate for IV insertion in adults, the key action in this scenario is to distend the veins using a blood pressure cuff to facilitate the procedure.
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When starting therapy with Lisinopril, a client should be instructed to monitor for which of the following adverse effects?
- A. Tinnitus
- B. Diarrhea
- C. Cough
- D. Weight gain
Correct Answer: C
Rationale: When starting therapy with Lisinopril, a client should be instructed to monitor for a persistent dry cough as an adverse effect. Lisinopril, an ACE inhibitor, commonly causes this cough as an adverse effect. It is important for the client to monitor for this symptom and notify their healthcare provider if it occurs. Choices A, B, and D are incorrect because tinnitus, diarrhea, and weight gain are not commonly associated adverse effects of Lisinopril.
A client has a prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?
- A. Take this medication in the morning.
- B. Increase intake of potassium-rich foods.
- C. Take this medication with food.
- D. Monitor for signs of dehydration.
Correct Answer: D
Rationale: The correct answer is to monitor for signs of dehydration. Hydrochlorothiazide is a diuretic that can lead to fluid loss and electrolyte imbalance, potentially causing dehydration. Signs of dehydration include dry mouth, increased thirst, and decreased urine output. It is important for the client to be vigilant in monitoring and reporting these symptoms to healthcare providers to prevent complications. Choices A, B, and C are incorrect because taking the medication in the morning, increasing potassium-rich foods, or taking the medication with food are not specific instructions related to the potential side effects of Hydrochlorothiazide.
When a client has a new prescription for Warfarin, which of the following foods should they avoid based on the nurse's instructions?
- A. Broccoli
- B. Bananas
- C. Chicken
- D. Potatoes
Correct Answer: A
Rationale: Clients prescribed Warfarin should avoid foods high in vitamin K, like broccoli, as they can counteract the medication's effectiveness. Warfarin works by inhibiting vitamin K-dependent clotting factors, so consuming high vitamin K foods can interfere with its anticoagulant effects. Bananas, chicken, and potatoes are not high in vitamin K and do not have a significant impact on Warfarin therapy.
A client with OCD has a new prescription for Paroxetine. Which of the following instructions should the nurse include?
- A. It can take several weeks before you feel like the medication is helping.
- B. Take the medication just before bedtime to promote sleep.
- C. You should take the medication when needed for obsessive urges.
- D. Monitor for weight gain while taking this medication.
Correct Answer: A
Rationale: The correct instruction for the nurse to include when teaching a client with OCD who has a new prescription for Paroxetine is that it can take several weeks before the client feels like the medication is helping. Paroxetine, like other selective serotonin reuptake inhibitors (SSRIs), can take 1 to 4 weeks before the client reaches the full therapeutic benefit. Therefore, it is important to inform the client about this delay in onset of action to manage their expectations and promote adherence to the treatment plan. Choices B, C, and D are incorrect because taking Paroxetine before bedtime is not necessary, it should be taken consistently at the same time each day; Paroxetine is usually taken regularly, not as needed; and while monitoring weight is important, it is not a specific instruction related to the onset of action for Paroxetine.
A client has a new prescription for Lithium Carbonate. When teaching the client about ways to prevent Lithium toxicity, what advice should the nurse provide?
- A. Avoid using acetaminophen for headaches.
- B. Restrict intake of foods high in sodium.
- C. Decrease fluid intake to less than 1,500 mL daily.
- D. Limit aerobic activity in hot weather.
Correct Answer: D
Rationale: The nurse should advise the client to limit aerobic activity in hot weather to prevent sodium/water depletion, which can increase the risk for Lithium toxicity. Excessive sweating and fluid loss can lead to dehydration and changes in lithium levels, potentially resulting in toxicity. Choices A, B, and C are incorrect. Avoiding acetaminophen for headaches is not directly related to Lithium toxicity. Restricting sodium intake and decreasing fluid intake can lead to increased lithium levels and toxicity, so these are not recommended actions.