Share This Link

Furosemide: Loop diuretics cause potassium loss (hypokalemia), not hyperkalemia.

Hydrochlorothiazide: Thiazide diuretic increases renal K⁺ excretion and typically causes hypokalemia, not hyperkalemia.

Bumetadine: (Bumetanide) Loop diuretic like furosemide - causes K⁺ loss and risk of hypokalemia, not hyperkalemia.

"Consume a low-residue diet.": Low-residue is not routinely recommended for heart failure-this is unrelated to fluid/sodium management.

"Begin exercising twice per week.": General activity is encouraged, but twice weekly is insufficient as a standard instruction; exercise plans should be individualized and usually more frequent.

"Weigh yourself every 2 days.": Not ideal - clients with heart failure should weigh themselves daily at the same time to detect early fluid retention.

White coating in the mouth: More associated with inhaled corticosteroids (oral candidiasis), not anticholinergic bronchodilators.

Tremors: Tremors are a side effect of beta-agonist bronchodilators (e.g., albuterol), not tiotropium.

Nausea: Not a common or characteristic side effect of tiotropium.

Asthma: Asthma presents with wheeze and episodic dyspnea, but edema and systemic tachycardia/chronically fatigue are less typical.

COPD: Can cause dyspnea and fatigue, but generalized edema is more suggestive of heart failure (though cor pulmonale can cause edema).

Pneumonia: Causes dyspnea and sometimes tachycardia and fatigue, but peripheral edema is not a typical feature.

PaO2 95 mm Hg: Normal arterial oxygen tension; clients in acute COPD exacerbation typically have lower PaO₂.

PaCO2 32 mm Hg: Low PaCO₂ (respiratory alkalosis) - not expected in an acute COPD exacerbation where hypoventilation/CO₂ retention occurs.

PaO2 85 mm Hg: Mildly decreased PaO₂ but still near-normal; more typical finding is a significantly reduced PaO₂ with concurrent elevated PaCO₂.

Serum potassium 4.8 mEq/L: Potassium is within/near normal-high range; digoxin toxicity risk increases with low K⁺, so this value alone is not a reason to withhold.

Urine output 35 mL/hr: This is borderline but generally acceptable (oliguria is usually <30 mL/hr); not an absolute reason to withhold digoxin.

Heart rate 66/min: Digoxin is typically withheld for significantly low heart rates (commonly <60/min); 66/min is usually acceptable to give with caution.

Intake 1,200 mL, output 700 mL: Output < intake - suggests net fluid retention, not the expected response after an effective diuretic.

Intake 2,000 mL, output 500 mL: Large net positive fluid balance - indicates retention or inadequate diuresis, not expected.

Intake 800 mL, output 800 mL: Net zero balance - no evidence of the increased urine output expected after diuretic administration.

Right upper quadrant pain: RUQ pain from liver congestion is more typical of right-sided heart failure.

Jugular venous distention: JVD is a sign of elevated systemic venous pressure - more characteristic of right-sided heart failure.

Pitting edema of the lower legs: Peripheral pitting edema is more commonly seen with right-sided heart failure (or biventricular failure), not isolated left failure.

Limit fluid intake throughout the day: Not recommended for emphysema-adequate hydration helps thin secretions and promote clearance.

Consume a low-protein diet: Protein needs are not routinely restricted for emphysema; dietary changes usually target carbohydrate/fat balance to reduce CO₂ production, not protein restriction.

Rest in a supine position: Supine often worsens dyspnea; upright or tripod positions improve chest expansion and breathing.