A client is teaching a client who has a new prescription for hydrochlorothiazide for management of hypertension. Which of the following Instructions should the nurse include?
"Reduce intake of potassium-rich foods."
"Take this medication before bedtime."
"Avoid grape juice.'
"Monitor for leg cramps."
The Correct Answer is D
A) "Reduce intake of potassium-rich foods":
Hydrochlorothiazide is a diuretic medication that can cause potassium loss through increased urinary excretion. Therefore, instructing the client to reduce intake of potassium-rich foods could further decrease potassium levels, leading to hypokalemia. Instead, clients taking hydrochlorothiazide should be encouraged to consume potassium-rich foods to help maintain normal potassium levels, unless otherwise instructed by their healthcare provider.
B) "Take this medication before bedtime":
While hydrochlorothiazide can be taken once daily, it is typically recommended to take it in the morning rather than before bedtime. Taking the medication earlier in the day can help minimize the need to wake up during the night to urinate, as it is a diuretic that increases urine production. Therefore, instructing the client to take hydrochlorothiazide before bedtime is not the optimal recommendation.
C) "Avoid grape juice":
There is no significant interaction between hydrochlorothiazide and grape juice. In general, grapefruit juice is known to interact with certain medications by inhibiting cytochrome P450 enzymes in the liver, affecting drug metabolism. However, grape juice is not known to interact with hydrochlorothiazide, so advising the client to avoid grape juice is not necessary.
D) "Monitor for leg cramps":
This is the correct instruction. Leg cramps can be a potential side effect of hydrochlorothiazide therapy due to electrolyte imbalances, particularly hypokalemia. By monitoring for leg cramps, the client can promptly report any symptoms to their healthcare provider for further evaluation and management. This instruction promotes client safety and awareness of potential adverse effects associated with the medication."
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["2"]
Explanation
Here's how to find the volume the nurse should administer:
Medication dose to be administered: 250 mg
Available medication concentration: 1000 mg/8 mL
We need to find the volume (in mL) that contains the desired dose (250 mg) of hydrocortisone sodium succinate.
Set up a proportion:
Desired dose (mg) : Volume to administer (mL) = Concentration (mg/mL) : Available volume (mL)
In this case:
Desired dose (mg) = 250 mg
Concentration (mg/mL) = 1000 mg/8 mL (available concentration)
Volume to administer (mL) = Unknown (what we need to find)
Available volume (mL) = 8 mL (volume of solution containing the concentrated medication)
Solve for the volume to administer (mL):
Volume to administer (mL) = (Desired dose (mg) x Available volume (mL)) / Concentration (mg/mL)
Volume to administer (mL) = (250 mg x 8 mL) / 1000 mg/mL
Calculate the volume:
Volume to administer (mL) = 2000 mg / 1000 mg/mL
Volume to administer (mL) = 2 mL (round to nearest whole number as requested)
Therefore, the nurse should administer approximately 2 mL of the hydrocortisone sodium succinate solution.
Correct Answer is C
Explanation
A) Glaucoma:
While propranolol can exacerbate symptoms of glaucoma, it is not an absolute contraindication. However, caution is warranted in clients with glaucoma due to its potential to increase intraocular pressure.
B) Depression:
Propranolol is not contraindicated in clients with a history of depression. In fact, it is sometimes used to manage anxiety symptoms associated with certain types of depression.
C) Asthma:
Propranolol is contraindicated in clients with a history of asthma or bronchospasm because it can exacerbate bronchoconstriction and potentially precipitate an acute asthma attack.
D) Migraines:
Propranolol is often used prophylactically in clients with migraines to reduce the frequency and severity of attacks. It is not contraindicated in clients with a history of migraines."
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