A client who has been taking allopurinol prophylactically comes into the clinic with reoccurring gout attack episodes in left ankle. The healthcare provider changes the prescription to febuxostat. Which instruction should the nurse include in the discharge teaching?

Eat high protein foods to achieve ideal body weight.

Report experiencing right upper quadrant discomfort.

Use electric heating pad when pain is at its worse.

Replace dietary table salt with salt substitutes.

Answer and Explanation

The Correct Answer is B

Febuxostat is a medication used to manage hyperuricemia and prevent gout attacks. However, it has been associated with hepatotoxicity, including liver enzyme elevations and liver failure. Therefore, it is important for the nurse to instruct the client to report any signs or symptoms of liver dysfunction, such as right upper quadrant discomfort. This will allow for prompt evaluation and appropriate management if hepatotoxicity occurs.

While maintaining a healthy weight and dietary modifications may be beneficial for managing gout, specific instructions regarding protein intake should be individualized and provided by a healthcare provider or a registered dietitian.

Using an electric heating pad when pain is at its worst may provide temporary symptomatic relief for gout attacks, but it is not specific to the use of febuxostat. The focus of discharge teaching should be on medication adherence, monitoring for adverse effects, and lifestyle modifications to prevent gout attacks.

Replacing dietary table salt with salt substitutes is not a specific instruction for a client taking febuxostat. While reducing sodium intake may be recommended as part of an overall healthy diet, it is not directly related to the use of febuxostat or management of gout attacks. Dietary modifications for gout management should be individualized and based on the client's specific needs and preferences.

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Correct Answer is A

Explanation

The correct answer ischoice A.

Choice A rationale:

Having the client vocalize the instructions provided ensures that they have understood the information correctly.This method allows the nurse to confirm comprehension and clarify any misunderstandings.

Choice B rationale:

Providing written instructions for eye drop administration is helpful but does not ensure that the client understands the instructions.It is a good supplementary measure but should not be the sole method of communication.

Choice C rationale:

Speaking clearly and facing the client for lip reading is important, especially for clients with hearing impairments.However, it does not guarantee that the client has understood the instructions.

Choice D rationale:

Ensuring that someone will stay with the client for 24 hours is a good safety measure but does not directly address the client’s understanding of the discharge instructions.

A. Evaluate glucose levels before and after meals. B. Assess the serum potassium level every 4 hours. C. Monitor and document strict intake and output. D. Obtain a 12-lead electrocardiogram daily.

Correct Answer is B

Explanation

The client's serum potassium level is elevated at 6.0 mEq/L (6.0 mmol/L), which is above the normal reference range of 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L).

Hyperkalemia can have significant cardiac implications, including the potential for life-threatening dysrhythmias. Therefore, close monitoring of the serum potassium level is crucial to assess the effectiveness of interventions and ensure that potassium levels are within a safe range.

While monitoring glucose levels before and after meals is important for clients receiving insulin therapy, in this scenario, the primary concern is the elevated potassium level.

The nurse should prioritize frequent assessment of the serum potassium level to guide appropriate management and prevent complications associated with hyperkalemia.

Monitoring and documenting strict intake and output are important for assessing fluid balance and renal function, but in this case, the elevated potassium level takes precedence as it poses a more immediate risk to the client's well-being.

Obtaining a 12-lead electrocardiogram (ECG) daily may be indicated in some cases of hyperkalemia, as certain ECG changes can be associated with elevated potassium levels. However, the more critical aspect is monitoring the potassium level itself, as ECG changes can occur rapidly and may not always be detectable on a daily basis.

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A client who has been taking allopurinol prophylactically comes into the clinic with reoccurring gout attack episodes in left ankle. The healthcare provider changes the prescription to febuxostat. Which instruction should the nurse include in the discharge teaching?

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Explanation

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