A client who has chronic stable angina is being discharged. Which statement by the client indicates an understanding of the discharge teaching?

Choice A reason: This is not the best answer. Respiratory rate and depth can indicate the client's oxygenation and ventilation, but not necessarily their fluid status. The client may have normal or increased respiratory rate and depth due to dehydration, acidosis, or anxiety, but this does not reflect their fluid volume or distribution. The nurse should monitor the client's respiratory rate and depth, but also assess other parameters of fluid status.

Choice B reason: This is not the best answer. Rectal temperature can indicate the client's core body temperature, but not necessarily their fluid status. The client may have normal or elevated rectal temperature due to infection, inflammation, or dehydration, but this does not reflect their fluid volume or distribution. The nurse should monitor the client's rectal temperature, but also assess other parameters of fluid status.

Choice C reason: This is the best answer. Blood pressure lying, sitting and standing can indicate the client's fluid status and vascular tone. The client may have low blood pressure due to fluid loss, hypovolemia, or vasodilation, and this can cause orthostatic hypotension, which is a drop in blood pressure when changing positions. The nurse should measure the client's blood pressure in different positions and observe for signs of orthostatic hypotension, such as dizziness, fainting, or blurred vision.

Choice D reason: This is not the best answer. Pulse oximetry reading at rest can indicate the client's oxygen saturation, but not necessarily their fluid status. The client may have normal or decreased pulse oximetry reading due to hypoxia, anemia, or poor peripheral perfusion, but this does not reflect their fluid volume or distribution. The nurse should monitor the client's pulse oximetry reading, but also assess other parameters of fluid status.

Choice A reason: The 68-year-old male who smokes one pack of cigarettes per day is not likely to have folic acid deficiency. Smoking can increase the risk of many health problems, such as lung cancer, heart disease, and stroke, but it does not affect the absorption or metabolism of folic acid. ¹ Folic acid is a type of vitamin B that is essential for the production of red blood cells and DNA. ²

Choice B reason: The 47-year-old male construction foreman who takes atenolol is not likely to have folic acid deficiency. Atenolol is a drug that lowers blood pressure and heart rate by blocking the effects of adrenaline. ³ It does not interfere with the absorption or metabolism of folic acid.

Choice C reason: The 35-year-old female who drinks a glass of wine with dinner is not likely to have folic acid deficiency. Moderate alcohol consumption, defined as one drink per day for women and two drinks per day for men, does not affect the absorption or metabolism of folic acid. However, excessive alcohol intake can impair the absorption of folic acid from the intestine and increase its excretion from the urine, leading to folic acid deficiency.

Choice D reason: The 43-year-old female with Crohn's disease is the most likely to have folic acid deficiency. Crohn's disease is a chronic inflammatory condition that affects the digestive tract, causing symptoms such as diarrhea, abdominal pain, and weight loss. Crohn's disease can impair the absorption of folic acid from the intestine, especially if the disease affects the small intestine, where most of the folic acid is absorbed. Crohn's disease can also increase the demand for folic acid, as inflammation and tissue damage require more folic acid for repair and regeneration.