A nurse is admitting a client who has acute heart failure. Which of the following prescriptions from the provider should the nurse anticipate?
Provide the client with a 4g sodium diet.
Ambulate the client every 4 hr while awake.
Infuse 0.9% sodium chloride 500 mL IV bolus over 1 hr.
Administer enalapril 2.5 mg PO twice daily.
The Correct Answer is D
A) Provide the client with a 4g sodium diet: This is incorrect. Clients with acute heart failure typically require a low-sodium diet (often less than 2g per day) to help manage fluid retention and reduce workload on the heart.
B) Ambulate the client every 4 hr while awake: While mobility is important, the frequency and timing of ambulation in clients with acute heart failure should be carefully considered based on their stability and fatigue level. It may not be appropriate to ambulate every 4 hours.
C) Infuse 0.9% sodium chloride 500 mL IV bolus over 1 hr: This is generally not appropriate for clients with acute heart failure due to the risk of fluid overload. Instead, fluid management often involves restricting IV fluids and closely monitoring fluid balance.
D) Administer enalapril 2.5 mg PO twice daily: This prescription is appropriate. Enalapril, an ACE inhibitor, is commonly used to manage heart failure by reducing afterload and improving cardiac output. It helps alleviate symptoms and improve quality of life in heart failure patients.
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Correct Answer is D
Explanation
A) Clonazepam: While clonazepam can be used for seizure management, it is not the first-line treatment for status epilepticus.
B) Carbamazepine: This medication is used for the long-term management of epilepsy but is not suitable for the acute treatment of status epilepticus.
C) Lamotrigine: Similar to carbamazepine, lamotrigine is used for long-term seizure control but is not indicated for acute episodes like status epilepticus.
D) Lorazepam: This is the correct answer. Lorazepam is a benzodiazepine and is commonly used as a first-line treatment for status epilepticus due to its rapid onset and effectiveness in terminating prolonged seizures. Administering lorazepam can help stabilize the client and prevent further complications.
Correct Answer is C
Explanation
A) An occupational therapist focuses on helping clients regain independence in daily activities and may assist with adaptive techniques for self-care. However, for a client with dysphagia, their primary need is related to swallowing, not daily tasks.
B) A physical therapist specializes in mobility and physical function. While they play an important role in overall physical health, they are not the primary resource for addressing dysphagia, which involves the swallowing process.
C) Consulting a speech-language pathologist is the priority. This professional specializes in communication and swallowing disorders. They can assess the severity of the dysphagia and recommend safe swallowing techniques or interventions to reduce the risk of aspiration, making them essential in the management of a client with amyotrophic lateral sclerosis.
D) A dietitian can provide guidance on nutrition and diet modifications to accommodate dysphagia. While important, the immediate priority is to address the swallowing difficulties through evaluation and intervention by a speech-language pathologist.
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