A nurse is caring for a client who has heart failure.
A nurse is caring for a client. After reviewing the findings above, which of the following actions should the nurse take? (For each potential provider's prescription, specify if the prescription is anticipated, nonessential, or contraindicated for the client)
Potential Prescriptions
Place the client on 24-hr urine collection.
Request to hold the client's metoprolol.
Place on sodium restriction of less than 1.500 mg per day.
Request for an increased dosage of furosemide.
Decrease the client’s oxygen to 1 L/min via nasal cannula.
Weigh the client daily.
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"C"},"D":{"answers":"A"},"E":{"answers":"C"},"F":{"answers":"A"}}
Based on the information provided and the search results, here are the potential actions the nurse should take:
Choice A. nonessential
Reason: A 24-hour urine collection helps diagnose kidney problems. However, there is no clear indication from the provided information that the patient has kidney issues. Therefore, this prescription is at this point.
Choice B. nonessential
Reason: Metoprolol is a beta-blocker used in the treatment of heart failure. There is no clear indication from the provided information that the patient is experiencing adverse effects from metoprolol that would necessitate holding the medication.
Choice C. contraindicated
Reason: For people with heart failure, restricting dietary sodium intake to levels below the standard recommended maximum of about 2.3 grams per day does not bring additional benefits and may increase the risk of death.
Choice D. anticipated
Reason: Furosemide is a diuretic used in the treatment of heart failure. The patient's weight has increased, which could indicate fluid retention, a common symptom of worsening heart failure. Therefore, this prescription is .
Choice E. contraindicated
Reason: Oxygen therapy is used in heart failure patients to ensure adequate oxygen supply. However, the patient's oxygen saturation has decreased from 93% to 90%.
Choice F. anticipated
Reason: Daily weight monitoring is crucial in heart failure management as it can help detect fluid retention, a common symptom of worsening heart failure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Sitting in a straight-backed chair helps maintain proper posture and alignment, which is important after hip arthroplasty to prevent dislocation.
Choice B reason: Cleansing the surgical incision with hydrogen peroxide is not recommended as it can be too harsh and impede healing.
Choice C reason: Performing range of motion by adducting the hip is not recommended immediately postoperative as it can increase the risk of dislocation.
Choice D reason: Applying moist heat to the incision while in bed is not recommended as it can increase the risk of infection and delay healing.
Correct Answer is C
Explanation
Choice A reason: Applying the heating pad as prescribed could be dangerous without proper precautions, as clients with diabetic neuropathy may not feel heat properly, leading to burns.
Choice B reason: Completing Semmes Weinstein monofilament testing following treatment is important, but it does not address the immediate safety concern regarding the use of a heating pad.
Choice C reason: Clarifying the prescription is essential to ensure the safety of the client, as those with diabetic neuropathy have reduced sensation and are at risk for burns.
Choice D reason: Observing the skin 10 minutes after the start of treatment is important, but it should not precede clarifying the prescription and ensuring proper application instructions.
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