A nurse is providing discharge teaching to a client who has a new diagnosis of heart failure. Which of the following instructions should the nurse include in the teaching?
Exercise at least three times per week.
Notify the provider of a weight gain of 0.5 kg (1 lb) in a week.
Take diuretics early in the morning and before bedtime.
Take naproxen for generalized discomfort.
The Correct Answer is A
a. This is appropriate as regular, moderate exercise can help improve cardiovascular health and functional capacity in clients with heart failure. It is essential to discuss appropriate types and levels of exercise based on the individual’s condition.
b. This is incorrect because clients should be instructed to notify the provider if they gain 1 kg (2.2 lbs) in one day or 2 kg (4.4 lbs) in one week. A weight gain of 0.5 kg is not typically a threshold for concern.
c. Take diuretics early in the morning and before bedtime is wrong because it may disrupt the client's sleep patern and cause nocturia. The nurse should advise the client to take diuretics early in the morning and avoid taking them in the evening or at night, unless prescribed otherwise.
d. Take naproxen for generalized discomfort is wrong because naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that can worsen heart failure by causing sodium and water retention, increasing blood pressure, and reducing the effectiveness of diuretics and other heart failure medications. The nurse should advise the client to avoid NSAIDs and use acetaminophen or other alternatives for pain relief, as prescribed by the provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["8"]
Explanation
To calculate the volume to administer, the nurse should use the following formula:
Volume (mL) = Dose (mg) / Concentration (mg/mL) x 1000
Plugging in the given values, the nurse should get:
Volume (mL) = 400 mg / 250 mg/5 mL x 1000
Volume (mL) = 8 mL
The nurse should round the answer to the nearest whole number and use a leading zero if it applies. Therefore, the nurse should administer 8 mL of valproic acid per dose.
Correct Answer is D
Explanation
Choice A reason:
Administering an anticholinesterase medication is not the primary intervention during a myasthenic crisis. While these medications can improve muscle strength in myasthenia gravis, they are not sufficient in the event of a crisis.
Choice B reason:
Pursed lip breathing is a technique used to manage dyspnea but is not adequate for the acute management of a myasthenic crisis, which can involve respiratory muscle paralysis.
Choice C reason:
Vasoconstrictors are not used in the treatment of myasthenic crisis. This condition is not related to vascular issues but to neuromuscular transmission failure leading to respiratory failure.
Choice D reason:
Mechanical ventilation is the correct intervention as it provides the necessary respiratory support when the patient's respiratory muscles are too weak to maintain adequate ventilation.
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