A nurse is providing discharge teaching to a client who has GERD. Which of the following information should the nurse include?

Choice A reason: Insomnia is not a primary sign of digoxin toxicity, which includes visual disturbances like blurred vision due to retinal effects. Assuming insomnia indicates toxicity risks missing critical symptoms, delaying interventions like dose adjustment, essential for preventing severe complications like arrhythmias in clients on digoxin for heart failure.

Choice B reason: Blurred vision is a classic sign of digoxin toxicity, resulting from retinal cone dysfunction, often with nausea or arrhythmias. Recognizing this prompts checking digoxin levels and adjusting doses, critical for preventing life-threatening complications like bradycardia or ventricular tachycardia, ensuring safety in clients managing chronic heart failure with digoxin.

Choice C reason: Tachycardia is less common in digoxin toxicity, which typically causes bradycardia or heart block due to cardiac glycoside effects. Blurred vision is a clearer indicator. Assuming tachycardia risks misdiagnosis, delaying toxicity management, critical for preventing arrhythmias and ensuring safe digoxin use in heart failure treatment.

Choice D reason: Hearing loss is not associated with digoxin toxicity, which prominently features visual changes like blurred vision. Misidentifying hearing loss as toxicity risks overlooking true symptoms, delaying interventions like serum level checks, essential for preventing cardiac complications in clients on digoxin for chronic heart failure management.

Choice A reason: Attaching a syringe to the inflation hub is a later step after sterile field setup and cleansing. Positioning the drape first maintains sterility. Doing this first risks contaminating the sterile field, increasing infection risk, critical to avoid in ensuring safe catheter insertion for clients.

Choice B reason: Cleansing the meatus follows sterile drape placement to maintain a sterile field. Performing cleansing first risks contamination before the field is set, potentially introducing pathogens, critical to prevent in ensuring infection-free catheter insertion, supporting client safety during urinary catheterization procedures.

Choice C reason: Positioning the sterile drape first establishes a sterile field, critical for preventing infection during catheter insertion. This initial step ensures all subsequent actions, like cleansing and insertion, remain sterile, essential for client safety, reducing urinary tract infection risk, and adhering to aseptic technique in catheterization.

Choice D reason: Lubricating the catheter is a later step after sterile field setup and meatal cleansing. Doing this first risks compromising sterility, potentially contaminating the catheter, critical to avoid in ensuring infection prevention, supporting safe insertion, and minimizing complications in clients undergoing urinary catheterization.