A nurse is providing teaching for a client who has neutropenia and is receiving chemotherapy. Which of the following client statements indicates an understanding of the teaching? (Select all that apply.)

Rationale:
A. "If my heart starts racing, my provider might need to adjust my dosage.": This statement shows understanding. Tachycardia is a common sign of overtreatment with levothyroxine, which may lead to hyperthyroidism. The provider should be notified to adjust the dosage if such symptoms occur.

B. "I will keep a journal of my daily food intake to show the provider.": While nutrition is important, this is not a routine requirement for levothyroxine management. The effectiveness of therapy is primarily monitored through thyroid function tests, not dietary logs.

C. "Once my weight is back to normal, I can gradually reduce and then stop the medication.": This indicates a misunderstanding. Levothyroxine is a lifelong therapy for most clients with hypothyroidism, and stopping it can lead to a return of symptoms and complications.

D. "I'm not forgetful, so I do not need a pill reminder system.": While this may be true for some, consistent daily dosing is critical with levothyroxine. Even clients with good memory may benefit from reminder systems to ensure adherence and maintain stable hormone levels.

Rationale:

• Place the client on bedrest: Bedrest is necessary after PCI to reduce the risk of bleeding at the catheter insertion site, typically in the femoral artery. The client must remain flat with the leg extended for several hours to allow vessel healing.
• Administer vitamin K: Vitamin K is not routinely given after PCI. It is used to reverse warfarin-induced anticoagulation, not to manage post-procedure care in stable clients unless there is a specific bleeding disorder or elevated INR.
• Check pedal pulses: Assessing distal circulation is essential to monitor for complications like arterial occlusion or hematoma formation. Diminished pulses may indicate compromised blood flow due to thrombus or arterial damage.
• Apply pressure to the insertion site: Manual pressure is applied immediately after sheath removal to prevent bleeding. Continuous monitoring of the site for swelling, bleeding, or hematoma is a standard post-PCI nursing responsibility.
• Elevate the operative leg: Elevating the leg can increase the risk of bleeding by disturbing the clot at the insertion site. The leg should remain flat and immobilized to promote hemostasis and prevent complications.