A nurse is reinforcing teaching with a client who is starting digoxin therapy to treat heart failure. The nurse should reinforce with the client that which of the following adverse effects is a possible indication of digoxin toxicity and should be reported to the provider?

Choice A Reason:

Suggesting that the client assist with meal planning may be appropriate, but it's not the first priority. Monitoring the client's eating behaviors and safety during meals takes precedence.

Choice B Reason:

Observe the client during and after meals. When caring for a client with bulimia nervosa, the initial priority is to monitor the client during and after meals to assess their eating behaviors and the potential for purging or other disordered eating habits. This helps ensure the client's safety and can provide valuable information for the treatment team. Once immediate safety concerns are addressed, the nurse can proceed with other aspects of care, such as assisting with meal planning, providing education on coping strategies, and referring the client to support groups as appropriate.

Choice C Reason:

Instructing the client about effective coping strategies is an important part of the treatment plan, but it's not the immediate priority. Ensuring the client's safety during meals is more critical initially.

Choice D Reason:

Referring the client to a support group can be a valuable part of long-term treatment, but it's not the first step. Monitoring and addressing immediate eating behaviors and safety come first.

Correct answer: D

A.Sharing a client's substance use information with their employer without their consent may violate confidentiality and privacy laws.

B.Sharing information about a client's suicide with another nurse may be appropriate for staff who need to know for safety reasons but should be done carefully and only with those who have a legitimate need for the information.

C.Sharing a client's medical information with their partner in this scenario may be appropriate under certain circumstances. However, it's essential to consider the client's safety and well-being first. If the client has reported intimate partner abuse, the nurse must assess the risk of harm to the client if their partner is informed. Depending on the situation, it may be necessary to involve other healthcare professionals, such as social workers or law enforcement, to ensure the client's safety. Before sharing any information with the partner, the nurse should follow institutional policies and legal requirements, which often involve obtaining the client's consent or assessing the potential harm of disclosure.

D.Sharing a client's medical information with a social worker who is directly involved in the client's care is generally appropriate and often necessary for effective interdisciplinary collaboration. In this scenario, the social worker is assigned to the client and is likely involved in coordinating the client's care and support services. Sharing relevant medical information with the social worker can facilitate continuity of care and help ensure that the client's needs are met appropriately. However, it's essential for the nurse to adhere to confidentiality requirements and only share information on a need-to-know basis, ensuring that the information is used for the purpose of providing care and support to the client.