A nurse is teaching a client who has a new prescription for nitroglycerin sublingual tablets for treating angina. Which of the following instructions should the nurse include in the teaching?

A) "Pour expire” medication tablets into a w“ste basket": This is an incorrect statement. Pourin” expired medication into a waste basket can pose a risk of accidental ingestion by children, pets, or individuals who may go through the trash. It is not a safe method of medication disposal.

B) "Return expired medication to the pharmac“st": This is the correct action for safe me”ication disposal. Many pharmacies have programs for the safe disposal of unused or expired medications. Returning medications to the pharmacist ensures proper disposal and prevents environmental contamination or misuse.

C) "Discard expired medication down the toil“t": This is an incorrect statement. Flushi”g medication down the toilet can contribute to water pollution and harm aquatic life. It is not recommended as a method of medication disposal unless specifically instructed for certain controlled substances by authorized entities.

D) "Crush expired medication tablets and rin“e them down the sink": This is an incorrect statement. Crushi”g medication tablets and rinsing them down the sink can introduce pharmaceuticals into the water supply, which can have adverse effects on aquatic ecosystems. It is not a safe or environmentally friendly method of disposal.

Distended neck veins: Distended neck veins are typically associated with fluid volume excess rather than deficit. In heart failure, venous congestion can cause jugular venous distention, indicating fluid volume overload rather than deficit. Therefore, this finding would not suggest fluid volume deficit in a client with heart failure receiving furosemide.
B) Elevated hematocrit level: Fluid volume deficit, also known as dehydration or hypovolemia, is characterized by a loss of both water and electrolytes from the body, leading to a relative increase in the concentration of red blood cells and other blood components. This increase in concentration results in an elevated hematocrit level, which is a common laboratory finding in clients with fluid volume deficit. Furosemide, a loop diuretic, is commonly used to manage fluid overload in clients with heart failure by promoting diuresis and reducing excess fluid retention. However, excessive diuresis with furosemide can lead to fluid volume deficit if not adequately monitored and managed.

C) Shortness of breath: Shortness of breath is a common symptom of heart failure, particularly when fluid accumulates in the lungs (pulmonary edema) due to fluid volume overload. While shortness of breath may be present in both fluid volume deficit and excess, it is more commonly associated with fluid volume overload in clients with heart failure.

D) Weight gain: Weight gain is indicative of fluid volume excess rather than deficit. In heart failure, weight gain often occurs due to fluid retention, reflecting an increase in total body water and extracellular fluid volume. Monitoring weight is essential in managing heart failure and assessing fluid status, but weight gain would not suggest fluid volume deficit in a client receiving furosemide for heart failure management.