A nurse is teaching a client who has heart failure about self-management techniques. Which of the following statements by the client indicates an understanding of the teaching?

"I will take ibuprofen for mild pain."

"I will weigh myself every other day."

"I will keep an exercise diary."

"I will expect swelling in my feet and ankles."

Answer and Explanation

The Correct Answer is C

A. "I will take ibuprofen for mild pain": NSAIDs like ibuprofen can lead to sodium and fluid retention, which can exacerbate heart failure by increasing preload and worsening edema. They can also reduce the effectiveness of diuretics and ACE inhibitors, both of which are commonly used in heart failure management. Acetaminophen is generally preferred for pain relief as it does not contribute to fluid retention.

B. "I will weigh myself every other day": Daily weight monitoring is essential for detecting fluid retention early, as a sudden increase of 2–3 pounds in 24 hours or 5 pounds in a week can indicate worsening heart failure. Weighing every other day may delay the recognition of fluid overload, increasing the risk of complications such as pulmonary congestion and hospitalization.

C. "I will keep an exercise diary": Regularly tracking physical activity helps assess functional status and detect any decline in exercise tolerance, which could indicate worsening heart failure. An exercise diary allows the healthcare team to adjust activity levels appropriately, ensuring that the client remains active without overexertion. This approach also promotes adherence to a safe and structured exercise regimen, improving overall cardiovascular health.

D. "I will expect swelling in my feet and ankles": While mild peripheral edema can occur, it should never be considered normal in heart failure management. Swelling in the lower extremities suggests worsening fluid retention and should be promptly reported to the healthcare provider. Early intervention, such as medication adjustments or dietary modifications, can help prevent further decompensation and reduce the risk of hospitalization.

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Correct Answer is D

Explanation

A. Place pillows under the client's knees: Placing pillows under the knees can lead to venous stasis, increasing the risk of deep vein thrombosis (DVT). Prolonged knee flexion can also reduce circulation and contribute to joint stiffness. Instead, the client should be encouraged to keep their legs extended and change positions frequently to promote blood flow.

B. Avoid use of anticoagulants: Anticoagulants are commonly prescribed after surgery to prevent thromboembolic complications such as DVT and pulmonary embolism. Avoiding them may increase the client's risk of clot formation, especially if they have limited mobility. The decision to withhold anticoagulation should be based on specific contraindications rather than routine avoidance.

C. Discourage leg exercises while in bed: Leg exercises help prevent blood pooling in the lower extremities, reducing the risk of DVT. Discouraging movement can lead to complications such as impaired circulation, muscle stiffness, and clot formation. Encouraging active and passive range-of-motion exercises supports recovery and decreases the likelihood of postoperative complications.

D. Apply compression stockings to the lower extremities: Compression stockings help improve venous return and reduce the risk of clot formation by preventing blood from pooling in the lower extremities. They are particularly beneficial for clients with limited mobility after surgery. Using them in combination with early ambulation and anticoagulation therapy further decreases the risk of thromboembolic events.

A. Constipation B. Peripheral neuropathy C. Mouth ulcers D. Decreased tear production

Correct Answer is C

Explanation

A. Constipation: Radiation therapy to the neck does not typically affect the gastrointestinal system directly. Constipation is more commonly associated with opioid pain management or radiation targeting the abdominal or pelvic region rather than the head and neck area.

B. Peripheral neuropathy: Nerve damage leading to peripheral neuropathy is more often linked to chemotherapy, particularly agents like vincristine or cisplatin, rather than radiation therapy. Radiation to the neck primarily affects tissues in the irradiated field, such as the oral mucosa.

C. Mouth ulcers: Radiation to the neck frequently causes mucositis, leading to painful mouth ulcers due to the direct impact on rapidly dividing mucosal cells. Clients may experience pain, difficulty swallowing, and increased risk of infection as a result of mucosal breakdown.

D. Decreased tear production: Radiation therapy to the neck is unlikely to directly affect the lacrimal glands. While radiation near the eyes can cause dry eyes, treatment focused on the neck primarily impacts the oral mucosa, salivary glands, and throat rather than tear production.

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A nurse is teaching a client who has heart failure about self-management techniques. Which of the following statements by the client indicates an understanding of the teaching?

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