A nurse provides discharge instructions to a client with a new diagnosis of heart failure. Which of the following instructions should the nurse include in the teaching?

Notify the health care provider of weight gain of 1 pound in a week

Take diuretics early in the morning and before bedtime

Exercise at least three times week

Take naproxen for generalized discomfort

Answer and Explanation

The Correct Answer is C

A. Clients with heart failure should notify the provider for a weight gain of 2–3 pounds in a day or 5 pounds in a week, not just 1 pound.
B. Diuretics should be taken early in the morning to avoid nocturia; taking them before bedtime can disrupt sleep.
C. Regular exercise, such as walking at least three times a week, helps improve cardiac function, endurance, and overall health and is appropriate for clients with heart failure.
D. Naproxen and other NSAIDs can cause fluid retention and may worsen heart failure; they should generally be avoided in these clients.

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Correct Answer is C

Explanation

A. Encourage the client to increase fluid intake to over 4 liters per day — This is unnecessary. A fluid intake of 3 to 3.5 liters per day is already adequate for promoting kidney function and flushing out bacteria in pyelonephritis.
B. Restrict fluids to prevent fluid overload and electrolyte imbalance — There is no indication of fluid overload or imbalance in this scenario. Fluid restriction is not appropriate unless clinically indicated.
C. Document the intake and continue to monitor the client — The client’s fluid intake is within a healthy range for managing pyelonephritis. The nurse should document and continue monitoring for adequate hydration and response to treatment.
D. Notify the healthcare provider to restrict fluid intake — Unwarranted. The fluid intake is therapeutic for this condition and does not require restriction.

A. Notify the health care provider B. Take the client's pulse rate C. Weigh the client. D. Perform Osler's maneuver while checking blood pressure.

Correct Answer is C

Explanation

A. Notifying the healthcare provider may be necessary, but only after the nurse gathers more assessment data to support the report.
B. Taking the pulse rate is part of a routine assessment but does not directly address the client's complaint of tight shoes, which may indicate fluid retention.
C. Weighing the client is the best initial action because sudden weight gain and tight shoes can indicate fluid overload, a common issue in clients with heart failure. Daily weights help assess fluid status.
D. Osler's maneuver is not relevant in this context; it’s a rarely used technique and not appropriate for assessing peripheral edema or fluid status.

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A nurse provides discharge instructions to a client with a new diagnosis of heart failure. Which of the following instructions should the nurse include in the teaching?

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