A patient with heart failure develops hyperaldosteronism and is prescribed spironolactone.


What instructions should the nurse include in the patient’s care plan?

Choice A rationale

While maintaining a healthy lifestyle and diet is generally beneficial, consuming large amounts of leafy green vegetables, which are high in vitamin K, can interfere with the effectiveness of warfarin, a medication that works by inhibiting the action of vitamin K-dependent clotting factors. Therefore, praising the patient for her healthy lifestyle without addressing the potential interaction between her diet and medication could lead to suboptimal treatment outcomes.

Choice B rationale

This statement is misleading. While a healthy diet can contribute to overall health and well- being, the patient’s dietary choices, specifically her daily consumption of leafy green

vegetables, could actually decrease the effectiveness of warfarin. Warfarin’s ability to prevent blood clots is dependent on a consistent intake of vitamin K67.

Choice C rationale

This is the most appropriate response. The healthcare provider should be informed about the patient’s current diet because it could impact the effectiveness of warfarin. The provider may need to adjust the dose of warfarin or provide additional dietary guidance to ensure the medication works as intended.

Choice D rationale

While this might seem like a reasonable suggestion, it’s important to remember that dietary changes should be made in consultation with a healthcare provider or a dietitian. Substituting leafy green vegetables with other protein sources may not be necessary or appropriate depending on the patient’s overall diet, nutritional needs, and personal preferences.

Choice A rationale

Glucagon should not be administered before meals to prevent hyperglycemia. Glucagon is a hormone that raises blood glucose levels and is used to treat severe hypoglycemia. It is not intended to prevent hyperglycemia.

Choice B rationale

Glucagon should be administered when signs of severe hypoglycemia occur. Hypoglycemia, or low blood sugar, can cause symptoms such as confusion, dizziness, hunger, and shakiness. If left untreated, severe hypoglycemia can lead to unconsciousness or seizures.

Choice C rationale

Glucagon should not be administered when unable to eat during sick days. While it’s important to maintain blood glucose levels during illness, glucagon is specifically used for severe hypoglycemia.

Choice D rationale

Glucagon should not be administered at the onset of signs of diabetic ketoacidosis. Diabetic ketoacidosis is a serious condition that requires immediate medical attention. Glucagon is not a treatment for this condition.