After providing discharge teaching, a nurse assesses the client's understanding regarding increased risk for metabolic alkalosis. Which statement indicates that the client needs additional teaching?

"In hot weather, I sweat so much that I drink six glasses of water each day."

"I take sodium bicarbonate after every meal to prevent heartburn."

"I don't drink milk because it gives me gas and diarrhea."

"I have been taking digoxin every day for the last 15 years."

Answer and Explanation

The Correct Answer is B

A. Drinking water in hot weather is important to prevent dehydration. This is not a risk factor for metabolic alkalosis unless the client is excessively losing electrolytes through sweating and not replacing them.

B. Sodium bicarbonate is an alkaline substance, and regular use, especially after meals, can contribute to metabolic alkalosis. The client should be instructed on the potential risks of using sodium bicarbonate too frequently.

C. Avoiding milk due to gastrointestinal symptoms does not directly contribute to metabolic alkalosis.

D. Digoxin does not directly affect acid-base balance, but it requires monitoring due to potential interactions with other medications or electrolyte imbalances.

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Correct Answer is D

Explanation

A. Increasing IV fluids would exacerbate the client's fluid overload and worsen heart failure symptoms.

B. Trendelenburg positioning is typically used for shock management, but this client’s fluid overload needs to be addressed first.

C. Monitoring is important but does not address the immediate need to manage fluid overload.

D. The client's elevated CVP, PAWP, and BNP levels indicate fluid overload and heart failure with reduced ejection fraction. The priority is to reduce fluid overload by administering IV diuretics, which will help reduce the pressure in the heart and lungs, improving oxygenation and decreasing the risk of pulmonary edema.

A. It must be taken on an empty stomach. B. It must not be handled by pregnant women. C. It is given deep intramuscular injection to avoid tissue irritation. D. The client needs to be warned that hair loss is a common adverse effect.

Correct Answer is B

Explanation

A. Finasteride does not need to be taken on an empty stomach.

B. Finasteride can cause harm to a developing male fetus, and pregnant women should avoid handling it to prevent potential absorption through the skin.

C. Finasteride is an oral medication and is not administered as an intramuscular injection.

D. Hair loss is not a common adverse effect of finasteride; in fact, it is used to treat hair loss in men with benign prostatic hyperplasia.

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After providing discharge teaching, a nurse assesses the client's understanding regarding increased risk for metabolic alkalosis. Which statement indicates that the client needs additional teaching?

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Correct Answer is D

Explanation

During the administration of finasteride (Proscar), the nurse must remember which important precaution?

Correct Answer is B

Explanation

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