Digoxin and furosemide were prescribed for a client with chronic heart failure, and the home health nurse is evaluating the client's self-care knowledge of these drugs. Which statement indicates that the client has a good understanding about the use of these drugs?

"I need to notify my healthcare provider if I lose my appetite or get nauseated."

"I should take my furosemide only if I have shortness of breath or swelling in my feet."

"I need to check my blood pressure three times a day."

"If I lose more than one pound in a week, I should hold my next dose of furosemide."

Answer and Explanation

The Correct Answer is A

A. "I need to notify my healthcare provider if I lose my appetite or get nauseated." This statement shows understanding because loss of appetite and nausea can be symptoms of digoxin toxicity or side effects, and it is important to report these symptoms to a healthcare provider. Monitoring for such side effects is crucial when taking digoxin.
B. "I should take my furosemide only if I have shortness of breath or swelling in my feet." This statement is incorrect because furosemide, a diuretic, should be taken according to the prescribed schedule, not based on symptoms. It is used to manage fluid retention and symptoms of heart failure, and its use should not be dependent solely on the presence of symptoms.
C. "I need to check my blood pressure three times a day." While monitoring blood pressure is important, it is not specifically required for patients on digoxin and furosemide unless instructed by a healthcare provider. The focus should be more on monitoring for symptoms of drug side effects and electrolyte imbalances.
D. "If I lose more than one pound in a week, I should hold my next dose of furosemide." Weight loss can be a normal effect of furosemide due to fluid loss, and the decision to hold a dose should be based on specific medical advice and not solely on weight change.

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Correct Answer is A

Explanation

A. Phosphate: Calcium acetate is used primarily to manage hyperphosphatemia in patients with chronic kidney disease (CKD). It works by binding to dietary phosphate in the gut, preventing its absorption, which helps lower phosphate levels in the blood. A decrease in phosphate levels indicates that the calcium acetate is effectively controlling phosphate levels.
B. pH: While maintaining normal pH levels is important in CKD, calcium acetate does not directly affect blood pH. The primary role of calcium acetate is to manage phosphate levels rather than pH balance.
C. Calcium: Calcium acetate is a phosphate binder and does not primarily target calcium levels. It can influence calcium levels indirectly, but a decrease in calcium is not the direct measure of the medication's effectiveness. Instead, monitoring phosphate levels is more indicative of the medication’s effectiveness.
D. Potassium: Calcium acetate does not have a direct effect on potassium levels. It is specifically used to manage phosphate levels in CKD patients. Changes in potassium levels would not indicate the effectiveness of calcium acetate.

A. Takes metformin hydrochloride for type 2 diabetes mellitus. B. Metal hip prosthesis was placed twenty years ago. C. Report of client's sobriety for the last five years. D. CT scan that was performed six months earlier.

Correct Answer is A

Explanation

A) Takes metformin hydrochloride for type 2 diabetes mellitus: Metformin can interact with the contrast dye used in CT scans, particularly in patients with impaired renal function. The contrast dye can affect kidney function, potentially leading to lactic acidosis in patients taking metformin. It is important to follow up on this history and possibly temporarily discontinue metformin and monitor kidney function before and after the procedure.

B) Metal hip prosthesis was placed twenty years ago: A metal hip prosthesis does not typically affect the CT scan with contrast, though it may affect the imaging technique or quality. This history usually does not require follow-up related to the contrast use.
C) Report of client's sobriety for the last five years: Sobriety does not directly impact the use of contrast dye in a CT scan. This information is relevant for overall health but not specifically for the use of contrast.
D) CT scan that was performed six months earlier: The timing of a previous CT scan is not a contraindication for a new scan with contrast. Follow-up on the history of a prior scan may be relevant for comparison but does not specifically impact the use of contrast dye.

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Digoxin and furosemide were prescribed for a client with chronic heart failure, and the home health nurse is evaluating the client's self-care knowledge of these drugs. Which statement indicates that the client has a good understanding about the use of these drugs?

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Correct Answer is A

Explanation

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Correct Answer is A

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