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The nurse has reviewed the Nurses' Notes and Vital Signs at 0730 on Day 3.

Exhibits

Which of the following statements by the client indicates understanding of the discharge instruction?Select all that Apply.

"I will restrict my fluid intake to less than 1 L per day."

"It is important to check my blood pressure at different times of the day."

“I understand that I need to restrict potassium in my diet."

“I will check my weight first thing in the morning”

“I will notify my provider if suddenly notice weight gain."

“I only need to check my weight weekly.”

Answer and Explanation

Correct Answer : B,C,D,E

Rationale:

A. "I will restrict my fluid intake to less than 1 L per day." Fluid restriction to less than 1L/day is excessive and unnecessary unless the client has severe fluid retention. The client should follow specific instructions from their healthcare provider regarding fluid intake.

B. "It is important to check my blood pressure at different times of the day." This shows understanding of blood pressure fluctuations. Regular monitoring, especially in those with kidney dysfunction, is important to detect abnormal increases.

C. "I understand that I need to restrict potassium in my diet." Impaired renal function can lead to impaired potassium excretion causing hyperkalemia. Potassium restriction helps prevent cardiac complications from elevated potassium levels.

D. "I will check my weight first thing in the morning." Weighing in the morning gives a consistent baseline to track sudden weight changes, which can indicate fluid retention or worsening kidney function.

E. "I will notify my provider if I suddenly notice weight gain." Rapid weight gain can indicate fluid retention or worsening kidney function. The client should inform their provider if this occurs to prevent complications.

F. "I only need to check my weight weekly." Daily weight monitoring is more appropriate for clients with kidney or heart conditions to detect sudden fluid retention. Weekly checks may miss early signs of fluid retention.

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Correct Answer is B

Explanation

Rationale:

A. Loss of skin turgor: Loss of skin turgor is a sign of dehydration, not hypervolemia. Hypervolemia typically results in fluid retention, leading to other symptoms such as weight gain.

B. Weight gain: Weight gain is a common sign of hypervolemia due to the accumulation of excess fluid in the body. It is often one of the first indicators of fluid overload.

C. Hypotension: Hypotension is more commonly associated with hypovolemia (fluid deficit) rather than hypervolemia. In hypervolemia, blood pressure is more likely to increase due to the excess fluid volume.

D. Bradycardia: Bradycardia is not typically associated with hypervolemia. Hypervolemia can lead to tachycardia (increased heart rate) as the body tries to compensate for the excess fluid volume.

A. "I have lunch with my friends once a week." B. "I need to get my blood pressure medicine refilled." C. "I've lost 15 pounds in the past 2 months." D. "I had to reschedule my doctor's appointment last week."

Correct Answer is A

Explanation

Rationale:

A. "I have lunch with my friends once a week." Maintaining social interactions and taking time for self-care is an indication of adapting well to the role of a caregiver. It's important to balance caregiving responsibilities with personal well-being.

B. "I need to get my blood pressure medicine refilled." This statement indicates that the client is attending to their own health needs, but it doesn't specifically reflect adaptation to the caregiver role.

C. "I've lost 15 pounds in the past 2 months." Significant weight loss could indicate stress, poor nutrition, or neglecting personal health, which suggests the client may be struggling to adapt to the caregiver role. This would need further assessment.

D. "I had to reschedule my doctor's appointment last week." Rescheduling medical appointments can sometimes happen due to caregiving demands, but it also could indicate difficulty in managing personal and caregiving responsibilities.

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The nurse has reviewed the Nurses' Notes and Vital Signs at 0730 on Day 3. Exhibits Which of the following statements by the client indicates understanding of the discharge instruction?Select all that Apply.

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The nurse has reviewed the Nurses' Notes and Vital Signs at 0730 on Day 3.

Exhibits

Which of the following statements by the client indicates understanding of the discharge instruction?Select all that Apply.