The nurse is caring for a client in the intensive care unit following a closed head injury. The nurse can anticipate which medication would be administered to treat an increase in intracranial pressure?

Choice A reason:

Expecting some swelling in the hands and feet is incorrect because furosemide is a diuretic that helps reduce fluid accumulation in the body. Instead of causing swelling, it helps alleviate it. Swelling would not be an expected outcome of taking furosemide and suggesting this would contradict the intended purpose of the medication.

Choice B reason:

Taking the medication at bedtime is generally not recommended for diuretics like furosemide because it can lead to nocturia, which is frequent urination during the night, disrupting sleep. Furosemide is usually taken in the morning to avoid this inconvenience and ensure the diuretic effect occurs during waking hours.

Choice C reason:

Eating foods that contain plenty of potassium is crucial for clients taking furosemide because it can cause significant loss of potassium, a vital electrolyte, through increased urination. Low potassium levels can lead to hypokalemia, which can cause muscle weakness, cramping, and heart rhythm disturbances. Therefore, consuming potassium-rich foods like bananas, oranges, and spinach is essential to maintain electrolyte balance.

Choice D reason:

Taking aspirin if headaches develop is not a standard instruction for clients taking furosemide. While managing headaches may be important, it is not directly related to the use of furosemide. Additionally, without medical advice, taking aspirin could pose risks, especially in patients who may have other underlying conditions or take other medications that interact with aspirin.

Choice A reason:

Restraint during a seizure can lead to injury. It is important to allow the seizure to run its course while ensuring the client is safe from harm. The priority is to protect the client from injury without restraining them, as this can cause fractures or muscle damage.

Choice B reason:

Moving objects away from the client helps prevent injury during a seizure. Clearing the area ensures that the client does not hit anything during the convulsions, reducing the risk of injury. This is a safe and effective measure to protect the client.

Choice C reason:

Placing the client on their back is not recommended during a seizure as it can increase the risk of aspiration if the client vomits. Instead, the client should be turned onto their side (recovery position) to keep the airway clear and prevent choking.

Choice D reason:

Inserting a padded tongue blade into the client’s mouth is outdated and dangerous. It can cause dental damage or block the airway. There is also a risk of injury to both the client and the person attempting to insert the object. It is no longer recommended.