The nurse is providing discharge instructions for the client diagnosed with heart failure. Which information should the nurse provide to assist the client to limit complications and prevent future hospitalizations? (SELECT ALL THAT APPLY).

Consume 2500mL of fluids per day during the summer months

Maintain daily sodium intake of no more than 2gm per day

Notify the health care provider if weight increases by 5 Ibs. in one week

If shortness of breath occurs with minimal activity, notify the provider

Take furosemide anytime when feeling bloated or short of breath

Answer and Explanation

Correct Answer : B,C,D

A.   Fluid intake may need to be regulated in heart failure patients, consuming 2500mL of fluids per day may be too high for some patients, depending on their condition and whether they are on fluid restriction. Fluid management should be individualized, and the provider should specify the amount based on the patient's condition.
B.   A low-sodium diet is essential for heart failure patients to help reduce fluid retention, decrease blood pressure, and lessen the burden on the heart. The American Heart Association recommends a sodium intake of no more than 2,000-2,300 mg per day for heart failure patients.
C.   Rapid weight gain is a sign of fluid retention, which can indicate worsening heart failure. A gain of 2-3 pounds in a single day or 5 pounds in a week should prompt the client to contact their healthcare provider for further evaluation.
D.   Shortness of breath with minimal activity can be a sign of worsening heart failure or fluid overload. This symptom should be reported immediately to a healthcare provider for further evaluation and possible adjustments to treatment.
E.   Furosemide (a diuretic) is often prescribed to reduce fluid retention but it should not be taken without proper guidance or as a response to symptoms without consulting the healthcare provider. Taking diuretics at the wrong time or in excessive amounts can lead to dehydration and electrolyte imbalances, which could worsen the condition.

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Correct Answer is A

Explanation

A. INR = 3.7: The International Normalized Ratio (INR) is a measure of blood clotting. An INR greater than
3.0 indicates that the blood is not clotting properly, which can be caused by warfarin overdose. An elevated INR requires FFP to correct coagulopathy.
B. Hemoglobin = 6.3g/dL: This is low, indicating anemia, but it is not directly related to warfarin overdose. The primary issue here is coagulopathy, not anemia.
C. Fibrinogen = 90mg/dL: Fibrinogen levels may be decreased in various conditions, but this alone does not necessarily require additional FFP unless it’s below a critical threshold. Fibrinogen is not the main marker for warfarin overdose.
D. Platelets = 101,000 mm3: This platelet count is within the lower end of the normal range but does not indicate that more FFP is needed in response to warfarin overdose.

A. Assess the incision site for signs of infection B. Apply a sling to the operative arm C. Remove the pacemaker leads D. Monitor vital signs regularly E. Encourage vigorous physical activity

Correct Answer is ["A","B","D"]

Explanation

A. Assess the incision site for signs of infection - This is an essential nursing intervention after any surgical procedure, including pacemaker insertion, to prevent and detect early signs of infection.
B. Apply a sling to the operative arm - This helps to limit movement and prevent dislodging of the pacemaker leads, which is important for the healing process.
C. Remove the pacemaker leads - This is not an appropriate intervention. The pacemaker leads are left in place after insertion to ensure proper function of the pacemaker.
D. Monitor vital signs regularly - Regular monitoring of vital signs, especially heart rate and rhythm, is important to detect any complications such as arrhythmias after pacemaker insertion.
E. Encourage vigorous physical activity - Vigorous physical activity should be avoided initially to prevent any strain or potential damage to the pacemaker or leads. Early mobility is important, but it should be gradual and restricted.

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The nurse is providing discharge instructions for the client diagnosed with heart failure. Which information should the nurse provide to assist the client to limit complications and prevent future hospitalizations? (SELECT ALL THAT APPLY).

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who received a transfusion of Fresh Frozen Plasma (FFP) for an acute GI bleed related to accidental wantarin overdose. Which laboratory result would indicate the need for an additional unit of Fresh Frozen Plasma (FFP) to correct the problem caused by the overdose?

Correct Answer is A

Explanation

Which intervention(s) should the nurse include in the post-operative care of a client following a permanent pacemaker insertion? (SELECT ALL THAT APPLY)

Correct Answer is ["A","B","D"]

Explanation

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