The nurse is teaching an older adult with a new prescription for hydrochlorothiazide as a second anti-hypertensive drug. What safety precaution will the nurse include in the teaching?

"Weigh yourself after breakfast every morning."

"Check your blood pressure anytime during the day."

"Call the primary care provider if you experience any seizures."

"Exercise at least twice a week"

Answer and Explanation

The Correct Answer is A

A. "Weigh yourself after breakfast every morning": Hydrochlorothiazide, a diuretic, can lead to fluid and electrolyte imbalances, including hyponatremia and hypokalemia. Monitoring weight daily, particularly after breakfast, helps detect any sudden weight changes that could indicate fluid retention or loss, allowing for timely intervention.

B. "Check your blood pressure anytime during the day": While monitoring blood pressure regularly is important for patients with hypertension, it is not a specific safety precaution related to taking hydrochlorothiazide. Blood pressure monitoring may be recommended, but it is not the primary safety precaution associated with this medication.

C. "Call the primary care provider if you experience any seizures": Seizures are not a common side effect of hydrochlorothiazide. Therefore, while it is important for patients to report any unusual symptoms to their healthcare provider, seizures are not specifically associated with this medication.

D. "Exercise at least twice a week": While regular exercise is beneficial for overall health, it is not a specific safety precaution related to taking hydrochlorothiazide. However, lifestyle modifications such as diet and exercise may complement medication therapy in managing hypertension.

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Correct Answer is D

Explanation

A. Having the primary provider prescribe a CT:
Prescribing a CT scan is not the initial action for assessing nonpalpable pedal pulses. CT scans are typically used for imaging purposes and are not the primary diagnostic tool for assessing peripheral pulses.

B. Apply a tourniquet for 3 to 5 minutes and then reassess:
While applying a tourniquet may increase the visibility of pulses in some cases, it is not the recommended method for assessing pedal pulses, especially if they are nonpalpable. Tourniquet use carries risks, such as tissue damage or ischemia, and is not a standard practice for assessing pulses.

C. Elevate the extremity and attempt to palpate the pulses:
Elevating the extremity may improve blood flow and make pulses easier to palpate, but if the pulses are nonpalpable, simply elevating the extremity may not be sufficient for assessment. Additionally, palpation alone may not accurately detect pulses in some cases.

D. Use the doppler ultrasound to detect pedal pulses:
This is the most appropriate action. Doppler ultrasound is a non-invasive diagnostic tool commonly used to assess peripheral pulses, especially when they are nonpalpable. It uses sound waves to detect blood flow and can provide accurate information about the presence and strength of pedal pulses. Using a doppler ultrasound can help confirm the status of pedal pulses and guide further management.

A. Oral candidiasis and nausea B. Genital ulcer and vomiting C. Memory deficit and apathy D. Progressive dyspnea and fever

Correct Answer is D

Explanation

A. Oral candidiasis and nausea: Oral candidiasis (thrush) and nausea are common manifestations in patients with AIDS, particularly when the CD4 count is low. While these symptoms require intervention, they are not typically considered emergent or immediately life-threatening.

B. Genital ulcer and vomiting: Genital ulcers and vomiting can occur in patients with AIDS due to various opportunistic infections and conditions. While these symptoms may warrant intervention, they are not typically indicative of an immediate life-threatening situation.

C. Memory deficit and apathy: Memory deficits and apathy can occur in patients with AIDS, particularly as the disease progresses. While these cognitive and behavioral changes may impact the patient's quality of life and require intervention, they are not typically considered emergent or immediately life-threatening.

D. Progressive dyspnea and fever: Progressive dyspnea (difficulty breathing) and fever are concerning findings in a patient with AIDS, especially with a CD4 count less than 200. These symptoms may indicate the presence of opportunistic infections such as Pneumocystis jirovecii pneumonia (PCP), which can rapidly progress and lead to respiratory failure and death if not promptly treated. Therefore, these assessment findings require immediate intervention to assess for and manage potential respiratory compromise and systemic infection.

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The nurse is teaching an older adult with a new prescription for hydrochlorothiazide as a second anti-hypertensive drug. What safety precaution will the nurse include in the teaching?

Nursing Test Bank

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