A client is teaching a client who has a new prescription for hydrochlorothiazide for management of hypertension. Which of the following Instructions should the nurse include?
"Reduce intake of potassium-rich foods."
"Take this medication before bedtime."
"Avoid grape juice.'
"Monitor for leg cramps."
The Correct Answer is D
A) "Reduce intake of potassium-rich foods":
Hydrochlorothiazide is a diuretic medication that can cause potassium loss through increased urinary excretion. Therefore, instructing the client to reduce intake of potassium-rich foods could further decrease potassium levels, leading to hypokalemia. Instead, clients taking hydrochlorothiazide should be encouraged to consume potassium-rich foods to help maintain normal potassium levels, unless otherwise instructed by their healthcare provider.
B) "Take this medication before bedtime":
While hydrochlorothiazide can be taken once daily, it is typically recommended to take it in the morning rather than before bedtime. Taking the medication earlier in the day can help minimize the need to wake up during the night to urinate, as it is a diuretic that increases urine production. Therefore, instructing the client to take hydrochlorothiazide before bedtime is not the optimal recommendation.
C) "Avoid grape juice":
There is no significant interaction between hydrochlorothiazide and grape juice. In general, grapefruit juice is known to interact with certain medications by inhibiting cytochrome P450 enzymes in the liver, affecting drug metabolism. However, grape juice is not known to interact with hydrochlorothiazide, so advising the client to avoid grape juice is not necessary.
D) "Monitor for leg cramps":
This is the correct instruction. Leg cramps can be a potential side effect of hydrochlorothiazide therapy due to electrolyte imbalances, particularly hypokalemia. By monitoring for leg cramps, the client can promptly report any symptoms to their healthcare provider for further evaluation and management. This instruction promotes client safety and awareness of potential adverse effects associated with the medication."
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) "I should limit my fluid intake while taking this medication":
This statement is incorrect. Furosemide is a loop diuretic that increases urine production to reduce fluid overload in conditions like heart failure or edema. It is essential for clients taking furosemide to maintain adequate hydration to prevent dehydration. Therefore, the client should not limit their fluid intake while taking this medication.
B) "My blood pressure will increase while I am taking this medication":
This statement is incorrect. Furosemide is primarily used to reduce blood pressure by promoting diuresis and reducing fluid volume. Therefore, it is unlikely that blood pressure would increase while taking this medication.
C) "I should take this medication in the morning rather than at night":
This is the correct answer. Furosemide is usually taken in the morning to prevent nocturia (excessive urination at night), as it can increase urinary frequency. Taking it earlier in the day allows for better fluid balance during waking hours and reduces the need to wake up frequently during the night to urinate.
D) "I should eat a diet low in potassium while taking this medication":
This statement is incorrect. Furosemide can cause potassium depletion as a side effect, so clients may be advised to consume potassium-rich foods or supplements unless contraindicated due to other medical conditions. However, it is not necessary to eat a diet low in potassium while taking furosemide unless specifically instructed by a healthcare provider.
Correct Answer is B
Explanation
A) Decreased bowel sounds:
While diarrhea can lead to changes in bowel function, such as increased frequency and urgency, it typically does not cause decreased bowel sounds. In fact, hyperactive bowel sounds may be present in some cases of diarrhea due to increased gastrointestinal motility and peristalsis as the body attempts to expel excess stool.
B) Dehydration:
This is the correct answer. Diarrhea can result in fluid and electrolyte losses, leading to dehydration if not adequately managed. Common symptoms of dehydration include increased thirst, dry mucous membranes, decreased urine output, dark urine, fatigue, weakness, and dizziness. In severe cases, dehydration can lead to hypovolemic shock, a life-threatening condition requiring immediate medical attention.
C) Rigid abdomen:
While abdominal discomfort and cramping are common symptoms of diarrhea, a rigid abdomen is not typically associated with uncomplicated cases of diarrhea. However, severe abdominal pain, distention, and rigidity may indicate underlying complications such as bowel obstruction or peritonitis, which require urgent medical evaluation.
D) Hypothermia:
Hypothermia, or abnormally low body temperature, is not a typical finding in clients with diarrhea. In fact, diarrhea is more commonly associated with fluid and electrolyte imbalances that can lead to hyperthermia (elevated body temperature) due to dehydration and inflammatory responses. However, hypothermia may occur in severe cases of dehydration or sepsis, but it is not a direct consequence of diarrhea itself.
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