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."

Answer and Explanation

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."

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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.

A. Severe pain. B. Frequent episodes of painful urination C. An inability to void D. Bladder spasms

Correct Answer is C

Explanation

Bethanechol is not indicated for the relief of severe pain following a transurethral resection of the prostate (TURP). Pain management for postoperative discomfort typically involves analgesics such as opioids or nonsteroidal anti-inflammatory drugs (NSAIDs), depending on the severity of pain. Therefore, this option is incorrect.

B) Frequent episodes of painful urination:
While frequent episodes of painful urination may occur after a TURP due to irritation of the urinary tract, bethanechol is not typically administered to address this symptom. Painful urination is often managed with analgesics and may improve as the urinary tract heals. Therefore, this option is incorrect.

C) An inability to void:
This is the correct response. Bethanechol is a cholinergic agonist that stimulates bladder contraction and can be used to treat urinary retention or an inability to void following surgical procedures such as TURP. By increasing bladder tone and promoting urination, bethanechol helps relieve urinary retention and prevents complications associated with prolonged bladder distension.

D) Bladder spasms:
While bladder spasms may occur postoperatively following a TURP, bethanechol is not typically administered to address this symptom. Bladder spasms are often managed with anticholinergic medications or muscle relaxants to reduce involuntary contractions of the bladder. Therefore, this option is incorrect.”

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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?

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