A client receives a prescription for ciprofloxacin 400 mg intravenously (IV) every 12 hours to be infused over an hour. The IV bag contains ciprofloxacin 400 mg in dextrose 5% in water (DW) 200 mL. The nurse should program the infusion pump to deliver how many mL/hr? (Enter numerical value only.)

When a client with heart failure (HF) develops hyperaldosteronism and is prescribed spironolactone, the nurse should include the following instruction in the client's plan of care:

A. Limit intake of high-potassium foods.

Explanation: Spironolactone is a potassium-sparing diuretic, and one of its actions is to promote the retention of potassium by the body. Therefore, it's important to instruct the client to limit the intake of high-potassium foods to avoid hyperkalemia (high potassium levels), which can be a potential side effect of this medication. High-potassium foods include bananas, oranges, potatoes, tomatoes, and many others.

Why the other choices are not appropriate:

B. Cover your skin before going outside:

This instruction is not directly related to spironolactone or hyperaldosteronism. It may be relevant for clients taking photosensitizing medications but is not specific to this situation.

C. Monitor skin for excessive bruising:

This instruction is also not directly related to spironolactone or hyperaldosteronism. It may be relevant in other clinical contexts, but it does not address the potential side effects or management of spironolactone.

D. Replace salt with a salt substitute:

While reducing sodium intake is often recommended for clients with heart failure, replacing salt with a salt substitute containing potassium is not advisable for clients taking spironolactone. This would increase the risk of hyperkalemia.

The over-the-counter medication that the home health nurse should encourage the client with a history of heart failure (HF) to discuss with the healthcare provider to relieve heartburn when lying down after dinner is:

A. Low sodium antacid.

Explanation: Heartburn is a common symptom of gastroesophageal reflux disease (GERD), and it can exacerbate symptoms in individuals with heart failure due to the discomfort and potential fluid retention associated with excessive sodium intake. Low sodium antacids can help relieve heartburn without exacerbating fluid retention, making them a better choice for individuals with heart failure.

B. Diphenhydramine:

Diphenhydramine is an antihistamine commonly used to relieve allergies and may cause drowsiness. It is not indicated for heartburn or GERD symptoms.

C. Acetaminophen:

Acetaminophen is a pain reliever and fever reducer. It is not used to address heartburn or GERD symptoms.

D. Low dose aspirin:

Aspirin is typically used to prevent cardiovascular events in individuals at risk for heart disease but is not used to treat heartburn or GERD symptoms. In fact, aspirin can irritate the stomach lining and potentially worsen heartburn symptoms.