A client with alcoholism is admitted to a medical-surgical unit with a serum magnesium level of 0.9 mEq/L. Which clinical manifestations would the nurse expect to find in this client?

Choice A reason: Performing meditation every day will not be the most important information that the nurse should stress first. Meditation is a practice that involves focusing the mind on a particular object, thought, or activity, and can help reduce stress, anxiety, and blood pressure. However, meditation alone is not enough to prevent or treat coronary artery disease, which is a condition where the arteries that supply blood to the heart become narrowed or blocked by plaque. The nurse should advise the client to practice meditation as a complementary therapy, but not as the primary intervention.

Choice B reason: It is important to look into a smoking cessation program is the most important information that the nurse should stress first. Smoking is a major risk factor for coronary artery disease, as it damages the lining of the arteries, increases the buildup of plaque, reduces the oxygen in the blood, and raises the blood pressure and heart rate. Smoking can also worsen the symptoms and complications of coronary artery disease, such as chest pain, shortness of breath, or heart attack. The nurse should urge the client to quit smoking as soon as possible, and provide them with resources and support to help them achieve this goal.

Choice C reason: It is important to take a fish oil capsule daily is not the most important information that the nurse should stress first. Fish oil is a source of omega-3 fatty acids, which are beneficial for the heart and blood vessels, as they can lower the triglycerides, reduce inflammation, and prevent blood clots. However, fish oil alone is not enough to prevent or treat coronary artery disease, which is a condition where the arteries that supply blood to the heart become narrowed or blocked by plaque. The nurse should recommend the client to take fish oil as a supplement, but not as the main treatment.

Choice D reason: You will not be able to eat meat or have other fats in your diet is not the most important information that the nurse should stress first. A healthy diet is essential for preventing and managing coronary artery disease, as it can help lower the cholesterol, blood pressure, and weight, and improve the blood flow and oxygen to the heart. However, a healthy diet does not mean that the client has to avoid all meat or fats, as some of them can be beneficial for the heart, such as lean meat, poultry, fish, nuts, seeds, or olive oil. The nurse should educate the client to limit the intake of saturated and trans fats, which are found in red meat, butter, cheese, pastries, or fried foods, and to choose more fruits, vegetables, whole grains, and low-fat dairy products.

Choice A reason: Withholding the dose and reassessing the blood pressure in 30 minutes is not the most appropriate action at this time. Furosemide is a drug that reduces fluid retention and swelling by increasing the urine output. ¹ The client has pulmonary congestion, which means that there is excess fluid in the lungs, causing difficulty breathing and low oxygen levels. ² Delaying the administration of furosemide may worsen the client's condition and increase the risk of complications, such as pulmonary edema or heart failure.

Choice B reason: Calling the healthcare provider to obtain an order for oral furosemide is not the most appropriate action at this time. Oral furosemide is a tablet that is swallowed and absorbed by the digestive system. ¹ It takes longer to act than intravenous (IV) furosemide, which is injected directly into the bloodstream. ¹ The client has pulmonary congestion, which requires immediate treatment to relieve the fluid accumulation in the lungs. Switching to oral furosemide may delay the therapeutic effect and compromise the client's outcome.

Choice C reason: Administering the medication and notifying the healthcare provider of the blood pressure is the most appropriate action at this time. Furosemide is a drug that reduces fluid retention and swelling by increasing the urine output. ¹ The client has pulmonary congestion, which means that there is excess fluid in the lungs, causing difficulty breathing and low oxygen levels. ² Administering IV furosemide can help remove the excess fluid from the lungs and improve the client's breathing and oxygenation. However, furosemide can also lower the blood pressure by reducing the volume of fluid in the blood vessels. ¹ The client already has low blood pressure, which can cause dizziness, fainting, or shock. The nurse should notify the healthcare provider of the blood pressure and monitor the client for any signs of hypotension or adverse reactions.

Choice D reason: Administering the dose and continuing to monitor the vital signs is not the most appropriate action at this time. Furosemide is a drug that reduces fluid retention and swelling by increasing the urine output. ¹ The client has pulmonary congestion, which means that there is excess fluid in the lungs, causing difficulty breathing and low oxygen levels. ² Administering IV furosemide can help remove the excess fluid from the lungs and improve the client's breathing and oxygenation. However, furosemide can also lower the blood pressure by reducing the volume of fluid in the blood vessels. ¹ The client already has low blood pressure, which can cause dizziness, fainting, or shock. The nurse should not only monitor the vital signs, but also notify the healthcare provider of the blood pressure and report any changes or concerns.