A nurse in a clinic is caring for a client who has heart failure and is taking digoxin. Which of the following statements by the client indicates the client is experiencing digoxin toxicity?

Choice A rationale
Suprapubic tenderness is correct. Cystitis, an inflammation of the bladder, often presents with suprapubic tenderness due to the irritation and inflammation of the bladder wall.
Choice B rationale

Proteinuria is incorrect. While proteinuria can be a sign of kidney disease, it is not a typical finding in cystitis. Cystitis primarily affects the bladder and does not usually cause significant protein leakage into the urine.
Choice C rationale
Generalized edema is incorrect. Generalized edema is more commonly associated with conditions that affect the kidneys’ ability to filter blood, such as nephrotic syndrome, rather than cystitis.
Choice D rationale
Oliguria is incorrect. Oliguria, or reduced urine output, is not a typical symptom of cystitis. Cystitis usually causes symptoms like frequent urination, urgency, and dysuria.

Choice A rationale
Telling the client to expect a decrease in urine output is incorrect because it may indicate dehydration, obstruction, or infection. Clients with urolithiasis should be encouraged to maintain adequate urine output to help flush out stones and prevent new stone formation. Decreased urine output can lead to complications and should be addressed promptly.
Choice B rationale
Providing the client with a high protein diet is incorrect because it may increase uric acid and calcium excretion, which can promote stone formation. Clients with urolithiasis should follow a balanced diet that is low in substances that can contribute to stone formation, such as oxalates, purines, and excessive calcium.
Choice C rationale
Maintaining the client on bed rest is incorrect because it may decrease renal perfusion and increase urinary stasis. Clients with urolithiasis should be encouraged to stay active and mobile to promote better circulation and prevent complications. Bed rest is not typically recommended unless there are specific medical indications for it.
Choice D rationale
Encouraging the client to drink 3 L of fluids per day is correct because it helps to flush out stones, prevent new stone formation, and reduce urinary concentration. Adequate hydration is essential for clients with urolithiasis to maintain proper kidney function and reduce the risk of complications. Drinking plenty of fluids helps to dilute the urine and promote the passage of stones.