A nurse is admitting a client who has acute heart failure. Which of the following prescriptions from the provider should the nurse anticipate?

Provide the client with a 4g sodium diet.

Ambulate the client every 4 hr while awake.

Infuse 0.9% sodium chloride 500 mL IV bolus over 1 hr.

Administer enalapril 2.5 mg PO twice daily.

Answer and Explanation

The Correct Answer is D

A) Provide the client with a 4g sodium diet: This is incorrect. Clients with acute heart failure typically require a low-sodium diet (often less than 2g per day) to help manage fluid retention and reduce workload on the heart.

B) Ambulate the client every 4 hr while awake: While mobility is important, the frequency and timing of ambulation in clients with acute heart failure should be carefully considered based on their stability and fatigue level. It may not be appropriate to ambulate every 4 hours.

C) Infuse 0.9% sodium chloride 500 mL IV bolus over 1 hr: This is generally not appropriate for clients with acute heart failure due to the risk of fluid overload. Instead, fluid management often involves restricting IV fluids and closely monitoring fluid balance.

D) Administer enalapril 2.5 mg PO twice daily: This prescription is appropriate. Enalapril, an ACE inhibitor, is commonly used to manage heart failure by reducing afterload and improving cardiac output. It helps alleviate symptoms and improve quality of life in heart failure patients.

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Correct Answer is C

Explanation

A) A client who has orthostatic hypotension and 4+ pitting edema in the lower extremities: While this client requires assessment, their condition is not immediately life-threatening. Orthostatic hypotension and edema need to be evaluated, but they are not acute emergencies.

B) A client who has Clostridium difficile and a temperature of 38.6° C (101.5° F): This client needs attention due to the infection and fever, but it is not as critical as the potential cardiac event presented in option C.

C) A client who has left shoulder pain and S-T elevation on a 12-lead ECG: This client is exhibiting signs that may indicate an acute myocardial infarction (heart attack). S-T elevation on an ECG is a significant finding and suggests that this client could be experiencing a serious cardiac event, making it the priority for assessment.

D) A client who has a complete femur fracture and reports a pain level of 7 on a scale from 0 to 10: While this client is in pain and requires care, the priority in emergency situations is often given to conditions that are life-threatening, such as those related to cardiac function. Therefore, this client can be assessed after addressing the potential cardiac emergency.

A. Increased erythrocyte sedimentation rate B. Increased neutrophil count C. Increased platelet count D. Increased hemoglobin level

Correct Answer is D

Explanation

A) "Increased erythrocyte sedimentation rate.": An increase in the erythrocyte sedimentation rate (ESR) indicates inflammation or the presence of disease but does not reflect a response to epoetin alfa, which aims to increase red blood cell production.

B) "Increased neutrophil count.": Epoetin alfa primarily stimulates erythropoiesis (red blood cell production) and does not significantly affect neutrophil counts. Therefore, an increased neutrophil count is not a relevant therapeutic response.

C) "Increased platelet count.": Epoetin alfa is not directly aimed at increasing platelet counts. While it can have some indirect effects on platelets due to increased hematocrit, a higher platelet count alone does not indicate a therapeutic response to this medication.

D) "Increased hemoglobin level.": An increased hemoglobin level is the primary therapeutic target of epoetin alfa. This medication is used to treat anemia, particularly in patients with chronic kidney disease or those undergoing chemotherapy, by stimulating the production of red blood cells and thus raising hemoglobin levels.

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A nurse is admitting a client who has acute heart failure. Which of the following prescriptions from the provider should the nurse anticipate?

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