A nurse is caring for a client diagnosed with congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first?

Check an apical pulse

Request a dietitian consult.

Request an order for an antiemetic

Suggest that the client rests before eating the meal

Answer and Explanation

The Correct Answer is A

A. Check an apical pulse: Digoxin is known to cause toxicity, which can manifest as nausea, weakness, and anorexia. Bradycardia is a common sign of digoxin toxicity. Therefore, the nurse's first action should be to assess the client's apical pulse rate to determine if there are any signs of bradycardia, which could indicate digoxin toxicity.

B. Request a dietitian consult: While nutrition is important, the client's symptoms of nausea and weakness need immediate attention to rule out digoxin toxicity before considering dietary interventions.

C. Request an order for an antiemetic: Administering an antiemetic may be indicated if the client is experiencing nausea, but it's crucial to assess for digoxin toxicity first, as antiemetics may mask symptoms of toxicity.

D. Suggest that the client rests before eating the meal: Rest may be beneficial for the client, but addressing the potential cause of the symptoms, such as digoxin toxicity, takes priority

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Correct Answer is D

Explanation

A. Dyspnea on exertion: Dyspnea on exertion is a common symptom in clients with heart failure and may indicate worsening heart function. While it warrants monitoring and potential intervention, it is not as urgent as rapid weight gain.

B. Increased urination: Increased urination may be expected with the use of diuretics, as they promote the excretion of excess fluid from the body. This finding is not typically concerning unless accompanied by other symptoms.

C. Weight gain of 2 pounds in a week: A weight gain of 2 pounds in a week may indicate fluid retention, but it is not as concerning as a rapid weight gain over a shorter period.

D. Weight gain of 3 pounds in 24 hours: A rapid weight gain of 3 pounds in 24 hours is significant and may indicate fluid overload, potentially leading to exacerbation of heart failure symptoms. It should be reported promptly to the healthcare provider for further evaluation and management.

A. Consumes spicy snacks daily. B. Uses flavored chewing tobacco. C. Employed as x-ray technician. D. Partner smokes cigarettes. E. Employed as industrial painter.

Correct Answer is ["B","D","E"]

Explanation

A. Consumes spicy snacks daily: Consuming spicy snacks daily is not a known risk factor for laryngeal cancer. Risk factors for laryngeal cancer typically include tobacco use, alcohol consumption, exposure to certain chemicals, and occupational hazards.

B. Uses flavored chewing tobacco: Chewing tobacco, especially flavored varieties, is a known risk factor for laryngeal cancer. Tobacco contains carcinogenic substances that can damage the cells of the larynx, increasing the risk of cancer development.

C. Employed as x-ray technician: Being employed as an x-ray technician is not a known risk factor for laryngeal cancer. However, prolonged exposure to radiation may increase the risk of other types of cancer, such as lung cancer.

D. Partner smokes cigarettes: Secondhand smoke exposure from a partner who smokes cigarettes is a risk factor for laryngeal cancer. Inhaling tobacco smoke, even indirectly, can expose the individual to carcinogens that may contribute to the development of cancer.

E. Employed as industrial painter: Occupational exposure to certain chemicals, such as those found in paint and industrial solvents, is a known risk factor for laryngeal cancer. Industrial painters may be exposed to carcinogens through inhalation or skin contact, increasing their risk of developing cancer.

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A nurse is caring for a client diagnosed with congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first?

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