A nurse is caring for a client who has heart failure and a prescription for digoxin 125 mcg PO daily. Available is digoxin PO 0.25 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

A. Rotate assignment of daily caregivers: Consistency in caregivers is important for individuals with Alzheimer's disease to build trust and rapport. Rotating caregivers frequently may disrupt the client's routine and lead to increased confusion and anxiety.
B. Provide an activity schedule that changes from day to day: Consistency and routine are beneficial for individuals with Alzheimer's disease as they provide structure and predictability. A consistent activity schedule helps the client feel more secure and can reduce agitation and behavioral issues.
C. Limit time for the client to perform activities: While it may be necessary to pace activities based on the client's abilities and fatigue level, arbitrarily limiting time for the client to perform activities can be counterproductive. Instead, individualizing the pace of activities based on the client's preferences and abilities is more beneficial.
D. Talk the client through tasks one step at a time: Individuals with Alzheimer's disease often experience cognitive impairment, including difficulty with memory, attention, and problem-solving. Breaking tasks down into manageable steps and providing clear, simple instructions can help the client understand and complete activities of daily living more effectively. This intervention supports the client's independence and reduces frustration.

A. Notify the client's provider: This option might be considered if there are signs of postpartum hemorrhage, such as excessive bleeding, signs of shock, or a boggy uterus that does not respond to massage. However, in this scenario, the fundus is midline and firm, which indicates appropriate uterine contraction. Therefore, notifying the provider at this point may not be necessary.
B. Encourage the client to empty her bladder: Encouraging the client to empty her bladder is always important in the postpartum period, as a full bladder can impede uterine contraction. However, the presence of lochia rubra and small clots along with a midline and firm fundus suggests that uterine involution is progressing well. While encouraging the client to empty her bladder is appropriate, it may not be the priority in this situation.
C. Increase the frequency of fundal massage immediately: Fundal massage is typically performed to promote uterine involution and prevent postpartum hemorrhage. However, in this scenario, the fundus is already midline and firm, indicating adequate contraction. Increasing the frequency of fundal massage unnecessarily could cause discomfort to the client and is not indicated based on the current assessment findings.
D. Document the findings and continue to monitor the client: This is the most appropriate action at this time. The presence of lochia rubra and small clots along with a midline and firm fundus suggests that the uterus is involuting properly. Documenting the findings allows for accurate documentation of the client's condition and continued monitoring for any changes or developments. If the client's condition changes or if there are signs of postpartum hemorrhage, further action, such as notifying the provider, can be taken.