A nurse is collecting data from a client who has heart failure and takes chlorothiazide sodium. Which of the following findings should the nurse identify as indicating hypokalemia?

Restlessness

Hyperactive bowel sounds

Decreased deep-tendon reflexes

Bounding peripheral pulses

Answer and Explanation

The Correct Answer is C

A. Restlessness:

Restlessness is not typically associated with hypokalemia. Instead, it may indicate anxiety, discomfort, or other factors unrelated to electrolyte imbalances.

B. Hyperactive bowel sounds:

Hyperactive bowel sounds are often associated with increased gastrointestinal motility, which may occur in conditions such as diarrhea or gastroenteritis. While electrolyte imbalances can contribute to gastrointestinal symptoms, hyperactive bowel sounds are not specific to hypokalemia.

C. Decreased deep-tendon reflexes:

Hypokalemia can lead to decreased deep-tendon reflexes due to its effects on nerve conduction. Potassium is essential for proper nerve and muscle function, and low levels can impair reflexes.

D. Bounding peripheral pulses:

Bounding peripheral pulses are not typically associated with hypokalemia. Instead, they may indicate increased cardiac output or volume overload, which can occur in conditions such as heart failure.

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Correct Answer is A

Explanation

A. "I will take my warfarin with a glass of water the night before my surgery":

This statement indicates a need for further teaching. Warfarin is an anticoagulant medication, and it should typically be discontinued or adjusted before surgery to reduce the risk of excessive bleeding. Taking it the night before surgery could increase the risk of bleeding during the procedure.

B. "I understand what risks I can expect with this surgery":

This statement suggests that the client has received information about the risks associated with the surgery, which is an essential component of preoperative education. There is no indication for further teaching based on this statement.

C. "I will take time to relax if I get nervous the night before surgery":

This statement demonstrates the client's awareness of the importance of managing stress and anxiety before surgery, which is a positive coping strategy. There is no need for further teaching based on this statement.

D. "I will have a glass of water the morning of my surgery":

This statement is generally acceptable. Clear fluids may be allowed up to a certain time before surgery, depending on the facility's protocol. However, specific instructions regarding fasting before surgery should be clarified with the healthcare provider or surgical team to ensure adherence to preoperative guidelines.

A. "incorporate walking into your daily routine." B. "Elevate your legs while in bed." C. "Shop for new shoes during the morning hours." D. "Wear knee length stockings."

Correct Answer is A

Explanation

(A) “Incorporate walking into your daily routine.”: This is the most appropriate instruction for a client with peripheral arterial disease (PAD). Regular exercise, such as walking, can help improve circulation, increase the distance a person can walk without pain, and promote overall cardiovascular health. It’s important to start slow and gradually increase the duration and intensity of the exercise as tolerated. The client should be advised to stop and rest if they experience any pain.

(B) “Elevate your legs while in bed.”: While elevating the legs can help reduce swelling in some conditions, it’s not typically recommended for clients with PAD. Elevation can actually decrease arterial blood flow to the legs, which could worsen symptoms.

(c) “Shop for new shoes during the morning hours.”: This instruction is more relevant for clients with conditions that cause foot swelling, such as heart failure or venous insufficiency. In PAD, the size of the feet does not typically change throughout the day.

(D) “Wear knee length stockings.”: Compression stockings are often used to improve venous circulation in conditions like deep vein thrombosis or chronic venous insufficiency. However, they’re not typically recommended for clients with PAD as they can restrict arterial blood flow.

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A nurse is collecting data from a client who has heart failure and takes chlorothiazide sodium. Which of the following findings should the nurse identify as indicating hypokalemia?

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