A nurse is evaluating a client who has heart failure and is receiving warfarin. Which of the following statements by the client indicates a need for further teaching?

Losartan (Cozaar) is an angiotensin II receptor blocker (ARB) that is used to treat heart failure by lowering blood pressure and reducing fluid retention.

Patients taking losartan should:

• Weigh themselves every morning and report any changes.

This helps to monitor fluid status and detect signs of worsening heart failure.Weight gain of more than 2 kg (4.4 lb) in a week or 1 kg (2.2 lb) in a day should be reported to the health care provider.

• Call their doctor if they have a sore throat or fever.This could indicate an infection or a rare but serious side effect of losartan called angioedema, which causes swelling of the face, lips, tongue, or throat.

The other choices are wrong because:

• Losartan does not need to be taken with food to prevent stomach upset.It can be taken with or without food.

• Losartan does not increase the sensitivity to sunlight.However, some other medications for heart failure, such as diuretics, may do so.

• Drinking plenty of fluids to stay hydrated is not recommended for patients with heart failure, as it may worsen fluid retention and overload the heart.Patients should follow their prescribed fluid restriction and limit their sodium intake.

The nurse should advise the patient with heart failure to limit or avoid canned soups and sauces because they are high in sodium, which can cause fluid retention and worsen cardiac function.Sodium intake should be restricted to less than 2 g per day for patients with heart failure.

Choice A is wrong because fresh fruits and vegetables are good sources of potassium, magnesium, and fiber, which are beneficial for heart health.Potassium and magnesium help regulate fluid and electrolyte balance, and fiber helps lower cholesterol and blood pressure.

Choice B is wrong because whole grains and cereals are also rich in fiber, as well as complex carbohydrates, which provide energy and prevent rapid fluctuations in blood glucose levels.Whole grains and cereals may also contain phytochemicals that have antioxidant and anti-inflammatory effects.

Choice C is wrong because lean meats and poultry are low in saturated fat and cholesterol, which can contribute to atherosclerosis and coronary artery disease. Lean meats and poultry provide protein, which is essential for tissue repair and wound healing.Protein intake should be adequate but not excessive for patients with heart failure, as too much protein can increase the workload of the kidneys.