A nurse is monitoring a client who is receiving intravenous heparin for angina and has a history of atrial fibrillation. Which of the following laboratory tests should the nurse use to evaluate the effectiveness of heparin therapy?

All of the statements by the client indicate alack of understandingof the medication.

Here is why:

Choice A is wrong because hydrochlorothiazide (HCTZ) is a diuretic (water pill) that increases the amount of urine produced and excreted by the kidneys. Taking this medication at bedtime may cause frequent urination at night and disrupt the sleep cycle.It is recommended to take HCTZ in the morning or early afternoon.

Choice B is wrong because HCTZ is prescribed to treat high blood pressure (hypertension), which is a chronic condition that requires long-term management. Stopping the medication abruptly may cause a rebound increase in blood pressure and increase the risk of complications such as stroke, heart attack, or kidney failure.The client should continue taking HCTZ as directed by the doctor, even if the blood pressure becomes normal.

Choice C is wrong because a persistent cough is not a common side effect of HCTZ. A cough may be a sign of an allergic reaction, a respiratory infection, or another condition that needs medical attention. HCTZ may cause other side effects such as nausea, dizziness, headache, low blood pressure, low potassium levels, high calcium levels, or skin rash.The client should report any unusual or bothersome symptoms to the doctor.

Choice D is wrong because HCTZ is not a medication that can be taken as needed for symptoms of high blood pressure. High blood pressure often has no symptoms and can damage the blood vessels and organs over time. HCTZ works by reducing the fluid volume and pressure in the blood vessels.It needs to be taken regularly and consistently to maintain its effectiveness and prevent fluctuations in blood pressure. The client should be educated about the purpose, benefits, risks, and instructions of taking HCTZ. The client should also be advised to monitor their blood pressure, weight, fluid intake and output, and electrolyte levels while on this medication.The client should also be counseled about lifestyle modifications such as diet, exercise, stress management, and smoking cessation that can help lower blood pressure and improve overall health.

This statement indicates a need for further teaching because sublingual nitroglycerin tablets should not be swallowed, but dissolved under the tongue for rapid absorption and onset of action. Swallowing the tablet would reduce its effectiveness and delay its action.

Choice A is wrong because nitroglycerin tablets should be kept in a dark, glass bottle to protect them from light, heat, and moisture, which can degrade the drug.The bottle should be tightly closed and labeled with the date of opening.

Choice B is wrong because nitroglycerin tablets can be taken every 5 minutes for up to three doses if chest pain persists.If the pain is not relieved after three doses, the client should call 911 or seek emergency medical attention.

Choice D is wrong because nitroglycerin tablets have a short shelf life and should be replaced every 6 months or as indicated by the manufacturer.The client should check the expiration date and discard any unused tablets after 6 months.