A nurse is providing discharge teaching about safety considerations to an older adult client who lives at home. The client has heart failure and a new prescription for hydrochlorothiazide. Which of the following statements by the client indicates an understanding of the teaching?

"I will weigh myself once weekly."

"I will take my new medication in the evening."

"I will take a hot bath before going to bed."

"I will leave a light on in my bathroom at night."

Answer and Explanation

The Correct Answer is D

A. "I will weigh myself once weekly." Clients with heart failure should weigh themselves daily to monitor for fluid retention. A sudden weight gain (e.g., 2-3 lbs in 24 hours or 5 lbs in a week) may indicate worsening heart failure and should be reported to the provider.

B. "I will take my new medication in the evening." Hydrochlorothiazide is a diuretic that increases urine output. Taking it in the evening can lead to nocturia and sleep disturbances. Instead, it should be taken in the morning to minimize nighttime urination.

C. "I will take a hot bath before going to bed." Hot baths can cause vasodilation, leading to a drop in blood pressure (orthostatic hypotension), which increases the risk of dizziness and falls, especially in older adults taking diuretics. A warm (not hot) bath is safer.

D. "I will leave a light on in my bathroom at night." Older adults, especially those taking diuretics like hydrochlorothiazide, are at increased risk for nocturia and falls due to frequent trips to the bathroom. Keeping a light on in the bathroom at night enhances visibility and reduces the risk of falls, which is a major concern in this population.

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Correct Answer is A

Explanation

A. Metabolic syndrome: Metabolic syndrome is a cluster of conditions that occur together, increasing the risk of cardiovascular disease, stroke, and type 2 diabetes. The conditions include increased blood pressure, high blood sugar levels, excess body fat around the waist, and abnormal cholesterol or triglyceride levels. Metabolic syndrome significantly increases the risk of developing cardiovascular disease by promoting atherosclerosis (hardening and narrowing of the arteries) and increasing the likelihood of developing other risk factors such as hypertension and diabetes.

B. Family history of alcohol use disorder: While excessive alcohol consumption can contribute to cardiovascular disease by raising blood pressure, increasing triglyceride levels, and promoting obesity, a family history of alcohol use disorder alone is not considered a direct risk factor for cardiovascular disease.

C. Participation in competitive sports: Regular physical activity, including participation in competitive sports, is typically associated with a reduced risk of cardiovascular disease. However, extreme levels of physical activity or certain types of competitive sports may pose risks, such as sudden cardiac events in individuals with underlying heart conditions. Overall, regular exercise is beneficial for cardiovascular health when performed in moderation and according to individual fitness levels.

D. Hypotension: Hypotension, or low blood pressure, is generally not considered a significant risk factor for cardiovascular disease. In fact, low blood pressure is often associated with a reduced risk of conditions such as heart attack and stroke. However, severe hypotension can indicate underlying health issues and may require medical evaluation and management.

A. Cut a 4 inch x 4 inch (10 cm x 10 cm) gauze pad to place under the flanges of the tracheostomy tube. B. Cleanse the skin around the stoma with full-strength hydrogen peroxide. C. Secure the tracheostomy in place with a collar that has hook-and-loop fasteners. D. Wear clean gloves while cleaning the inner cannula.

Correct Answer is C

Explanation

A.Placing gauze under the flanges of the tracheostomy tube is not recommended because it can create a breeding ground for bacteria and increase the risk of infection.Pre-cut gauze pads should be used to avoid loose fibers from entering the stoma.

B.Full-strength hydrogen peroxide is too harsh and can cause skin irritation or damage. When performing tracheostomy care, the skin around the stoma should be cleaned with a mild saline solution.

C.A collar with hook-and-loop fastenersis commonly used to secure the tracheostomy tube in place. This collar should be snug enough to hold the tube securely but not too tight to cause discomfort or restrict airflow. The collar helps prevent accidental dislodgement of the tracheostomy tube, ensuring it remains properly positioned.

D.Sterile gloves should be worn when cleaning the inner cannula of the tracheostomy tube to minimize the risk of introducing pathogens.

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A nurse is providing discharge teaching about safety considerations to an older adult client who lives at home. The client has heart failure and a new prescription for hydrochlorothiazide. Which of the following statements by the client indicates an understanding of the teaching?

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Correct Answer is A

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Correct Answer is C

Explanation

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