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."
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Move items in the room away from the client: During a seizure, the client may have uncontrolled movements that could cause them to hit nearby objects and potentially injure themselves. Moving items away from the client helps create a safer environment and reduces the risk of injury from contact with objects.
B. Loosen the client's clothing: Seizures can lead to muscle contractions and movements that might constrict the client's clothing, particularly around the neck or chest area. Loosening the client's clothing helps ensure that their breathing is not restricted during the seizure.
C. Turn the client onto their side: Turning the client onto their side is an important step for airway protection. During a seizure, there is a risk of saliva or vomit obstructing the airway, which can lead to aspiration. Turning the client onto their side helps prevent aspiration by allowing any fluids to drain out safely and maintaining an open airway.
D. Help the client lie on the floor: If the client is seated in a chair during a seizure, it's safer to assist them in lying on the floor. This action prevents the client from falling out of the chair and potentially sustaining injuries from the fall. Once on the floor, the nurse can continue to monitor the client and provide appropriate care and support.
Correct Answer is ["B","E","F"]
Explanation
A. Phosphorous level: While phosphorus is important for bone health, deficiencies are rare in individuals with a normal diet and are not typically associated with osteoporosis.
B. Vitamin D level: Vitamin D is essential for calcium absorption and bone health. Inadequate vitamin D levels can lead to decreased calcium absorption and increase the risk of osteoporosis.
C. Smoking history: Smoking is a risk factor for osteoporosis due to its adverse effects on bone metabolism, but the client is a nonsmoker, so this finding does not apply.
D. Alcohol use: Excessive alcohol consumption is a risk factor for osteoporosis, but the client does not drink alcohol, so this finding does not apply.
E. Activity level: A sedentary lifestyle is a risk factor for osteoporosis. Weight-bearing exercises and physical activity help maintain bone density and strength, reducing the risk of osteoporosis.
F. Lactose intolerant: Lactose intolerance may lead to decreased intake of dairy products, which are a significant source of calcium. Inadequate calcium intake can contribute to decreased bone density and increase the risk of osteoporosis.
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