A nurse is providing teaching to a client who has heart failure and a decreased cardiac output. Which of the following information should the nurse include in the teaching?

Rationale:

A. Check the client for indications of bleeding: The priority action following a heparin overdose is to assess the client for signs of active or internal bleeding, such as hematuria, melena, bruising, or hypotension. Immediate assessment guides urgent interventions to prevent life-threatening complications.

B. Monitor the client's aPTT levels: Monitoring aPTT is important to evaluate the anticoagulant effect and guide treatment, but it is secondary to assessing for actual bleeding. Assessment of clinical signs takes precedence over laboratory monitoring in urgent situations.

C. Complete an incident report: Documenting the medication error is necessary for legal and quality improvement purposes, but it is not the first action. Patient safety and immediate clinical assessment come before reporting.

D. Notify the risk manager: Informing the risk manager is part of the incident reporting process, but addressing the client’s immediate safety needs comes first. Notification can occur after urgent assessment and stabilization.

Rationale:

A. "I will provide my child with high-fiber foods": While fiber is important for overall health, many high-fiber grains contain gluten, which must be avoided in celiac disease. Offering high-fiber foods without confirming they are gluten-free could cause intestinal damage and symptoms in the child.

B. "I will give my child whole wheat toast and milk for breakfast": Whole wheat contains gluten, which triggers an autoimmune response in children with celiac disease. Serving whole wheat toast is unsafe and indicates a misunderstanding of dietary restrictions for managing this condition.

C. "I will keep my child on a gluten-free diet": A strict gluten-free diet is the primary treatment for celiac disease. Eliminating all sources of wheat, barley, rye, and derivatives allows intestinal healing, prevents symptoms, and reduces the risk of long-term complications, showing correct understanding of dietary management.

D. "I will administer digestive enzymes with meals and snacks.": Digestive enzymes are not a standard treatment for celiac disease and do not prevent the autoimmune response caused by gluten. The focus should remain on dietary avoidance of gluten rather than relying on enzyme supplementation.