A nurse is reinforcing discharge teaching with a client who has heart failure. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

Alternate activity and rest.

Reduce sodium intake to 2 g per day.

Consume a low-fiber diet.

Gradually increase activity each day.

Eat small, frequent meals each day.

Answer and Explanation

Correct Answer : A,B,D,E

A. Alternate activity and rest. Clients with heart failure should balance activity and rest to prevent overexertion and minimize cardiac workload. Frequent rest periods help conserve energy and reduce symptoms such as dyspnea and fatigue.
B. Reduce sodium intake to 2 g per day. Limiting sodium intake helps prevent fluid retention and reduces the risk of worsening heart failure. Excess sodium contributes to increased blood volume and exacerbates symptoms such as edema and shortness of breath.
C. Consume a low-fiber diet. A low-fiber diet is not necessary for heart failure management. Adequate fiber intake is beneficial for preventing constipation, which can increase strain during bowel movements and lead to hemodynamic stress. A high-fiber diet is generally encouraged.
D. Gradually increase activity each day. Clients should slowly increase their activity level based on tolerance to improve cardiovascular function. Overexertion should be avoided, but regular, controlled exercise helps maintain mobility and enhance overall heart health.
E. Eat small, frequent meals each day. Eating smaller meals reduces gastric distension and minimizes pressure on the diaphragm, which can help alleviate shortness of breath. Large meals can increase metabolic demands and contribute to discomfort in clients with heart failure.

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Correct Answer is ["A","B","E","F"]

Explanation

A. Sputum characteristics. The presence of blood-tinged sputum raises concern for tuberculosis (TB) or another serious pulmonary condition, requiring further evaluation. Hemoptysis can indicate active infection or cavitary lung disease.
B. Respiratory complaint. The client reports a persistent, productive cough, night sweats, and fatigue, which are hallmark symptoms of TB. These symptoms, combined with recent travel to a TB-endemic region, increase the likelihood of infection and warrant further assessment.
C. Blood pressure. The client’s blood pressure is within the normal range and does not indicate an immediate concern requiring further evaluation.
D. Heart rate. A heart rate of 98/min is elevated but still within an acceptable range for mild illness or fever. While tachycardia can be associated with infection, it is not the most critical finding requiring urgent follow-up.
E. Temperature. A temperature of 38.1°C (100.5°F) indicates a low-grade fever, which is a common sign of TB or other infections. Given the client's symptoms and history, this finding warrants further investigation.
F. Travel history. The client recently traveled to South Africa, a region with a high prevalence of TB. Travel history is a crucial factor in determining TB risk and must be considered in the diagnostic process.
G. Oxygen saturation. The client’s oxygen saturation is 98% on room air, which is within normal limits and does not require further evaluation at this time.

A. Peeling of the hands and feet B. Beefy, red tongue C. Fever D. Facial erythema

Correct Answer is C

Explanation

A. Peeling of the hands and feet is not a common manifestation of pertussis. This symptom is typically associated with other conditions, such as Kawasaki disease or toxic shock syndrome, rather than an infection caused by Bordetella pertussis.
B. Beefy, red tongue is usually seen in conditions like scarlet fever or certain nutritional deficiencies, such as vitamin B12 deficiency. It is not characteristic of pertussis and does not align with the typical clinical presentation of this respiratory illness.
C. Fever is a common manifestation of pertussis, especially in the early stages. The child may present with a mild to moderate fever as the immune system responds to the infection. Fever can help in distinguishing pertussis from other respiratory illnesses, especially in conjunction with the classic coughing fits.
D. Facial erythema is not typically seen in pertussis. While some flushing may occur during intense coughing episodes, it is not a primary symptom. Pertussis is more characterized by severe coughing fits, the distinctive "whoop" sound during inspiration, and potential vomiting after coughing.

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A nurse is reinforcing discharge teaching with a client who has heart failure. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

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Explanation

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Explanation

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