A nurse is teaching a client who has a new prescription for hydrochlorothiazide for management of hypertension. Which of the following instructions should the nurse include?
Reduce intake of potassium-rich foods.
Avoid grapefruit juice.
Take this medication before bedtime.
Monitor for leg cramps.
The Correct Answer is D
Choice A reason: Reducing intake of potassium-rich foods is not necessary for clients taking hydrochlorothiazide, as this medication can cause hypokalemia (low potassium levels) due to increased potassium excretion in the urine. Clients may need to increase their intake of potassium-rich foods or take potassium supplements to prevent hypokalemia.
Choice B reason: Avoiding grapefruit juice is not necessary for clients taking hydrochlorothiazide, as this medication does not interact with grapefruit juice. Grapefruit juice can affect the metabolism of some other medications, such as statins, calcium channel blockers, and cyclosporine, by inhibiting the enzyme CYP3A4 in the liver.
Choice C reason: Taking this medication before bedtime is not advisable for clients taking hydrochlorothiazide, as this medication can cause increased urination and nocturia (nighttime urination). Clients should take this medication in the morning or at least 6 hours before bedtime to avoid disrupting their sleep.
Choice D reason: Monitoring for leg cramps is an important instruction for clients taking hydrochlorothiazide, as this medication can cause muscle cramps due to electrolyte imbalances, such as hypokalemia, hyponatremia (low sodium levels), or hypomagnesemia (low magnesium levels). Clients should report any signs of muscle cramps, weakness, or fatigue to their provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Black cohosh is an herbal supplement that is used to treat menopausal symptoms, such as hot flashes and mood swings. It does not have a significant interaction with warfarin and does not affect the coagulation status of the client.
Choice B reason: Echinacea is an herbal supplement that is used to boost the immune system and prevent or treat common colds and infections. It does not have a significant interaction with warfarin and does not affect the coagulation status of the client.
Choice C reason: Feverfew is an herbal supplement that is used to treat migraines, arthritis, and fever. It has a significant interaction with warfarin and can increase the risk of bleeding and bruising. It can also reduce the effectiveness of warfarin and alter the client's international normalized ratio (INR).
Choice D reason: Flaxseed is an herbal supplement that is used to lower cholesterol, blood pressure, and inflammation. It does not have a significant interaction with warfarin and does not affect the coagulation status of the client.
Correct Answer is B
Explanation
Choice A reason: Client report of a headache is not the nurse's priority to report to the provider. A headache is a common and mild side effect of vancomycin, which is an antibiotic used to treat serious infections. A headache may be caused by dehydration, stress, or other factors, and can be relieved by drinking fluids, resting, or taking analgesics.
Choice B reason: Audible inspiratory stridor is the nurse's priority to report to the provider. Stridor is a high-pitched, wheezing sound that occurs when breathing in, and indicates a narrowing or obstruction of the airway. Stridor may be a sign of a severe allergic reaction, or anaphylaxis, to vancomycin, which can be life-threatening. Anaphylaxis can also cause swelling of the face, lips, tongue, or throat, difficulty breathing, low blood pressure, and shock. The nurse should stop the infusion, administer epinephrine, and monitor the client's vital signs.
Choice C reason: Client report of tinnitus is not the nurse's priority to report to the provider. Tinnitus is a ringing or buzzing sound in the ears, and may be a rare and serious side effect of vancomycin. Tinnitus may indicate damage to the inner ear, or ototoxicity, which can lead to hearing loss. The nurse should check the client's hearing and report any changes to the provider. The provider may adjust the dose or frequency of vancomycin, or switch to another antibiotic.
Choice D reason: Localized redness at the catheter insertion site is not the nurse's priority to report to the provider. Redness at the catheter insertion site may indicate irritation, inflammation, or infection of the skin or vein, and may be caused by the needle, the catheter, or the medication. The nurse should inspect the site, clean it with antiseptic, and apply a sterile dressing. The nurse should also monitor the site for signs of phlebitis, such as pain, swelling, warmth, or pus. The nurse may need to change the catheter or the infusion site if the redness persists or worsens.
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