A nurse is teaching a client who has a prescription for ferrous gluconate. Which of the following statements by the client indicates an understanding of the teaching?

Furosemide is a diuretic that is used to treat heart failure by reducing fluid retention and lowering blood pressure. It can cause some side effects, such as increased urination, thirst, dry mouth, headache, dizziness, nausea, and electrolyte imbalance.

Choice A is wrong because BUN (blood urea nitrogen) is a measure of kidney function and a normal range is 7 to 20 mg/dL.

A BUN of 15 mg/dL is not a cause for concern and does not indicate any adverse effect of furosemide.

Choice C is wrong because potassium is an electrolyte that is important for nerve and muscle function and a normal range is 3.5 to 5.0 mEq/L.

Potassium of 3.8 mEq/L is within the normal range and does not indicate any adverse effect of furosemide. However, furosemide can cause low potassium levels (hypokalemia) in some cases, so the nurse should monitor the client’s potassium levels regularly and advise the client to eat foods rich in potassium, such as bananas, oranges, and potatoes.

Choice D is wrong because dizziness upon standing is a common side effect of furosemide and does not require immediate notification of the provider. However, the nurse should instruct the client to rise slowly from a sitting or lying position to prevent falls and to drink enough fluids to prevent dehydration.

Choice B is correct because difficulty hearing or hearing loss is a rare but serious side effect of furosemide that may indicate ototoxicity (damage to the inner ear). This can be irreversible if not treated promptly and may affect the client’s quality of life and safety. The nurse should notify the provider immediately if the client reports difficulty hearing or any other signs of ototoxicity, such as ringing in the ears (tinnitus) or vertigo (a sensation of spinning). The provider may need to adjust the dose of furosemide or switch to another diuretic that is less ototoxic.

The nurse should instruct the client to avoid drinking beverages while sucking on a nicotine lozenge because this can interfere with the absorption of nicotine and reduce its effectiveness. Some possible explanations for the other choices are:

Choice B is wrong because chewing nicotine gum for 10 minutes before spitting it out is too short.

The recommended duration is at least 30 minutes to allow enough nicotine to be released and absorbed through the lining of the mouth.

Choice C is wrong because changing the nicotine patch every other day is not frequent enough.

The patch should be changed daily and applied to a different skin site to prevent irritation and ensure a steady dose of nicotine.

Choice D is wrong because administering 2 sprays of nicotine nasal spray in each nostril with each dose is too much.

The recommended dose is one spray per nostril, up to five times per hour or 40 times per day.

Using too much nasal spray can cause side effects such as nasal irritation, sneezing, coughing, headache, or nausea.