A senior nurse is providing instructions to a newly hired nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The senior nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia?

A) Women should start yearly mammograms at age 40:
Mammography is a key screening tool for breast cancer detection. According to guidelines from the American Cancer Society (ACS) and other leading health organizations, women should begin annual mammograms at age 40. This recommendation applies to average-risk women who are not showing any symptoms of breast cancer. Mammograms are effective in detecting early-stage breast cancer, which is crucial for better treatment outcomes.

B) Women should have a yearly clinical breast examination starting at age 50:
The clinical breast examination (CBE) is a physical exam performed by a healthcare provider to check for breast cancer. However, the recommendation is to have a clinical breast examination every 1-3 years for women in their 20s and 30s and annually for women 40 and older, not just beginning at age 50. It is not necessary to wait until age 50 to start yearly CBEs.

C) Clients should have fecal occult blood test every other year:
The fecal occult blood test (FOBT) is used to detect hidden blood in the stool, which may be a sign of colon cancer. However, this test is not typically performed every other year for all clients. The recommended schedule for colorectal cancer screening depends on risk factors. The American Cancer Society recommends annual FOBT or fecal immunochemical test (FIT) for clients over the age of 45 who are at average risk for colon cancer. More invasive tests, such as colonoscopy, are generally recommended for people at higher risk or after positive results from non-invasive tests like FOBT.

D) Clients should have a colonoscopy at age 40 and every 10 years thereafter:
The recommended age for the first colonoscopy is age 45 for individuals at average risk of colorectal cancer, not 40. Colonoscopies are typically performed every 10 years after the initial screening unless there are risk factors (e.g., family history, genetic conditions) that require earlier or more frequent screenings.

A) Assess for dislodgement and use forceps to retrieve the dislodged pellets and place in the lead container:
The priority action when a patient is receiving brachytherapy for uterine cancer is to assess for potential dislodgement of the radioactive implant. If the radiation source has been displaced, it must be handled carefully to prevent radiation exposure to the nurse, other patients, and staff. The nurse should use forceps to carefully retrieve the dislodged pellets and place them in a lead container to prevent contamination.

B) Assess the patient's knowledge of the treatment plan and her willingness to participate:
While it is important to assess the patient's understanding of the treatment plan and her willingness to participate, this is not the immediate priority in this situation. The nurse’s first priority is to address the potential risk of radiation exposure due to the dislodgement of the implant.

C) Assess the UAP's knowledge and explain the rationale for strict bed rest:
Although it is important for the nurse to ensure that all team members, including UAPs, understand the rationale for strict bed rest during brachytherapy, this action is not the most immediate priority in this scenario. The potential dislodgement of the radiation implant requires urgent assessment and intervention.

D) Notify the physician about the potential dislodgment of the radiation implant:
Notifying the physician about the dislodgement is an important step, but it is not the first action the nurse should take. The immediate priority is to assess and secure the radiation implant using appropriate protocols. Once the dislodged pellets have been safely contained in the lead container, the nurse should then notify the physician for further guidance on the next steps in treatment or care.