Digoxin and furosemide were prescribed for a client with chronic heart failure, and the home health nurse is evaluating the client's self-care knowledge of these drugs. Which statement indicates that the client has a good understanding about the use of these drugs?

A) Takes metformin hydrochloride for type 2 diabetes mellitus: Metformin can interact with the contrast dye used in CT scans, particularly in patients with impaired renal function. The contrast dye can affect kidney function, potentially leading to lactic acidosis in patients taking metformin. It is important to follow up on this history and possibly temporarily discontinue metformin and monitor kidney function before and after the procedure.

B) Metal hip prosthesis was placed twenty years ago: A metal hip prosthesis does not typically affect the CT scan with contrast, though it may affect the imaging technique or quality. This history usually does not require follow-up related to the contrast use.
C) Report of client's sobriety for the last five years: Sobriety does not directly impact the use of contrast dye in a CT scan. This information is relevant for overall health but not specifically for the use of contrast.
D) CT scan that was performed six months earlier: The timing of a previous CT scan is not a contraindication for a new scan with contrast. Follow-up on the history of a prior scan may be relevant for comparison but does not specifically impact the use of contrast dye.

A. Instruct the client that since the hematocrit remains low, the daily injections are still necessary: A hematocrit of 43% is within the normal range, suggesting the client’s anemia is improving. If the hematocrit were still low, continuing daily injections would be appropriate, but this is not the case here.

B. Notify the healthcare provider of the client’s hematocrit level so the frequency of injections can be reduced: Since the hematocrit is normal, there is no need to notify the healthcare provider specifically for changing the injection frequency based solely on the hematocrit level. Reducing injection frequency should be based on the overall treatment plan and not just the current hematocrit.
C. Advise the client that the medication is having the desired effect, but daily injections will continue to be needed for life for this chronic condition: While the medication may be effective, informing the client about the potential for less frequent injections could improve adherence and reduce discomfort, if the healthcare provider approves.
D. Offer to instruct the client in self-administration techniques to improve the client's sense of control over the painful daily injections: Teaching self-administration can empower the client and potentially reduce discomfort by allowing the client to become more comfortable with the process. It also offers the opportunity for the client to manage their injections more conveniently and with greater control.