The nurse is caring for a client with heart failure. Which of these prescribed medications places the client at risk for cardiogenic shock?

Digoxin.

Hydrochlorothiazide.

Nadolol.

Captopril.

Answer and Explanation

The Correct Answer is C

A. Digoxin.
Digoxin is a cardiac glycoside that helps increase the force of myocardial contraction and is generally used to treat heart failure. It does not typically pose a significant risk for cardiogenic shock.

B. Hydrochlorothiazide.
Hydrochlorothiazide is a diuretic used to manage fluid retention in heart failure. It can cause electrolyte imbalances but is not directly linked to causing cardiogenic shock.

C. Nadolol.
Nadolol is a beta-blocker, which can reduce the heart rate and the strength of heart contractions. In a client with severe heart failure, excessive beta-blockade can lead to a significant decrease in cardiac output, increasing the risk for cardiogenic shock.

D. Captopril.
Captopril is an ACE inhibitor that helps manage heart failure by reducing afterload and preload.
While it can cause hypotension, it is not typically associated with a direct risk of cardiogenic shock.

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Correct Answer is D

Explanation

A. Avoid stimulation of the breasts and wear a tight bra. Avoiding breast stimulation and wearing a tight bra may exacerbate breast engorgement by preventing milk expression and constricting blood flow. This recommendation is not appropriate for managing engorgement.
B. Express a small amount of breast milk by hand. While hand expression can help relieve engorgement, it may also stimulate further milk production, leading to increased engorgement. This recommendation may not be sufficient for managing severe engorgement.
C. Place warm packs on both breasts. Warm packs can increase blood flow and may provide temporary relief from discomfort, but they are not the most effective intervention for breast engorgement. Warmth can also increase inflammation and swelling in some cases.
D. Take a prescribed analgesic and expose breasts to air. Taking a prescribed analgesic can help relieve pain associated with breast engorgement, while exposing the breasts to air allows for
cooling and may reduce swelling. This recommendation addresses both pain relief and management of engorgement symptoms.

Correct Answer is []

Explanation

Cardiovascular

- Capillary refill 4 seconds

- A prolonged capillary refill time indicates poor peripheral perfusion, which can be a sign of hypoxia. Hypoxia can lead to reduced oxygen delivery to the tissues, resulting in delayed capillary refill.

Respiratory

- Oxygen saturation 90% on room air

- An oxygen saturation level of 90% is below the normal range (95-100%) and indicates that the blood is not adequately oxygenated, which is a direct sign of hypoxia.

- Respiratory rate 28 breaths/minute

- An elevated respiratory rate (tachypnea) is a common compensatory mechanism in response to hypoxia. The body attempts to increase oxygen intake and carbon dioxide expulsion by breathing more rapidly.

Neurological

- Anxious

- Anxiety can be a symptom of hypoxia. When the brain and other vital organs do not receive enough oxygen, it can trigger a sense of anxiety and restlessness as part of the body's alarm system.

- Restless

- Restlessness is another common symptom of hypoxia. It occurs because the body is trying to compensate for the lack of oxygen, leading to increased agitation and an inability to remain
calm.

Rationales for the Incorrect Choices:

- Cardiovascular

- Heart rate 101 beats/minute: While an elevated heart rate can be a compensatory response to hypoxia, it alone does not directly indicate hypoxia.
- Blood pressure 145/89 mm Hg: Elevated blood pressure is not a direct indicator of hypoxia and can be influenced by various factors including anxiety and pain.

- Respiratory

- Productive cough: A productive cough suggests respiratory infection or inflammation but does not directly measure oxygenation status or indicate hypoxia.

- Neurological

- Awake and alert: Being awake and alert indicates normal mental status and does not suggest hypoxia. Hypoxia typically affects cognitive function, leading to confusion or decreased level of consciousness in more severe cases.

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The nurse is caring for a client with heart failure. Which of these prescribed medications places the client at risk for cardiogenic shock?

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Naxlex Comprehensive Predictor Exams

A postpartum client who is bottle-feeding develops breast engorgement. Which is the best recommendation for the nurse to provide this client?

Correct Answer is D

Explanation

Exhibits here The nurse places the client on a cardiorespiratory monitor and places the nasal cannula on the client. The nurse then completes an assessment and documents it in the chart. For each body system, click to specify the assessment findings that indicates hypoxia.

Correct Answer is []

Explanation

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