The nurse is preparing a teaching plan for a client taking a prescribed diuretic for edema in the lower extremities. Which instruction should the nurse include in this teaching plan?

Take the diuretic every day, regardless of weight loss or muscle weakness.

Weigh yourself daily at the same time and report excessive weight loss.

Limit fluid intake while taking the diuretic to reduce fluid retention.

Stop taking the medication when the edema in the lower extremities subsides.

Answer and Explanation

The Correct Answer is B

A.   Diuretics can cause electrolyte imbalances and dehydration, leading to muscle weakness. The patient should report any signs of muscle weakness to the healthcare provider.
B.   Weight is a good indicator of fluid loss. Monitoring daily weight and reporting excessive weight loss helps to evaluate the effectiveness of the diuretic and detect potential complications.
C.   Limiting fluid intake while on a diuretic can lead to dehydration and electrolyte imbalances. Adequate fluid intake is essential.
D.   Diuretics are often prescribed for long-term management of edema. The patient should not stop taking the medication without consulting the healthcare provider.

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Correct Answer is C

Explanation

A. A chest x-ray can be useful to assess for complications or changes in lung status, such as pneumothorax, pleural effusion, or changes in lung volume. However, the change in drainage color from viscous green to clear watery fluid may not immediately warrant an x-ray unless there are additional clinical concerns or symptoms suggesting a need for imaging.
B. Continuing the IV antibiotic schedule is important if there is an ongoing infection that needs treatment. However, if the change in drainage is significant and suggests a potential change in the underlying condition or complication, it’s important to evaluate the cause of the change rather than solely relying on antibiotics.
C. Obtaining a specimen of the drainage for culture is a valuable action if there is concern about infection or if the drainage characteristics have changed unexpectedly. Clear, watery fluid could indicate the presence of serous fluid or a change in the nature of the drainage, potentially due to infection or resolution of an infection.
D. “Milking” or stripping the chest tube is not recommended as a routine practice because it can create negative pressure and potentially damage the pleural tissues or exacerbate issues. Additionally, the change in the drainage from viscous green to clear watery fluid does not necessarily indicate that clots are present or that tube milking would be helpful.

A. Limit intake of chips and pretzels. B. Encourage mountain biking. C. Elevate lower extremities. D. Restrict fluid intake to water.

Correct Answer is C

Explanation

A. Chips and pretzels are high in sodium, which can contribute to fluid retention and exacerbate symptoms of CVI. While reducing sodium intake can help manage fluid retention and swelling, it is not the most direct action for promoting circulation itself. It’s more of an adjunctive measure that can support overall management of CVI but does not directly improve venous circulation.
B. Mountain biking is an intense physical activity that may not be suitable for all clients with chronic venous insufficiency, especially if they have significant symptoms or mobility issues. High-impact exercises can potentially exacerbate symptoms or lead to injury. Low-impact activities are generally recommended to improve circulation and manage CVI.
C. Elevating the lower extremities is a highly effective measure for promoting circulation in clients with chronic venous insufficiency. It helps reduce venous pressure and promotes the return of blood to the heart, thereby alleviating swelling and discomfort. This action is directly beneficial in managing CVI.
D. Restricting fluid intake to water alone does not directly address the underlying issues of venous insufficiency. While managing overall fluid intake can be part of a comprehensive plan to prevent excessive fluid retention, it is not the most direct or effective action for promoting circulation compared to elevating the legs.

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The nurse is preparing a teaching plan for a client taking a prescribed diuretic for edema in the lower extremities. Which instruction should the nurse include in this teaching plan?

Nursing Test Bank

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