The nurse is providing discharge instructions for the client diagnosed with heart failure. Which information should the nurse provide to assist the client to limit complications and prevent future hospitalizations? (SELECT ALL THAT APPLY).

Consume 2500mL of fluids per day during the summer months

Maintain daily sodium intake of no more than 2gm per day

Notify the health care provider if weight increases by 5 Ibs. in one week

If shortness of breath occurs with minimal activity, notify the provider

Take furosemide anytime when feeling bloated or short of breath

Answer and Explanation

Correct Answer : B,C,D

A.   Fluid intake may need to be regulated in heart failure patients, consuming 2500mL of fluids per day may be too high for some patients, depending on their condition and whether they are on fluid restriction. Fluid management should be individualized, and the provider should specify the amount based on the patient's condition.
B.   A low-sodium diet is essential for heart failure patients to help reduce fluid retention, decrease blood pressure, and lessen the burden on the heart. The American Heart Association recommends a sodium intake of no more than 2,000-2,300 mg per day for heart failure patients.
C.   Rapid weight gain is a sign of fluid retention, which can indicate worsening heart failure. A gain of 2-3 pounds in a single day or 5 pounds in a week should prompt the client to contact their healthcare provider for further evaluation.
D.   Shortness of breath with minimal activity can be a sign of worsening heart failure or fluid overload. This symptom should be reported immediately to a healthcare provider for further evaluation and possible adjustments to treatment.
E.   Furosemide (a diuretic) is often prescribed to reduce fluid retention but it should not be taken without proper guidance or as a response to symptoms without consulting the healthcare provider. Taking diuretics at the wrong time or in excessive amounts can lead to dehydration and electrolyte imbalances, which could worsen the condition.

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Correct Answer is A

Explanation

A. A decreased D-dimer level is a positive outcome, as D-dimer is elevated in DIC due to the formation of clots and the breakdown of fibrin. Lower levels indicate less clot formation and better control of the condition.
B. Fibrinogen levels are typically low in DIC due to consumption of clotting factors. Elevated fibrinogen in this case would be a negative indicator, suggesting that clotting is not resolving.
C. A decreased platelet count is a hallmark of DIC and indicates ongoing consumption of platelets due to widespread clotting. A decrease would not be a positive outcome.
D. A prolonged PT is another indicator of DIC, suggesting impaired clotting function. This is not a positive outcome.

A. diltiazem. B. nitroglycerine. C. verapamil. D. morphine.

Correct Answer is D

Explanation

A. Diltiazem is a calcium channel blocker that can be used to manage conditions like atrial fibrillation or hypertension by slowing the heart rate and reducing blood pressure. However, it may not be the most appropriate drug in the acute setting for heart failure with dyspnea.
B. Nitroglycerine is a vasodilator that helps reduce preload and afterload, which can be beneficial in heart failure. However, it primarily works by reducing the workload on the heart and may help with fluid overload but may not directly address anxiety.
C. Verapamil is another calcium channel blocker that slows the heart rate and reduces the heart's workload. While it may be useful for controlling tachyarrhythmias, it is not the best option for managing acute heart failure with severe dyspnea and anxiety.
D. Morphine is an opioid that can be used in acute heart failure to reduce both anxiety and respiratory distress. It works by reducing the sympathetic nervous system response, decreasing heart rate and blood pressure, and providing a sense of calm, which reduces anxiety. It also reduces preload by venodilation and helps manage severe dyspnea.

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The nurse is providing discharge instructions for the client diagnosed with heart failure. Which information should the nurse provide to assist the client to limit complications and prevent future hospitalizations? (SELECT ALL THAT APPLY).

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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