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 C

Explanation

A. Hypermagnesemia can cause bradycardia and hypotension, but it is less commonly associated with PVCs. This does not align with the lab results provided.
B. Hypocalcemia can cause arrhythmias, but it is not the most likely cause of PVCs in this case, considering other findings.
C. Hypokalemia (low potassium) is a known cause of PVCs. The patient's potassium level is 2.8 mEq/L, which is significantly low and most likely contributing to the PVCs.
D. Although hyperglycemia can affect cardiac function, it is less commonly linked to PVCs compared to electrolyte imbalances, such as hypokalemia.

A. Serum sodium level is 135 mEq/L (normal 135-145mEq/L) B. Respiratory rate of 16/minute C. Blood pressure reading of 120/80 D. Urine output 120 mL one hour following administration

Correct Answer is B

Explanation

A. Serum sodium level of 135 mEq/L (normal 135-145mEq/L) - Although important, sodium levels do not directly assess the effectiveness of furosemide in relieving fluid overload.
B. Respiratory rate of 16/minute - A decrease in respiratory rate following the administration of furosemide indicates that the client is improving, as furosemide works to reduce fluid overload and ease breathing.
C. Blood pressure reading of 120/80 - While blood pressure may be influenced by fluid status, it is not the best indicator for the effectiveness of diuretics in this case.
D. Urine output 120 mL one hour following administration - While urine output is important, a single hour’s output may not show the full effectiveness of the diuretic, and output can vary depending on the client’s hydration status.

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LAB	Result	Normal Range
Potassium	2.8 mEq/L	3.5-5.3mEq/L
Sodium	133 mEq/L	135-145 mEqL
Chloride	90 mEq/L	97-107 mEqL
Glucose	200 mg/dL	70mg/dL to 110mg/dL
Magnesium	2.5 mg/dL	1.6-2.2 mg/dL
Calcium	8.0 mg/dL	8.2-10.2 mg/dL:

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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Correct Answer is C

Explanation

The client with heart failure exhibits bibasilar crackles, dyspnea and a respiratory rate of 26/min. The physician prescribes furosemide 40 mg IV. Which parameter would the nurse use to best evaluate if the client is responding to this medication?

Correct Answer is B

Explanation

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