The nurse is teaching a patient with heart failure about dietary modifications to reduce fluid retention and improve cardiac function. Which of the following foods should the nurse advise the patient to limit or avoid?

Fresh fruits and vegetables

Whole grains and cereals

Lean meats and poultry

Canned soups and sauces.

Answer and Explanation

The Correct Answer is D

The nurse should advise the patient with heart failure to limit or avoid canned soups and sauces because they are high in sodium, which can cause fluid retention and worsen cardiac function. Sodium intake should be restricted to less than 2 g per day for patients with heart failure.

Choice A is wrong because fresh fruits and vegetables are good sources of potassium, magnesium, and fiber, which are beneficial for heart health. Potassium and magnesium help regulate fluid and electrolyte balance, and fiber helps lower cholesterol and blood pressure.

Choice B is wrong because whole grains and cereals are also rich in fiber, as well as complex carbohydrates, which provide energy and prevent rapid fluctuations in blood glucose levels. Whole grains and cereals may also contain phytochemicals that have antioxidant and anti-inflammatory effects.

Choice C is wrong because lean meats and poultry are low in saturated fat and cholesterol, which can contribute to atherosclerosis and coronary artery disease. Lean meats and poultry provide protein, which is essential for tissue repair and wound healing. Protein intake should be adequate but not excessive for patients with heart failure, as too much protein can increase the workload of the kidneys.

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Correct Answer is A

Explanation

The nurse should monitor the serum potassium level to determine the therapeutic effectiveness of digoxin (Lanoxin), a cardiac glycoside that improves the contractility and pumping ability of the heart. Digoxin has a narrow therapeutic range and can cause toxicity if the serum level is too high or if the patient has hypokalemia (low potassium).Hypokalemia can result from diuretic therapy, which is often prescribed for heart failure patients to reduce fluid overload.

Therefore, the nurse should monitor the serum potassium level and report any abnormal values to the provider.The normal potassium level is 3.5 to 5.0 mEq/L.

Choice B) Serum sodium level is wrong because sodium level is not directly affected by digoxin therapy.

Sodium level may be altered in heart failure patients due to fluid retention or diuretic use, but it does not indicate the effectiveness of digoxin.

Choice C) Serum magnesium level is wrong because magnesium level is not directly affected by digoxin therapy.

Magnesium level may be altered in heart failure patients due to diuretic use or renal impairment, but it does not indicate the effectiveness of digoxin.

Choice D) Serum calcium level is wrong because calcium level is not directly affected by digoxin therapy.

Calcium level may be altered in heart failure patients due to renal impairment or vitamin D deficiency, but it does not indicate the effectiveness of digoxin.

A. Administer diltiazem as ordered by physician B. Instruct patient to change positions slowly C. Notify physician immediately D. Hold diltiazem and notify physician if symptoms persist. E. Hold diltiazem and notify physician if symptoms persist.

Correct Answer is B

Explanation

This is because diltiazem (Cardizem) is a calcium channel blocker that lowers blood pressure and can cause orthostatic hypotension, which is a sudden drop in blood pressure when standing up from a sitting or lying position. This can lead to dizziness and lightheadedness, which can increase the risk of falls and injuries. Changing positions slowly can help prevent or reduce these symptoms by allowing the body to adjust to the change in blood pressure.

Choice A) Administer diltiazem as ordered by physician is wrong because it does not address the patient’s complaint of dizziness and lightheadedness, which are side effects of the medication.

The nurse should monitor the patient’s blood pressure and heart rate before and after administering diltiazem, and report any abnormal findings to the physician.

Choice C) Notify physician immediately is wrong because it is not necessary to notify the physician immediately for a common and mild side effect of diltiazem, unless the patient has other signs of severe hypotension, such as fainting, chest pain, or confusion.

The nurse should educate the patient about the possible side effects of diltiazem and how to prevent or manage them.

Choice D) Hold diltiazem and notify physician if symptoms persist is wrong because it is not appropriate to hold a prescribed medication without a valid reason or an order from the physician.

Holding diltiazem could cause the patient’s blood pressure to rise and increase the risk of complications from atrial fibrillation, such as stroke or heart failure.

The nurse should administer diltiazem as ordered and monitor the patient’s response.

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The nurse is teaching a patient with heart failure about dietary modifications to reduce fluid retention and improve cardiac function. Which of the following foods should the nurse advise the patient to limit or avoid?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has heart failure and is receiving digoxin (Lanoxin). The nurse should monitor which of the following laboratory values to determine therapeutic effectiveness of this medication?

Correct Answer is A

Explanation

The nurse is caring for a patient with atrial fibrillation who has been prescribed diltiazem (Cardizem). The patient reports feeling dizzy and lightheaded when standing up quickly from a sitting position or when getting out of bed in the morning. What action should the nurse take?

Correct Answer is B

Explanation

A patient with atrial fibrillation has been prescribed digoxin (Lanoxin). The nurse should monitor which laboratory value to evaluate therapeutic effectiveness?

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