The nursing students are preparing a care plan for a patient with heart failure. The patient will be prescribed diuretic therapy after discharge. What evidence-based instructions will the nurse include in this plan?

Potassium supplements can cause irregular heart rhythm and must be avoided.

Instruct the patient to take diuretics at bedtime to promote diuresis during the night.

Notify the physician if weight increases by three pounds in one week.

Administer diuretics in the morning and notify physician of decreased urine output.

Answer and Explanation

The Correct Answer is C

Choice A reason: Potassium supplements can actually be important for patients on diuretic therapy, especially if they are taking loop diuretics like furosemide, which can cause potassium loss. However, it is important to monitor potassium levels and follow the physician's guidance on supplement use.

Choice B reason: Instructing the patient to take diuretics at bedtime is not recommended. Diuretics should be taken in the morning to avoid frequent urination during the night, which can disrupt sleep.

Choice C reason: Notifying the physician if weight increases by three pounds in one week is a key instruction for patients with heart failure. Rapid weight gain can indicate fluid retention and worsening heart failure, requiring prompt medical evaluation and adjustment of treatment.

Choice D reason: Administering diuretics in the morning and notifying the physician of decreased urine output is important, but the focus on notifying the physician about significant weight gain provides a more specific and actionable guideline for managing heart failure.

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Correct Answer is B

Explanation

Choice A reason: Notifying the blood bank of the suspected transfusion reaction is important, but maintaining the IV access with normal saline infusion takes priority to ensure that the patient remains stable and to prevent any further complications.

Choice B reason: Maintaining IV access with normal saline infusion is the first priority. This action helps to keep the vein open, provide fluids, and flush out any remaining blood product from the IV line, reducing the risk of further reaction.

Choice C reason: Facilitating the transfer of the patient to the critical care unit may be necessary if the patient's condition worsens, but it is not the immediate first step.

Choice D reason: Rechecking identification labels and numbers is important to confirm the correct blood product was given, but it comes after ensuring the patient’s stability by maintaining IV access with saline.

A. Ondansetron on a PRN basis B. Vitamin B12 injections to prevent pernicious anemia C. Antidiarrheal medications 30 minutes before a meal D. Beta adrenergic blockers to reduce bowel motility

Correct Answer is A

Explanation

Choice A reason: Ondansetron is an antiemetic given to control nausea and vomiting, which are common symptoms in patients with inflammatory bowel disease, especially when they have a flare-up.

Choice B reason: Vitamin B12 injections are crucial for preventing pernicious anemia but are not specific treatments for acute management of inflammatory bowel disease symptoms.

Choice C reason: Antidiarrheal medications should be used cautiously in inflammatory bowel disease as they can worsen symptoms or lead to complications like toxic megacolon.

Choice D reason: Beta-adrenergic blockers are not used to reduce bowel motility and are not a part of the standard treatment regimen for inflammatory bowel disease.

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The nursing students are preparing a care plan for a patient with heart failure. The patient will be prescribed diuretic therapy after discharge. What evidence-based instructions will the nurse include in this plan?

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