Which specific drug therapy will the nurse anticipate for management of the client who has septic shock?

Choice A reason: Explaining ways to decrease paroxysmal nocturnal dyspnea is helpful for managing this specific symptom of heart failure, which involves difficulty breathing at night due to fluid accumulation in the lungs. While this can improve comfort, it doesn't provide a comprehensive approach to managing heart failure symptoms at home.

Choice B reason: Discussing the effects of medications, ways to assess fluid balance, and positions for enhancing respirations offers a comprehensive approach to managing heart failure symptoms at home. Understanding medication effects helps clients adhere to their treatment plan and manage side effects. Assessing fluid balance is crucial for detecting fluid overload early, a common issue in heart failure. Learning positions that enhance respirations can improve breathing and overall comfort.

Choice C reason: Teaching stress management techniques is beneficial for overall well-being and can indirectly improve heart health by reducing stress, which can exacerbate heart failure symptoms. However, it is not as directly related to managing the physical symptoms of heart failure as other interventions.

Choice D reason: Providing a list of support systems in the community is valuable for emotional and practical support, which can improve quality of life for clients with heart failure. However, it does not directly address the physical symptoms or management of heart failure at home.

Choice A reason: Complete bedrest for the duration of the treatment with subcutaneous enoxaparin is not the best approach for managing infective endocarditis. While bed rest may be recommended initially to reduce cardiac workload, long-term bed rest is not necessary and could lead to complications such as muscle atrophy or thromboembolism. Subcutaneous enoxaparin is used for prophylaxis against deep vein thrombosis, but it does not address the underlying infection.

Choice B reason: Long-term anticoagulant therapy with IV heparin followed by oral warfarin is not the standard treatment for infective endocarditis. Although anticoagulant therapy may be necessary in some cases, such as for patients with prosthetic valves or specific cardiac conditions, it is not the primary treatment for the infection itself. The focus should be on eradicating the infection with appropriate antibiotics.

Choice C reason: Administration of IV penicillin, followed by oral penicillin for 10 weeks, is not the typical treatment regimen for infective endocarditis. While penicillin may be part of the antibiotic therapy, the duration and route of administration need to be tailored to the specific causative organism and the patient's clinical condition. Usually, a combination of antibiotics and a specific treatment plan is developed based on culture and sensitivity results.

Choice D reason: Hospitalization for initial IV antibiotics, followed by continued IV antibiotics at home, is the best treatment approach for a client newly diagnosed with infective endocarditis. This allows for intensive management and monitoring during the critical initial phase of treatment, ensuring that the infection is adequately controlled. Transitioning to continued IV antibiotics at home provides the necessary long-term therapy while allowing the patient to recover in a familiar environment. This approach ensures compliance with the treatment regimen and reduces the risk of complications.