Which statement by a client with newly diagnosed heart failure indicates to the nurse that teaching was effective?
"I will use the nitroglycerin patch whenever I have chest pain."
"I will take furosemide (Lasix) every day just before bedtime."
"I will call the clinic if my weight goes up 3 pounds in a week."
"I will use an additional pillow if I am short of breath at night.”
The Correct Answer is C
The statement "I will call the clinic if my weight goes up 3 pounds in a week" indicates that the teaching about heart failure was effective. Monitoring weight is an essential self-care measure for patients with heart failure to manage fluid retention effectively. A sudden weight gain of 2-3 pounds in a week can indicate fluid retention and worsening heart failure. It is crucial for the patient to report such weight changes promptly to the healthcare provider or clinic to adjust medication doses or treatment plans as needed.
The other statements are incorrect:
A) "I will use the nitroglycerin patch whenever I have chest pain." Nitroglycerin is not typically used to manage heart failure. It is used for angina, which is chest pain caused by reduced blood flow to the heart muscle due to narrowed coronary arteries.
B) "I will take furosemide (Lasix) every day just before bedtime." While furosemide is a diuretic commonly prescribed for heart failure to reduce fluid retention, it is not usually taken just before bedtime. Taking furosemide in the evening may lead to frequent nighttime urination and disrupt sleep.
D) "I will use an additional pillow if I am short of breath at night." Using an extra pillow may provide temporary relief for positional dyspnea (shortness of breath when lying flat) but is not an appropriate long-term strategy for managing heart failure. Elevated pillows may not effectively improve breathing and can lead to neck strain. Instead, patients with heart failure should be encouraged to sleep with their head slightly elevated on a regular basis, using a wedge pillow or adjustable bed if needed. Managing fluid retention and adhering to prescribed medications are essential for improving heart failure symptoms and preventing complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Hemodialysis is a treatment used to remove waste products and excess fluids from the blood in individuals with kidney failure or chronic kidney disease. The primary purpose of hemodialysis is to filter and clear the blood of waste products that the kidneys can no longer remove adequately. As a result, one of the key indicators that hemodialysis is having the desired effect is a decrease in serum creatinine levels. Creatinine is a waste product that builds up in the blood when the kidneys are not functioning properly. A decrease in serum creatinine indicates that the dialysis treatment is effectively removing waste products from the blood.
Weight loss is also a positive sign after hemodialysis since it indicates that excess fluid is being removed from the body. In individuals with kidney failure, the kidneys cannot adequately remove extra fluid, leading to fluid retention and weight gain. Hemodialysis helps to eliminate this excess fluid, leading to weight loss and reducing the risk of fluid overload-related complications.
The other options listed (decreased hematocrit and diuresis, increased potassium level and improved appetite, and decreased white blood cell count and diaphoresis) are not direct indicators of the effectiveness of hemodialysis in removing waste products and excess fluid from the blood.
Correct Answer is C
Explanation
Among the given options, the most important information for the nurse to include when teaching a client newly diagnosed with hypertension is option C, "Increasing physical activity controls blood pressure (BP) for most people."
Option C emphasizes the importance of increasing physical activity as a primary lifestyle modification to control blood pressure for most people with hypertension. Regular physical activity can help improve cardiovascular health, reduce blood pressure, and manage overall health. It is a proactive step that the individual can take immediately to start managing their hypertension.
Incorrect:
Option A, "Most people are able to control BP through dietary changes," is not necessarily true for everyone. While dietary changes, such as reducing sodium intake and adopting a heart-healthy diet, can be beneficial in managing hypertension, they may not be sufficient for everyone. Physical activity is an essential component of hypertension management and has broader health benefits.
Option B, "Annual BP checks are needed to monitor treatment effectiveness," is important information, but it is more of a recommendation for ongoing hypertension management rather than the most critical information for someone newly diagnosed with hypertension. Regular blood pressure monitoring is indeed crucial for treatment assessment and ensuring that the chosen treatment plan is effective.
Option D, "Hypertension is usually asymptomatic until target organ damage occurs," is important information to understand the nature of hypertension, but it does not provide immediate guidance for the newly diagnosed individual on how to manage their condition effectively.
As part of a comprehensive hypertension education plan, the nurse can provide additional information about dietary changes, regular blood pressure monitoring, and the importance of early management to prevent target organ damage. However, emphasizing physical activity as a fundamental aspect of hypertension management is the most important initial step for a newly diagnosed client. The nurse can then tailor the education based on the individual's specific needs and health status.
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