A client began taking hydrochlorothiazide 1 week ago and is reporting occasional dizziness when standing up quickly from sitting or lying. What is the nurse's best action?
Arrange for the client's potassium levels to be assessed as soon as possible
Teach the client about the blood pressure effects of the medication and relevant safety measures.
Educate the client about the need for bed rest until the body adjusts to the new medication.
Tell the client to withhold the medication until the client can be assessed by the primary health care provider.
The Correct Answer is B
A. While assessing potassium levels is important for clients on diuretics, the immediate concern is the client's dizziness, which indicates a potential issue with blood pressure.
B. Teaching the client about the potential for orthostatic hypotension caused by hydrochlorothiazide and instructing them on safety measures (e.g., standing up slowly) is crucial to prevent falls and address the dizziness.
C. Bed rest is not necessary; the client should be educated about managing dizziness instead.
D. Withholding the medication is not warranted unless directed by a healthcare provider; the focus should be on safety education.
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Correct Answer is ["B","C","D"]
Explanation
A. Sit up comfortably in the bed is incorrect; the client should be in an upright position, which can be done while sitting up comfortably, but it’s essential to emphasize a more upright posture for optimal administration.
B. Tilt the head slightly to the side is correct; this position helps facilitate the delivery of the medication into the nasal passages.
C. Insert the tip of the nose piece into one nostril is correct; proper insertion ensures effective delivery of the medication.
D. Hold the breath for a few seconds after administering the spray is correct; this allows the medication to be absorbed more effectively.
E. Blow the nose 1 minute after administering the spray is incorrect; clients should avoid blowing their nose immediately after use to allow for proper absorption of the medication.
Correct Answer is A
Explanation
A. Changing positions slowly is critical for older adults taking beta-adrenergic blockers and diuretics to prevent orthostatic hypotension, which can lead to lightheadedness or dizziness.
B. Reducing fluid intake is not advisable, as thiazide diuretics can lead to dehydration, and maintaining adequate fluid intake is essential for overall health and to avoid excessive urinary output.
C. Identifying and eliminating high-potassium foods is unnecessary unless there is a specific indication of hyperkalemia, particularly since thiazide diuretics do not typically cause potassium retention, and beta-blockers are not potassium-specific.
D. Expecting blood pressure to increase before it decreases is misleading; clients should see a gradual reduction in blood pressure with proper medication adherence, and any sudden increases should be reported.