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 A
Explanation
A. An INR of 5.0 indicates a significantly increased risk of bleeding, and administering vitamin K is the appropriate antidote for reversing the effects of warfarin. This is a critical intervention to restore coagulation.
B. Increasing the dose of warfarin is inappropriate in this scenario because the INR is already elevated; it would further increase bleeding risk.
C. While heparin can be used for anticoagulation, it is not appropriate to administer it while the INR is dangerously high without reversing the warfarin first.
D. Continuing warfarin is unsafe at this INR level due to the high risk of bleeding; monitoring for symptoms without intervention is not adequate care.
Correct Answer is B
Explanation
A. "I will take this medication at bedtime to help with my symptoms." is correct; famotidine is often taken at bedtime to reduce nocturnal gastric acid secretion and help manage symptoms.
B. "I can take this medication with antacids for faster relief." is incorrect; antacids can interfere with the absorption of famotidine, and patients should be advised to separate the doses by at least an hour.
C. "I should avoid alcohol while taking this medication." is correct; alcohol can increase the risk of gastrointestinal irritation and should generally be avoided.
D. "I will monitor for signs of unusual bleeding or bruising." is correct; while famotidine is not typically associated with bleeding risks, monitoring for signs of unusual bleeding is a good practice when taking any medication, particularly in patients with risk factors.