A client who has high blood pressure is having difficulty following their treatment plan. Which of the following factors should the nurse recognize as being the greatest barrier to the client's ability to be compliant?
Dietary salt restriction
Absence of symptoms
Addition of a new medication
A detailed plan of care
The Correct Answer is B
Rationale:
A. Dietary salt restriction is challenging but is a specific intervention that can be managed with education and support.
B. The absence of symptoms can significantly hinder compliance because clients may not perceive the need to adhere to a treatment plan if they do not feel unwell. This perception can lead to underestimating the importance of managing their blood pressure.
C. The addition of a new medication may pose some challenges, but clients often adapt to new medications with proper guidance.
D. A detailed plan of care can enhance understanding and compliance, making it less likely to be a barrier compared to the lack of symptomatic cues indicating a need for treatment.
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Correct Answer is D
Explanation
Rationale:
A. A dry cough is not a common adverse effect associated with ibuprofen and is more related to respiratory issues.
B. An increase in urine output is not a typical adverse effect of ibuprofen; rather, it may indicate a different condition.
C. Muscle stiffness is a symptom of juvenile idiopathic arthritis itself and not specifically an adverse effect of ibuprofen.
D. Asking about stomach pain or bloody stools is crucial as ibuprofen can cause gastrointestinal irritation, ulcers, or bleeding, which are serious adverse effects of long-term use.
Correct Answer is C
Explanation
Rationale:
A. The reason for the medication error should not be documented in the client's medical record due to potential legal implications; such information belongs in the incident report instead.
B. Documentation of notification to the pharmacist is relevant for the incident report but is not appropriate for the client's medical record.
C. The time the medication was given is an important detail that should be documented in the client's medical record as it affects the client's treatment and future medication administration.
D. Documenting the completion of the incident report should be done in the facility's quality assurance system, not in the client’s medical record.