A nurse is assessing a client who has pulmonary edema. Which of the following findings should the nurse expect?
Bradycardia
Wheezing
Pale, Dry Skin
Pink, frothy sputum
The Correct Answer is D
Rationale:
A. Bradycardia is not typically associated with pulmonary edema; instead, tachycardia is more common as the body tries to compensate for decreased oxygenation.
B. Wheezing may occur in certain respiratory conditions but is not a classic finding in pulmonary edema; instead, crackles or rales are more expected due to fluid accumulation.
C. Pale, dry skin is not characteristic of pulmonary edema; the client may present with cyanosis or clammy skin due to hypoxia.
D. Pink, frothy sputum is a classic sign of pulmonary edema, indicating fluid in the alveoli and is often associated with acute heart failure.
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Correct Answer is B
Explanation
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.
Correct Answer is B
Explanation
Rationale:
A. Taking the medication 2 hours apart from calcium supplements is important, but the timing is not the primary instruction; the focus should be on the medication itself.
B. Levothyroxine should be taken on an empty stomach, ideally 30 to 60 minutes before breakfast, to enhance absorption.
C. Taking a double dose if a dose is missed can lead to toxicity; patients should be instructed to skip the missed dose and resume the regular schedule.
D. While taking the medication with a small sip of water is acceptable, it is not the most critical instruction for ensuring proper absorption and effectiveness of levothyroxine.