A nurse is caring for a client who has heart failure and has been taking digoxin 0.25 mg daily. The client refuses breakfast and reports nausea. Which of the following actions should the nurse take first?
Suggest that the client rests before eating the meal.
Check the client's vital signs.
Request a dietary consult.
Request an order for an antiemetic.
The Correct Answer is B
A. Suggest that the client rests before eating the meal. Although rest can help with nausea, it does not address the potential issue of digoxin toxicity, which can cause nausea.
B. Check the client's vital signs. Checking vital signs, especially heart rate, is the priority because nausea can indicate digoxin toxicity, which affects heart function.
C. Request a dietary consult. A dietary consult may be helpful if the client continues to refuse meals, but it does not address the immediate potential for digoxin toxicity.
D. Request an order for an antiemetic. Although an antiemetic may help with nausea, assessing for toxicity takes priority.
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Correct Answer is A
Explanation
A. "Cardiac rehabilitation cannot undo the damage to your heart, but it can help you get back to your previous level of activity safely." This response is therapeutic and educative, helping the client understand that while damage cannot be reversed, rehabilitation supports safe recovery and improved quality of life.
B. "Your doctor is the expert here, and I'm sure he would only recommend what is best for you." This response does not address the client’s concerns and lacks supportive or educational value.
C. "You are probably right and I agree with you, but I still think you should go." This dismissive response fails to provide support, education, or empathy.
D. "It's not unusual to feel that way at first, but once you learn the routine, you'll be fine." Although this statement offers some support, it lacks the educational element needed to address the client’s concerns about the purpose of rehabilitation.
Correct Answer is D
Explanation
A. Elevated thyroid hormone levels. While amiodarone can cause thyroid dysfunction, elevated thyroid levels (hyperthyroidism) would typically present with symptoms like increased energy or restlessness.
B. Low blood glucose levels. Low blood glucose is not related to amiodarone. Symptoms of hypoglycemia include sweating, hunger, and confusion, not heat intolerance or fatigue.
C. Elevated blood glucose levels. Hyperglycemia is not a known side effect of amiodarone.
D. Low thyroid hormone levels. Amiodarone can induce hypothyroidism, which may cause fatigue and heat intolerance. Regular thyroid monitoring is recommended with long-term amiodarone use.