A nurse is providing discharge teaching for parents of a child who has congestive heart failure and is about to start taking furosemide. Which of the following instructions should the nurse include?
Eat foods that contain plenty of potassium.
Take the medication at bedtime.
Take aspirin if headaches develop.
Expect some swelling in the hands and feet.
The Correct Answer is A
A. Furosemide is a loop diuretic that can cause potassium loss; therefore, it is essential for the child to eat potassium-rich foods to prevent hypokalemia.
B. Taking furosemide at bedtime is not advisable due to the increased risk of nocturia and sleep disturbances from frequent urination.
C. Aspirin is not recommended without medical guidance, especially for children, as it can increase the risk of Reye's syndrome.
D. Expecting swelling in the hands and feet contradicts the purpose of furosemide, which is to reduce fluid overload; parents should report any unexpected swelling to the healthcare provider.
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Correct Answer is B
Explanation
A. Doubling the dose if a dose is missed can increase the risk of bleeding and is not recommended for warfarin. Instead, the client should take the missed dose as soon as remembered unless it's almost time for the next dose.
B. Using an electric razor is recommended to minimize the risk of cuts and bleeding, which is particularly important for clients on anticoagulants like warfarin.
C. While increasing fiber intake can be beneficial for overall health, it is not specifically necessary for addressing constipation related to warfarin therapy.
D. While mild nosebleeds may occur, they are not typically common during initial treatment. Clients should be informed to report any unusual or severe bleeding.
Correct Answer is C
Explanation
A. Clients on digoxin should actually have an adequate intake of potassium, as low potassium levels can increase the risk of digoxin toxicity.
B. If a pediatric client spits out digoxin, the dose should not be repeated automatically; instead, the nurse should assess the situation and follow the facility's protocol regarding missed doses.
C. Measuring the apical pulse for one full minute before administering digoxin is critical; if the pulse is below the established threshold (usually <60 bpm for children), the medication should be held and the provider notified.
D. While evaluating for nausea, vomiting, and anorexia is important, it is not an appropriate immediate action before administering the medication. The priority action is to assess the apical pulse.