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 D
Explanation
A. Encouraging excessive rest and avoidance of physical activities can lead to feelings of inferiority by limiting opportunities for achievement and social interactions.
B. Limiting social interactions is counterproductive, as friendships and peer relationships are critical for social development during this stage.
C. While supervision is important, overly controlling the child’s activities can inhibit their ability to explore and learn, negatively impacting their sense of industry.
D. Involving the child in decision-making and providing opportunities for independent tasks fosters a sense of competence and accomplishment, essential for developing a sense of industry, according to Erikson’s theory.
Correct Answer is B
Explanation
A. Tricuspid atresia typically leads to decreased pulmonary blood flow due to the absence of normal blood flow to the lungs.
B. Patent ductus arteriosus results in increased pulmonary blood flow because it allows blood to flow from the aorta to the pulmonary artery, increasing the volume of blood going to the lungs.
C. Coarctation of the aorta can cause decreased blood flow to the lower body, which may not directly relate to increased pulmonary blood flow.
D. Tetralogy of Fallot is characterized by decreased pulmonary blood flow due to right ventricular outflow obstruction, making it not associated with increased pulmonary blood flow.