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. Weak pulses are more indicative of reduced cardiac output or other cardiac issues, rather than specifically a large patent ductus arteriosus (PDA).
B. Cyanosis with crying can occur in various conditions, but it is not a hallmark of a large PDA; it typically presents with other symptoms.
C. Chronic hypoxemia is more associated with severe heart defects or lung conditions, whereas a large PDA may present with other signs first.
D. A systolic murmur is a classic finding in large PDAs due to the left-to-right shunting of blood, making it the most expected manifestation in this scenario.
Correct Answer is C
Explanation
A. By age 6, while children can dress themselves, they may still need assistance with more complex grooming tasks, making this statement too absolute.
B. Counting backwards from 20 to 1 is typically expected by age 8, not age 7, indicating this statement is inaccurate regarding cognitive development.
C. Engaging in motor activities that require balance, such as jumping rope, is appropriate for children around age 6, demonstrating the expected physical development in this age group.
D. While children can use simple tools, mastery and effective use of tools like a screwdriver or hammer are more typical around ages 8 to 10, making this statement premature for age 6.