A nurse is providing teaching to a client who has emphysema and a new prescription for theophylline. Which of the following instructions should the nurse provide?
Increase fluids to 1L/per day.
Administer the medication with food.
Consume a high-protein diet.
Avoid caffeine while taking this medication.
The Correct Answer is D
A. Increase fluids to 1L/per day. Clients with emphysema are often encouraged to increase fluid intake beyond 1 liter to help thin secretions, but 1 liter per day is generally insufficient.
B. Administer the medication with food. Theophylline should not necessarily be taken with food; it is generally taken on an empty stomach, but it can be taken with food if gastrointestinal upset occurs.
C. Consume a high-protein diet. High-protein diets may increase the metabolism of theophylline, potentially decreasing its therapeutic effect. Dietary considerations for theophylline involve avoiding caffeine.
D. Avoid caffeine while taking this medication. Theophylline is a methylxanthine, similar to caffeine, and consuming caffeine can increase the risk of side effects like tachycardia, nervousness, and insomnia.
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Correct Answer is B
Explanation
A. The patient is hypertensive. Hypertension is not a prerequisite for starting BPH medication; in fact, some BPH medications can lower blood pressure.
B. The patient has had a prostate examination, including measurement of the PSA level. A prostate examination and PSA measurement are important for diagnosing BPH and ruling out prostate cancer before starting treatment.
C. The patient is still sexually active. Sexual activity status is not a determining factor for administering BPH medication.
D. The patient has not had a vasectomy. Vasectomy status does not influence the treatment of BPH.
Correct Answer is D
Explanation
A. Digoxin: Digoxin requires caution with elevated potassium levels, as hyperkalemia can increase the risk of digoxin toxicity. A potassium level of 5.3 mEq/L is borderline high, so it should be used cautiously.
B. Lisinopril: Lisinopril, an ACE inhibitor, can also increase potassium levels. It may not be the best choice for this client due to the elevated potassium.
C. Potassium iodide: Potassium iodide would further increase the client's potassium level and is contraindicated.
D. Furosemide: Furosemide is a loop diuretic that can help to lower serum potassium levels by promoting potassium excretion. Therefore, it is appropriate for this client with an elevated potassium level.