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 ["A","C","D"]
Explanation
A. Perform passive range of motion exercises. Passive range of motion exercises help maintain circulation and reduce venous stasis, which is crucial for preventing pulmonary embolism in clients who are immobile.
B. Place pillows under the client's knees when in bed. Placing pillows under the knees can actually promote venous stasis and increase the risk of a pulmonary embolism. It is better to keep the legs flat to encourage circulation.
C. Assess legs for redness. Regular assessment of the legs for redness, swelling, or warmth helps in the early detection of deep vein thrombosis (DVT), which can lead to pulmonary embolism if not addressed.
D. Apply elastic compression stockings. Elastic compression stockings promote venous return from the legs to the heart and help prevent DVT, thereby reducing the risk of pulmonary embolism.
E. Massage the calves every shift. Massaging the calves can dislodge a thrombus and potentially lead to a pulmonary embolism. Instead, interventions should focus on preventing thrombus formation.
Correct Answer is D
Explanation
A. Limit caffeine intake. While caffeine can affect some patients, it is not a specific concern with inhaled corticosteroids like beclomethasone.
B. Take the medication with meals. Inhaled corticosteroids like beclomethasone are typically not taken with meals as they are inhaled, not ingested.
C. Check the pulse after medication administration. Monitoring the pulse is not necessary for beclomethasone unless the client experiences specific symptoms related to tachycardia, which is not common with inhaled corticosteroids.
D. Rinse the mouth after administration. Rinsing the mouth after using inhaled corticosteroids helps prevent oral thrush and other oral side effects associated with the medication.