A nurse is reinforcing teaching with a client about risk factors for heart disease. Which of the following risk factors is modifiable? (Select All that Apply.)
Family history
Sedentary Lifestyle
Smoking
Diabetes
Correct Answer : B,C,D,E
A. Family history is a non-modifiable risk factor as it cannot be changed or controlled.
B. A sedentary lifestyle is a modifiable risk factor; increasing physical activity can reduce the risk of heart disease.
C. Smoking is a modifiable risk factor; quitting smoking can significantly decrease the risk of heart disease.
D. Diabetes can be managed and controlled through lifestyle changes and medication, making it a modifiable risk factor.
E. Hypertension is also a modifiable risk factor; it can be managed through diet, exercise, and medication.
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Correct Answer is B
Explanation
A. Documenting the findings and continuing the visit does not address the potential seriousness of the weight gain and edema in a patient with heart failure. It is important to act promptly on such findings.
B. Notifying the RN case manager of the change in status is essential because a weight gain of this magnitude, along with generalized edema, may indicate worsening heart failure. This requires a timely assessment and possible adjustment of the treatment plan, including medication and fluid management.
C. While reinforcing the importance of daily weights is beneficial for long-term management, it is not an immediate intervention for the acute change in the patient’s condition.
D. Ensuring the client has been taking their prescribed diuretic is important, but the nurse should first communicate the significant changes to the RN case manager for further evaluation and intervention, as this might require a medication review or adjustment.
Correct Answer is C
Explanation
A. Monitoring electrolyte levels is important but is not as immediate as ensuring airway patency.
B. Performing passive range of motion is beneficial for mobility but does not address the immediate needs of an unconscious patient.
C. Suctioning saliva from the client's mouth is the highest priority intervention, as maintaining airway clearance is critical to prevent aspiration and ensure adequate ventilation.
D. Recording intake and output is necessary for overall assessment but is not as urgent as managing the airway.