A nurse is teaching a client just diagnosed with mild hypertension. Which of the following information should the nurse include in the teaching?
"Diuretics are the first line therapy to control hypertension."
"Reaching your goal blood pressure will occur within 2 months."
"Plan to add saturated fats to 10 percent of your daily calorie intake."
"Limit your alcohol consumption to three drinks a day."
The Correct Answer is A
A. "Diuretics are the first line therapy to control hypertension.": This statement is accurate. Thiazide diuretics are commonly recommended as first-line treatment for mild hypertension, as they help reduce blood volume and lower blood pressure effectively.
B. "Reaching your goal blood pressure will occur within 2 months.": While treatment can lead to improvements in blood pressure, the timeline for reaching target levels can vary significantly among individuals based on adherence to lifestyle changes and medication. It's important to communicate that achieving the goal may take longer than two months.
C. "Plan to add saturated fats to 10 percent of your daily calorie intake.": This recommendation is misleading. Guidelines generally suggest limiting saturated fats to less than 10 percent of total daily calories to promote heart health, not adding them.
D. "Limit your alcohol consumption to three drinks a day.": This statement is also inaccurate. For most adults, the recommendation is to limit alcohol to no more than two drinks per day for men and one drink per day for women to help manage blood pressure effectively.
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Correct Answer is C
Explanation
A) Vitamin A: While vitamin A can affect various bodily functions, it is not known to have a direct interaction with warfarin. Therefore, it is not considered incompatible with warfarin therapy.
B) Alprazolam: This medication, a benzodiazepine, is primarily used to treat anxiety and does not have a significant interaction with warfarin. Thus, it is not incompatible with warfarin therapy.
C) Vitamin K: This vitamin is a critical consideration when a client is on warfarin therapy. Warfarin works by inhibiting vitamin K-dependent clotting factors, so an increased intake of vitamin K can counteract the effects of warfarin, making this the correct answer. Clients on warfarin should maintain a consistent intake of vitamin K to prevent fluctuations in their INR levels.
D) Furosemide: This loop diuretic is used to manage conditions such as heart failure and edema. While it may affect electrolyte levels, it does not have a direct interaction that would render it incompatible with warfarin. It can be safely used alongside warfarin with appropriate monitoring.
Correct Answer is C
Explanation
A) Apply cold therapy to the affected leg: Cold therapy may be used for certain conditions to reduce swelling and pain, but in the case of suspected deep vein thrombosis (DVT) indicated by redness, warmth, tenderness, and pain in the calf, cold therapy is not appropriate. Instead, the focus should be on confirming the diagnosis before applying any treatment.
B) Monitor Homan's sign: Homan's sign involves dorsiflexion of the foot to assess for pain in the calf, which can suggest DVT. However, it is no longer considered a reliable diagnostic tool. Instead, confirmation through imaging or other diagnostic measures is preferred, so simply monitoring this sign would not be sufficient in this situation.
C) Obtain a venous duplex ultrasound: A venous duplex ultrasound is the gold standard for
diagnosing DVT. Given the client’s symptoms—redness, warmth, tenderness, and pain in the calf—the appropriate order is to obtain this ultrasound to confirm the presence of a thrombus. This imaging study provides critical information for diagnosis and subsequent management.
D) Obtain impedance plethysmography: While impedance plethysmography can assess venous flow and help diagnose DVT, it is less commonly used than venous duplex ultrasound. The more direct and widely accepted method for diagnosing DVT in this scenario is the ultrasound, making this option less suitable as the initial order.