An older adult client recovering from coronary artery bypass surgery becomes weak and dizzy when standing to ambulate in the hall with the unlicensed assistive personnel (UAP). The UAP assists the client back into bed and notifies the nurse of the occurrence. Which intervention is most important for the nurse to include in the client's plan of care?
Provide client with dietary teaching regarding a cardiac diet.
Obtain client's vital signs every 4 hours when awake.
Obtain a blood pressure reading before client gets out of bed.
Measure and record the client's urinary output every day.
The Correct Answer is C
Rationale:
A. Dietary teaching is important for long-term health but does not address the immediate issue of dizziness upon standing.
B. Monitoring vital signs every 4 hours is important, but obtaining blood pressure before standing is crucial to prevent falls and manage orthostatic hypotension.
C. Measuring blood pressure before the client stands helps identify orthostatic hypotension, which could be causing weakness and dizziness.
D. Measuring urinary output is relevant but not immediately pertinent to the client's dizziness and weakness on standing.
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Correct Answer is C
Explanation
Rationale:
A. Erythromycin does not require the client to avoid sunlight, unlike some other antibiotics.
B. The timing of medication intake does not affect the interaction between erythromycin and oral contraceptives.
C. Erythromycin can reduce the effectiveness of oral contraceptives. It is essential to use an additional contraceptive method to prevent unintended pregnancy.
D. Stopping the oral contraceptive is not necessary but using an additional form of contraception is important.
Correct Answer is B
Explanation
Rationale:
A. Insulin requirements generally increase as pregnancy progresses due to the growing placenta and hormones that cause insulin resistance, not fluctuate significantly.
B. Insulin requirements typically begin to increase around 18 weeks of gestation and continue to rise until approximately 36 weeks due to increased insulin resistance caused by placental hormones.
C. While insulin needs do increase, they do not typically double or quadruple during the second trimester. The increase is more gradual.
D. Insulin requirements increase during pregnancy and may decrease after delivery as the placenta is no longer present, removing the source of insulin resistance.