An older adult client with hypertension has recently been prescribed a beta-adrenergic blocker and a thiazide diuretic. When educating the client about preventing and managing adverse effects, the nurse will provide which instruction?
"Change positions slowly to prevent lightheadedness or dizziness."
"Reduce your fluid intake initially, to prevent excessive urination."
"Identify and eliminate any high-potassium foods from your diet."
"Expect your blood pressure to increase for several days before it begins to decrease."
The Correct Answer is A
A. Changing positions slowly is critical for older adults taking beta-adrenergic blockers and diuretics to prevent orthostatic hypotension, which can lead to lightheadedness or dizziness.
B. Reducing fluid intake is not advisable, as thiazide diuretics can lead to dehydration, and maintaining adequate fluid intake is essential for overall health and to avoid excessive urinary output.
C. Identifying and eliminating high-potassium foods is unnecessary unless there is a specific indication of hyperkalemia, particularly since thiazide diuretics do not typically cause potassium retention, and beta-blockers are not potassium-specific.
D. Expecting blood pressure to increase before it decreases is misleading; clients should see a gradual reduction in blood pressure with proper medication adherence, and any sudden increases should be reported.
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Correct Answer is B
Explanation
A. Performing a blood sugar analysis is important, but in the case of sudden symptoms such as weakness, shakiness, and dizziness, it is crucial to act quickly to address the potential hypoglycemia without delay.
B. Having the client drink a 4-ounce glass of orange juice is the most appropriate initial response as it provides a quick source of glucose to alleviate symptoms of hypoglycemia, which is a common concern in clients with type 1 diabetes experiencing these symptoms.
C. Administering 1 ampule of 50% dextrose intravenously is an effective treatment for hypoglycemia but is typically reserved for severe cases where the patient is unable to consume oral glucose or is unconscious.
D. Administering 10 units of regular insulin subcutaneously would exacerbate the problem by lowering blood sugar further and is contraindicated in a patient experiencing hypoglycemic symptoms.
Correct Answer is ["A","B","E"]
Explanation
A. Improved sleep is an indication that fluoxetine is effectively alleviating depressive symptoms, as sleep disturbances are common in depression.
B. Decreased anxiety suggests that the medication is effective, as fluoxetine can help reduce both depressive and anxiety symptoms.
C. Reduced appetite is typically not a sign of effectiveness; it may indicate a side effect or worsening of depression rather than improvement.
D. Weight loss is also not a clear indicator of effectiveness; it may indicate adverse effects or worsening mental health symptoms rather than improvement in mood or behavior.
E. Interest in physical activity indicates improvement in mood and energy levels, which are positive signs of fluoxetine's effectiveness.