Heart Failure Review

What instruction is most important for the nurse to include in the teaching plan for a client with right-sided heart failure?

• Count pulse rate every hour.

• Eat three meals per day.

• Maintain bed rest.

• Elevate the legs while sitting.

Prior to giving a client the morning dose of digoxin, the nurse determines that the apical pulse is less than 55 beats/minute. What nursing action is the priority?

• Call the physician and report the finding.

• Hold the drug and assess for toxic effects.

• Take the client’s blood pressure.

• Recheck the pulse in 30 minutes.

A client with chronic heart failure takes a daily thiazide diuretic. The client asks the nurse why it is important to consume potassium-rich foods on a daily basis. What is the most accurate response?

• Consuming potassium-rich foods replaces what is lost in your urine.

• Potassium promotes the excretion of excess fluid by your kidneys.

• Potassium improves the therapeutic action of your diuretic.

• Your thiazide diuretic may cause significant hypocalcemia.

A client comes to the clinic complaining of shortness of breath, pink-tinged sputum, and a cough. The nurse suspects left-sided heart failure. What assessment finding further confirms the diagnosis?

• Moist crackles in the lung fields

• Bradycardia less than 60 beats/minute

• Blood pressure 90/60 mm Hg

• Increased excretion of urine

The best description of how diuretic medications work is that they:

• promote retention of fluid in the kidney.

• achieve acid balance in the lungs.

• increase the removal of potassium from the blood.

• inhibit reabsorption of sodium in the nephron.

When ordered two times daily, the best schedule for taking furosemide would be ______.

• 9 AM and 9 PM

• 7 AM and 9 AM

• 6 AM and 7 PM

• 8 AM and 2 PM

When evaluating the effectiveness of chlorothiazide, the nurse questions the client about ______.

• number of times voiding

• relief of eye pain

• amount of fluids drank

• daily weight

When administering spironolactone (Aldactone), the nurse monitors the client for which of the following electrolyte imbalances?

• Hypernatremia

• Hyponatremia

• Hyperkalemia

• Hypokalemia

Which electrolyte imbalance would the patient taking a loop or thiazide diuretic most likely develop?

• Hypernatremia

• Hyponatremia

• Hyperkalemia

• Hypokalemia

The nurse is seeing a client in the clinic 1 week after the client began taking a diuretic. Which finding would make you suspect that the client is not taking the diuretic?

• Serum potassium of 3.0 mEq/mL

• Urine output of 200 mL for the last 2 hours

• Blood pressure of 130/90 mm Hg

• Weight gain of 4 lb since last week