A client with heart failure is prescribed digoxin (Lanoxin). Which sign of digoxin toxicity should the nurse teach the client to report?

Correct Answer: B

Rationale: The correct answer is B: Yellow or blurred vision. Digoxin toxicity can lead to visual disturbances, such as yellow or blurred vision, due to its effects on the optic nerve. The nurse should teach the client to report this symptom immediately as it indicates a serious adverse effect. Increased appetite (A), weight gain (C), and nasal congestion (D) are not specific signs of digoxin toxicity and are more commonly associated with other health conditions or side effects of medications. It is crucial for the nurse to emphasize the importance of monitoring and reporting any visual changes to prevent serious complications from digoxin toxicity.

Correct Answer: C

Rationale: The correct answer is C: Activated partial thromboplastin time (aPTT). The aPTT measures the effectiveness of heparin therapy by assessing the clotting time. In patients with DVT receiving heparin, the goal is to keep the aPTT within a therapeutic range to prevent clot formation. Monitoring aPTT helps ensure the dose of heparin is appropriate. Prothrombin time (PT) and International normalized ratio (INR) are used to monitor warfarin therapy, not heparin. Platelet count is important to monitor for heparin-induced thrombocytopenia but does not directly assess the effectiveness of heparin therapy for DVT.

Correct Answer: A

Rationale: The correct answer is A: High Fowler's position. Placing the client in a High Fowler's position helps reduce dyspnea and orthopnea by facilitating lung expansion and improving ventilation. In this position, the client's head and chest are elevated at a 90-degree angle, allowing for maximal chest expansion and improved oxygenation. This position also helps reduce the workload on the heart by decreasing venous return, which can help alleviate symptoms of left-sided heart failure. Summary: - A: High Fowler's position is correct as it facilitates lung expansion and improves ventilation. - B: Supine position would not be ideal as it can exacerbate symptoms by increasing pressure on the lungs and heart. - C: Trendelenburg position would worsen symptoms by increasing venous return and fluid overload. - D: Sims' position is used for procedures or to facilitate drainage, not for relieving dyspnea and orthopnea.

Correct Answer: C

Rationale: The correct answer is C: Hypernatremia. Fludrocortisone is a mineralocorticoid that promotes sodium retention and potassium excretion, leading to an increase in sodium levels. Addison's disease involves low levels of cortisol and aldosterone, so fludrocortisone is used to replace aldosterone. Monitoring for hypernatremia is crucial to prevent complications like hypertension and fluid retention. Hyperkalemia (A) is not expected due to the drug's potassium-excreting effect. Hyponatremia (B) is unlikely as the drug promotes sodium retention. Hypocalcemia (D) is not directly related to fludrocortisone therapy.

Correct Answer: C

Rationale: The correct answer is C: Take the medication on an empty stomach. Omeprazole is a proton pump inhibitor that works best when taken on an empty stomach, about 30 minutes before meals. This allows the medication to be absorbed effectively and provides optimal therapeutic effects in reducing stomach acid production. Taking it with food (choice A) may decrease its efficacy. Taking it at bedtime (choice B) is not ideal as it may not coincide with the peak acid production in the stomach. Taking it as needed for pain relief (choice D) is not appropriate as omeprazole is a scheduled medication for the management of peptic ulcer disease, not for immediate pain relief.