A client with heart failure is receiving instructions about laxative use. The client should be advised to avoid which of the following laxatives?

Correct Answer: A

Rationale: In the context of a client with heart failure, it is crucial to avoid sodium phosphate laxatives. Sodium phosphate can lead to electrolyte imbalances, particularly hyperphosphatemia, which can exacerbate heart failure by increasing the workload on the heart. This can further compromise the client's cardiac function and lead to fluid retention, worsening heart failure symptoms. Psyllium, bisacodyl, and polyethylene glycol are safer options for individuals with heart failure. Psyllium is a bulk-forming laxative that can help regulate bowel movements without impacting electrolyte balance. Bisacodyl is a stimulant laxative that acts directly on the colon and is typically safe for heart failure patients in moderation. Polyethylene glycol is an osmotic laxative that works by drawing water into the colon, but it does not significantly impact electrolyte levels. Educationally, this question highlights the importance of understanding the potential adverse effects of medications in specific patient populations. It reinforces the need for healthcare providers to consider comorbidities and tailor treatment plans to ensure the safety and well-being of patients with complex medical conditions like heart failure. This knowledge is crucial for nursing students and healthcare professionals to provide optimal care and prevent complications in vulnerable patient populations.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Offer oral hygiene every 2 hours. This is the most appropriate action for a client in labor receiving IV opioid analgesics because opioids can cause dry mouth as a side effect. Providing oral hygiene helps alleviate discomfort, maintain oral health, and enhance overall comfort for the client during labor. Option A) Instruct the client to self-ambulate every 2 hours is incorrect because opioid analgesics can cause drowsiness and impair coordination, making ambulation unsafe for the client. Option C) Anticipate medication administration 2 hours prior to delivery is incorrect because the timing of medication administration should be based on the client's pain level and not a predetermined time frame. Option D) Monitor fetal heart rate every 2 hours is incorrect because while fetal monitoring is essential during labor, monitoring the maternal vital signs and comfort measures take precedence over fetal heart rate monitoring in this context. Educationally, this question highlights the importance of understanding the effects of opioid analgesics on laboring clients and the appropriate nursing interventions to ensure their safety and comfort. It emphasizes the need for individualized care based on the client's condition and medication effects.

Correct Answer: C

Rationale: The correct answer is option C: "I'll let the doctor know if I develop sores in my mouth while taking this medication." This statement indicates understanding because one of the side effects of Methotrexate is mucosal ulceration, which can manifest as sores in the mouth. By recognizing and reporting this side effect to the healthcare provider, the client can receive appropriate management and potentially prevent further complications. Option A is incorrect because the frequency of blood monitoring for Methotrexate is more frequent than once a year due to its potential for adverse effects on the bone marrow, liver, and kidneys. Option B is incorrect because Methotrexate is usually taken with food to reduce gastrointestinal side effects. Option D is incorrect because Methotrexate does not interact with oral contraceptives, so there is no need to stop taking them while on Methotrexate therapy. In an educational context, it is crucial for nurses to ensure that clients understand the side effects and monitoring requirements of medications like Methotrexate to promote safe and effective treatment. Teaching clients about potential side effects and when to seek medical attention empowers them to take an active role in their healthcare and enhances medication adherence and safety.

Correct Answer: A

Rationale: The nurse should educate the client that taking Celecoxib increases the risk of a myocardial infarction due to its suppression of vasodilation. This medication belongs to the class of NSAIDs known to have cardiovascular risks, including an increased risk of heart attacks. Therefore, it is essential for the nurse to emphasize this potential adverse effect during client teaching to ensure the client is aware of the associated risks.

Correct Answer: D

Rationale: Butorphanol, an opioid agonist/antagonist, can lead to abstinence syndrome in clients who are opioid-dependent. This syndrome may present with symptoms like abdominal pain, fever, and anxiety. It is crucial for healthcare professionals to consider this risk when administering Butorphanol to clients with a history of substance use disorder.