A client diagnosed with left-sided cardiac failure would be most ...

[karlynnae]

A client diagnosed with left-sided cardiac failure would be most comfortable in which sleeping position?
 
  1. Lying on either side with the head of the bed elevated 30
   2. Seated in a recliner with 23 pillows under head
   3. Lying on the left side with the head of the bed elevated 30
   4. Seated in a recliner with 23 pillow under feet

Question 2

Which of the following instructions should the nurse include when administering a beta-adrenergic like propranolol (Inderal) to the client?
 
  1. Discontinue the medication immediately.
   2. Notify your physician if you experience urinary retention.
   3. Take a laxative every day.
   4. Take the medication on an empty stomach.

[raenoj]

Answer to Question 1

4. Seated in a recliner with 2-3 pillows under head

Rationale:
The client with left-sided cardiac failure could develop orthopnea. This is a result of the pulmonary congestion and decreased cardiac output. Being in an upright position will ease the work of breathing. Side-lying positions will not help alleviate or prevent the development of orthopnea. Propping the lower legs up while in a sitting position can help decrease dependent edema, but 23 pillows are not needed for sleep.

Answer to Question 2

2. Notify your physician if you experience urinary retention.

Rationale:
A beta-adrenergic blocker such as propranolol can cause urinary retention; therefore, it would be of the utmost importance to notify one's physician. Clients should always check with their physician before stopping any medication because there could be some major complications. Constipation has been reported from clients taking propranolol, but a laxative should not be taken every day as one can become dependent. This medicine should be taken with food, not on an empty stomach, in order to enhance absorption.