The nurse plans discharge teaching for a patient with chronic ...

[ts19998]

The nurse plans discharge teaching for a patient with chronic heart failure who has prescriptions for digoxin (Lanoxin) and hydrochlorothiazide (HydroDIURIL). Appropriate instructions for the patient include
 
  a. limit dietary sources of potassium.
  b. take the hydrochlorothiazide before bedtime.
  c. notify the health care provider if nausea develops.
  d. skip the digoxin if the pulse is below 60 beats/minute.

Question 2

When teaching the patient with newly diagnosed heart failure about a 2000-mg sodium diet, the nurse explains that foods to be restricted include
 
  a. canned and frozen fruits.
  b. fresh or frozen vegetables.
  c. eggs and other high-protein foods.
  d. milk, yogurt, and other milk products.

[Amiracle]

Answer to Question 1

ANS: C
Nausea is an indication of digoxin toxicity and should be reported so that the provider can assess the patient for toxicity and adjust the digoxin dose, if necessary. The patient will need to include potassium-containing foods in the diet to avoid hypokalemia. Patients should be taught to check their pulse daily before taking the digoxin and if the pulse is less than 60, to call their provider before taking the digoxin. Diuretics should be taken early in the day to avoid sleep disruption.

Answer to Question 2

ANS: D
Milk and yogurt naturally contain a significant amount of sodium, and intake of these should be limited for patients on a diet that limits sodium to 2000 mg daily. Other milk products, such as processed cheeses, have very high levels of sodium and are not appropriate for a 2000-mg sodium diet. The other foods listed have minimal levels of sodium and can be eaten without restriction.