a nurse is providing instructions about the use of laxatives to a client who has heart failure the nurse should tell the client he should avoid which

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ATI Pharmacology

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

A. Sodium phosphate
B. Psyllium
C. Bisacodyl
D. Polyethylene glycol

Correct answer: A

Rationale: Clients with heart failure often have sodium restrictions. Sodium phosphate can lead to fluid retention due to sodium absorption, which is harmful for individuals with heart failure. Therefore, it should be avoided in this population to prevent exacerbating fluid overload. Psyllium, Bisacodyl, and Polyethylene glycol are safer options for individuals with heart failure as they do not pose the risk of exacerbating fluid overload through sodium retention.

2. When caring for a client prescribed Lithium, which laboratory value should the nurse monitor to assess for potential toxicity?

A. Serum sodium
B. Serum lithium
C. Serum potassium
D. Serum calcium

Correct answer: B

Rationale: The nurse should monitor the client's serum lithium levels to ensure they are within the therapeutic range and to assess for potential toxicity. Monitoring serum lithium levels is crucial because lithium has a narrow therapeutic range, and levels outside this range can lead to toxicity, which can be life-threatening. Therefore, regular monitoring is essential to prevent adverse effects and ensure the medication's effectiveness.

3. What is the therapeutic action of Phenytoin?

A. Antidiabetic
B. Anticonvulsant
C. Mood stabilizer
D. Antianxiety agent

Correct answer: B

Rationale: Phenytoin is primarily used as an anticonvulsant to prevent and control seizures. It works by stabilizing electrical activity in the brain, making it effective in managing conditions like epilepsy. Antidiabetic medications are used to regulate blood sugar levels, mood stabilizers help manage mood disorders, and antianxiety agents are used to reduce anxiety symptoms, none of which are the primary therapeutic action of Phenytoin.

4. How do ACE inhibitors work?

A. Block the vasoconstrictor and aldosterone effects of angiotensin II at the receptor site
B. Block stimulation of beta 1 and beta 2 at the receptor sites
C. Block the conversion of angiotensin I to the vasoconstrictor angiotensin II
D. None of the above

Correct answer: C

Rationale: ACE inhibitors work by inhibiting the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor, and by blocking its production, ACE inhibitors help dilate blood vessels, reduce blood pressure, and decrease the workload of the heart. Choice A is incorrect because it describes the mechanism of action of angiotensin receptor blockers (ARBs), not ACE inhibitors. Choice B is incorrect as it describes beta-blockers, not ACE inhibitors. Choice D is incorrect as ACE inhibitors do have a specific mechanism of action.

5. A client has a new prescription for Captopril. Which of the following instructions should the nurse include?

A. Take this medication with food.
B. Avoid foods high in potassium.
C. Take this medication on an empty stomach.
D. Increase your intake of sodium-rich foods.

Correct answer: C

Rationale: Captopril should be taken on an empty stomach for better absorption. The client should be instructed to take it 1 hour before or 2 hours after meals to optimize its effectiveness. Taking it with food can reduce its absorption and efficacy.