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Chapter 6: Problem 14

Multiple-choice question: In preparation for discharge, what teaching should the nurse include regarding use of hydrochlorothiazide (HydroDIURIL)? A. Decrease intake of foods high in potassium. B. Take this medication upon waking in the morning. C. Th is medication may cause weight gain. D. Report impaired hearing to health care provider immediately

Short Answer

Expert verified
The correct answer is B: Take this medication upon waking in the morning.

Step by step solution

01

Understanding Hydrochlorothiazide (HydroDIURIL)

Firstly, understand that hydrochlorothiazide is a diuretic medication used to treat high blood pressure and fluid retention. It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine.
02

Analyze the Answer Options

Next, review the answer options individually and analyze their relevance based on your understanding of HydroDIURIL. This includes potential side effects, usage instructions, and any potential risks.
03

Cross Referencing the Options

Hydrochlorothiazide can cause the body to lose too much potassium, leading to hypokalemia. Therefore, decreasing intake of foods high in potassium (option A) would not be correct as these foods will help maintain potassium levels. This medication may actually cause a slight weight loss due to diuresis, so option C is not accurate. Hydrochlorothiazide does not affect hearing, so option D is incorrect.
04

Determining the Correct Answer

Finally, conclude that the correct answer is option B: 'Take this medication upon waking in the morning.' This is a correct instruction because taking this medication early in the day can help avoid frequent trips to the bathroom during the night.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

Hydrochlorothiazide Education
Hydrochlorothiazide is a commonly prescribed diuretic, also known as a water pill, used to help control high blood pressure and reduce fluid retention associated with conditions such as heart failure, edema, and kidney disorders. It is vital for patients to understand how hydrochlorothiazide works to ensure its effectiveness and recognize any potential concerns that require attention.

Here are some key points patients should be educated on:
  • Dosage: Patients should adhere to their prescribed dosage and schedule. Taking it in the morning is often recommended to avoid nocturia鈥攁 frequent need to urinate during the night.
  • Potassium Levels: Since hydrochlorothiazide can lower potassium levels in the blood, patients may need to increase their intake of potassium-rich foods or take supplements as directed by a healthcare provider.
  • Hydration: Maintaining adequate fluid intake is important, while also being aware of any signs of dehydration.
  • Other Medications: Patients should discuss all current medications with their healthcare provider, as hydrochlorothiazide can interact with other drugs.
  • Monitoring: Regular monitoring of blood pressure, electrolyte levels, and kidney function is important while taking hydrochlorothiazide.
Imparting this information to patients can help them manage their treatment effectively and minimize the risk of adverse effects.
Nursing Discharge Teaching
Discharge teaching is a critical aspect of a nurse's role in ensuring that a patient's transition from hospital to home care is safe and effective. For patients prescribed hydrochlorothiazide, there are specific instructions and precautions that should be included in discharge education.

Key topics a nurse should cover include:
  • Medication Schedule: Advise patients to consistently take the medication as directed, and reiterate the importance of the timing related to hydrochlorothiazide.
  • Diet and Nutrition: Educate on maintaining a balanced diet, over and above the focus on potassium, to support overall health.
  • Side Effects: Inform about common side effects and urgent symptoms that would necessitate contacting a healthcare provider.
  • Activity Level: Advise on gradually resuming activities and reporting excessive fatigue or weakness that could indicate underlying issues.
  • Follow-Up Appointments: Emphasize the need for regular follow-up appointments for monitoring the response to the medication and adjusting the care plan as needed.
Providing these details during discharge can enhance patient understanding, promote adherence to the treatment plan, and reduce readmission rates.
Diuretic Side Effects
While diuretics like hydrochlorothiazide are effective in treating certain conditions, they can also lead to a range of side effects. Health care providers need to educate patients about what to expect and when to seek medical attention.

Potential side effects of diuretics include:
  • Electrolyte Imbalance: Symptoms might include muscle cramps or weakness, irregular heartbeats, or confusion, signaling issues like low potassium or sodium levels.
  • Dehydration: Excessive urination can lead to dehydration; warning signs include dry mouth, thirst, and dizziness.
  • Hypotension: Lowered blood pressure, which may cause fainting or lightheadedness, particularly when standing up quickly.
  • Renal Function: Impaired kidney function, signaled by reduced urine output or swelling, which should be reported immediately.
  • Uncommon Effects: Patients should also be aware of rare side effects, such as rash, pancreatitis, or jaundice鈥攖hese require immediate medical evaluation.
When patients are informed about these potential side effects and know how to respond, they can participate more actively in their healthcare and experience better outcomes.

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Most popular questions from this chapter

Multiple-choice question: Which of the following measures should the nurse implement in order to ensure patient safety when using a continuous insulin infusion? A. Check capillary blood glucose every 8 hours. B. Administer the insulin as a piggyback to 0.9% normal saline. C. Infuse the insulin using an IV volumetric pump. D. Have the nursing assistant perform a double check of the infusion rate.

Select all that apply: Which of the following are therapeutic uses for atorvastatin (Lipitor)? A. Decreases low-density lipoproteins. B. Increases high-density lipoprotein. C. Decreases risk of a heart attack or stroke. D. Helps to maintain blood glucose within normal limits.

Matching: Match the antihypertensive class with the mechanism. Antihypertensive class Mechanism by which it decreases blood pressure 1\. Diuretics A. Decreases sympathetic stimulation from the central nervous system, resulting in decreased heart rate, decreased vasoconstriction, and decreased vascular resistance within the kidneys. 2\. Beta blockers B. Cause vasodilation by blocking the receptor sites of alpha-1 adrenergic receptors. 3\. Calcium channel blockers C. Blocks the receptor sites of angiotensin II, thus preventing the vasoconstricting eff ects. Prevents the release of aldosterone, which causes increased sodium and water reabsorption. 4\. Angiotensin-converting enzyme inhibitors (ACE inhibitors) D. Decreases heart rate, resulting in decreased cardiac output. 5\. Angiotensin II receptor antagonists E. Causes direct relaxation to arterioles, resulting in decreased peripheral resistance. 6\. Centrally acting alpha-2 stimulators F. Inhibits the conversion of angiotensin I to angiotensin II, thereby preventing the vasoconstrictive actions of angiotensin II. Prevents the release of aldosterone, which causes increased sodium and water reabsorption. 7\. Peripherally acting alpha-1 blockers G. Decreases reabsorption of water in the kidneys, resulting in decreased circulating volume and decreased peripheral resistance. 8\. Alpha-1 beta blockers H. Decreases heart rate, resulting in decreased cardiac output, and causes dilation of peripheral vessels resulting in decreased vascular resistance. 9\. Direct vasodilators I. Decreases the mechanical contraction of the heart by inhibiting the movement of calcium across cell membranes. Also dilates coronary vessels and peripheral arteries.

Fill in the blank: What is the rationale for not mixing phenytoin (Dilantin) with other medications?

Fill in the blanks: Explain the rationale for administering IV nitroglycerin. How would you respond to the family鈥檚 concerns about a potential overdose of nitroglycerin? Briefl y summarize the diff erence in pharmacokinetics between IV and sublingual nitroglycerin.
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