A nurse is providing discharge teaching about safety considerations to an older adult client who lives at home. The client has heart failure and a new prescription for hydrochlorothiazide. Which of the following statements by the client indicates an understanding of the teaching?
A.
“I will weigh myself once weekly.”
B.
“I will take my new medication in the evening.”
C.
“I will leave a light on in my bathroom at night.”
D.
“I will take a hot bath before going to bed.”
The Correct Answer and Explanation is:
The correct answer is:
C. “I will leave a light on in my bathroom at night.”
Explanation:
For an older adult client with heart failure who is prescribed hydrochlorothiazide, safety considerations are critical due to the potential side effects of the medication and the client’s condition. Let’s break down why option C is the best response and why the others are less appropriate:
- Option A: “I will weigh myself once weekly.”
- Explanation: Monitoring weight is crucial for clients with heart failure, but it should be done daily rather than weekly. Daily weight measurements help in early detection of fluid retention or worsening heart failure, which might not be noticeable on a weekly basis. Weekly monitoring could delay the recognition of symptoms such as fluid buildup, which can lead to complications.
- Option B: “I will take my new medication in the evening.”
- Explanation: Hydrochlorothiazide is a diuretic, and it is typically advised to take it in the morning. Taking it in the evening can lead to nocturia (frequent urination at night), which might disrupt sleep and potentially increase the risk of falls during nighttime bathroom trips. Hence, it is generally recommended to take such medications earlier in the day.
- Option C: “I will leave a light on in my bathroom at night.”
- Explanation: This statement indicates an understanding of safety measures to prevent falls, which is particularly important for older adults. Hydrochlorothiazide can cause dizziness and orthostatic hypotension (a drop in blood pressure when standing up), increasing the risk of falls. By leaving a light on in the bathroom, the client ensures better visibility, reducing the risk of accidents during nighttime trips to the bathroom.
- Option D: “I will take a hot bath before going to bed.”
- Explanation: Taking a hot bath before bed might not be advisable for clients on hydrochlorothiazide. Hot baths can exacerbate dizziness or hypotension, particularly if the client stands up quickly after the bath. This could further increase the risk of falls, which is a significant concern for older adults taking diuretics.
In summary, leaving a light on in the bathroom at night is a proactive safety measure that addresses the increased fall risk associated with both heart failure and the side effects of hydrochlorothiazide, making it the most appropriate response for ensuring the client’s safety.