RN Nursing · Heart Failure · Practice question
A 66-year-old client has been in the hospital for care and management of heart failure. There are orders for discharge and the nurse is reviewing discharge instructions with the client. Which of the following information would be included as part of discharge information for this client?
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The client should not increase the intake of sodium daily
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The client should take non-steroidal anti-inflammatory drugs (NSAIDs) for pain
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The client should restrict fluid intake to less than 4,000 mL per day
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The client should not have more than 3 alcoholic beverages per day
Answer & explanation
Correct: The client should not increase the intake of sodium daily
For a client with heart failure, restricting sodium intake is a cornerstone of management and discharge education. Excess sodium leads to fluid retention, which increases preload and worsens heart failure symptoms including edema and dyspnea. Informing the client not to increase daily sodium intake — typically advised to stay below 2,000 mg per day — is correct and appropriate discharge teaching. NSAIDs are contraindicated in heart failure because they cause sodium and water retention, reduce the effectiveness of diuretics and ACE inhibitors, and can precipitate acute kidney injury, all of which worsen heart failure. Fluid restriction for heart failure patients is typically limited to 1,500–2,000 mL per day, not 4,000 mL; a 4,000 mL limit would be far too permissive and would lead to fluid overload. Alcohol is a known cardiac depressant and should be avoided or minimized strictly — generally no more than one drink per day for women and two for men at most, and ideally avoided entirely in heart failure — so advising up to three drinks per day would be harmful. The correct discharge instruction is to maintain a sodium-restricted diet.
Study note
Heart Failure: A Nursing Overview
What heart failure is, how left-sided and right-sided failure differ, and the nursing priority that catches fluid overload earliest.
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