A client with a long-standing diagnosis of angina has been prescribed nitroglycerin and diltiazem. In addition to monitoring the client's heart rate, the nurse should prioritize what assessment?
Blood pressure
Level of consciousness
Daily weights
Respiratory status
The Correct Answer is A
A. Blood pressure is correct because both nitroglycerin and diltiazem can cause vasodilation, leading to hypotension; thus, monitoring blood pressure is crucial for patient safety.
B. Level of consciousness is incorrect; while important, it is not the primary concern in this context.
C. Daily weights are incorrect; they are more relevant for assessing fluid status over time, not immediate drug effects.
D. Respiratory status is incorrect; while monitoring is important, blood pressure takes precedence due to the risk of hypotension associated with these medications.
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Correct Answer is B
Explanation
A. Performing a blood sugar analysis is important, but in the case of sudden symptoms such as weakness, shakiness, and dizziness, it is crucial to act quickly to address the potential hypoglycemia without delay.
B. Having the client drink a 4-ounce glass of orange juice is the most appropriate initial response as it provides a quick source of glucose to alleviate symptoms of hypoglycemia, which is a common concern in clients with type 1 diabetes experiencing these symptoms.
C. Administering 1 ampule of 50% dextrose intravenously is an effective treatment for hypoglycemia but is typically reserved for severe cases where the patient is unable to consume oral glucose or is unconscious.
D. Administering 10 units of regular insulin subcutaneously would exacerbate the problem by lowering blood sugar further and is contraindicated in a patient experiencing hypoglycemic symptoms.
Correct Answer is B
Explanation
A. Using combination therapy may be beneficial in some cases but is not the first step in ensuring the most appropriate drug is chosen for a specific pathogen.
B. Obtaining sensitivity testing is essential to determine the specific antibiotic to which the pathogen is susceptible, ensuring effective treatment.
C. Checking client allergies is important to prevent adverse reactions but does not directly address whether the chosen drug is appropriate for the pathogen.
D. Evaluating the bactericidal effects is part of assessing the treatment's effectiveness, but it should follow sensitivity testing to determine the correct medication.