A nurse is assessing a client who has been taking sertraline (Zoloft) for 2 weeks. The nurse should identify which of the following findings as an indication that the medication is effective?
The client's blood pressure is within the expected reference range.
The client reports a recent weight gain.
The client reports an increase in mood.
The client's legs are not swollen.
The Correct Answer is C
A. While maintaining blood pressure within the expected range is important, it does not specifically indicate the effectiveness of sertraline, which is an antidepressant.
B. Weight gain can occur with some antidepressants, but it is not a direct indicator of their effectiveness.
C. An increase in mood is a primary goal of treatment with sertraline, and reporting this improvement suggests that the medication is having a positive effect.
D. The absence of swollen legs is not a relevant indicator for assessing the effectiveness of sertraline, as it does not relate to mood or depression symptoms.
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Correct Answer is B
Explanation
A. Bradycardia is not a common side effect of atorvastatin and would not necessarily require immediate reporting unless it is significantly low and symptomatic.
B. Dark-red urine could indicate the presence of myoglobinuria, which can occur due to rhabdomyolysis, a serious side effect of statins like atorvastatin that necessitates immediate medical attention.
C. Elevated HDL cholesterol is generally a positive finding and does not require reporting unless it is part of a larger adverse effect context.
D. A migraine headache, while concerning, is not a known side effect specifically associated with atorvastatin and may not require immediate intervention unless severe or persistent.
Correct Answer is C
Explanation
A. Glucose tablets are appropriate for clients with mild hypoglycemia who are alert and able to chew and swallow; they are not suitable for someone who is difficult to arouse.
B. Epinephrine is not used as a treatment for hypoglycemia; it does not directly increase blood glucose levels.
C. IVP (intravenous push) dextrose 50% is indicated for severe hypoglycemia in clients who are lethargic or unresponsive, as it rapidly increases blood glucose levels.
D. Orange juice is effective for mild hypoglycemia but is not appropriate in this case due to the client’s altered mental status and risk of aspiration.