A nurse is obtaining vital signs for a client who has been taking propranolol. Which of the following findings should the nurse identify as an adverse effect of the medication?
Respiratory rate 24/min
Oral temperature 38.9° C (102° F)
Blood pressure 118/78 mm Hg
Apical pulse 50/min
The Correct Answer is D
Rationale:
A. A respiratory rate of 24/min is elevated and may suggest respiratory distress, but it is not a specific adverse effect of propranolol.
B. An oral temperature of 38.9° C (102° F) indicates fever, which is not a typical adverse effect of propranolol.
C. A blood pressure of 118/78 mm Hg is within normal limits and does not indicate an adverse effect of propranolol, which is often used to manage hypertension.
D. An apical pulse of 50/min indicates bradycardia, a known adverse effect of propranolol, which can occur due to its action on the heart rate.
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Correct Answer is E
Explanation
Rationale:
A. Mostly cloudy: This is an unclear statement. It is not related to a physical manifestation that would result from haloperidol overdose.
B. Constipation: Although haloperidol can cause constipation as a side effect, it is not the most urgent concern. Other manifestations are more immediately life-threatening.
C. Dry mouth: Dry mouth is a common side effect of antipsychotics, but it is not life-threatening and would not be the priority assessment in the case of a medication overdose.
D. Daytime drowsiness: Sedation is a known side effect of haloperidol, but it is not the priority in this scenario where an overdose occurred.
E. Muscle stiffness: Muscle stiffness may indicate extrapyramidal symptoms (EPS) or neuroleptic malignant syndrome (NMS), both of which are serious and potentially life-threatening side effects of haloperidol, especially in cases of overdose. Assessing for these symptoms is the priority.
Correct Answer is D
Explanation
Rationale:
A. Mostly cloudy: This option appears to be incorrectly stated. It does not pertain to a critical client assessment related to morphine administration.
B. Apical heart rate: Monitoring the heart rate is important, but respiratory depression is a more immediate and life-threatening concern with morphine administration, so it is not the first priority.
C. Blood pressure: Morphine can cause hypotension, but this is not as critical as respiratory depression, which must be assessed first in opioid administration.
D. Respiratory rate: The most critical assessment when administering morphine is the respiratory rate, as opioid medications like morphine can cause respiratory depression, which can be life-threatening if not addressed.
E. Level of consciousness: While important, changes in consciousness typically follow respiratory depression, so assessing the respiratory rate takes priority.