A nurse is talking with a client who has a new prescription for an ipratropium inhaler to treat exercise-induced bronchospasm.
Which of the following client statements should the nurse report to the provider?
“I hope this new medication won’t make my high blood pressure worse.”.
“I want to keep using my albuterol when I feel like I need it.”.
“I am allergic to atropine.”.
“I usually have a glass of red wine with dinner.”.
The Correct Answer is C
Choice A rationale
Ipratropium inhalers can potentially increase heart rate and blood pressure, but this is not a common side effect. The concern about high blood pressure is valid but not as critical as an allergy to atropine.
Choice B rationale
Using albuterol with ipratropium is common practice for managing bronchospasm. There is no contraindication for using both medications together.
Choice C rationale
An allergy to atropine is significant because ipratropium is chemically related to atropine. This could lead to a severe allergic reaction.
Choice D rationale
There are no known interactions between ipratropium and alcohol. However, it is always best to consult with a healthcare provider regarding alcohol consumption while on medication.
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Correct Answer is ["A","B","C"]
Explanation
Choice A rationale
Potassium level should be reviewed because captopril can cause hyperkalemia due to its effect on aldosterone secretion.
Choice B rationale
WBC with differential should be reviewed because captopril can cause neutropenia or agranulocytosis, especially in patients with renal impairment or collagen vascular disease.
Choice C rationale
BUN level should be reviewed because captopril can affect renal function, leading to increased BUN levels.
Choice D rationale
Hemoglobin level is not typically affected by captopril, so it is not a priority for review.
Choice E rationale
Glucose level is not typically affected by captopril, so it is not a priority for review.
Correct Answer is ["A","B","D","E"]
Explanation
Choice A rationale
Contacting the provider is essential to inform them of the error and receive further instructions on managing the client’s condition.
Choice B rationale
Reporting the error to the charge nurse is necessary for proper documentation and to ensure that corrective actions are taken to prevent future errors.
Choice C rationale
Incident reports should not be placed in the client’s chart. They are for internal use to improve safety and quality of care.
Choice D rationale
Auscultating the client’s lungs is important to check for signs of fluid overload, such as crackles or wheezing.
Choice E rationale
Checking for peripheral edema helps assess the extent of fluid overload and its impact on the client’s condition.