A client who is receiving magnesium sulfate has a urine output of 20 mL/hr. Which of the following medications should the nurse expect to administer?

Choice A reason: The extra letters after the name of the medication do not mean it is a stronger dose, but that it is a combination of two different medications. Metoprolol is a beta-blocker that lowers blood pressure and heart rate, while hydrochlorothiazide is a diuretic that reduces fluid retention and blood volume. The combination of these two medications may have a synergistic effect and lower blood pressure more effectively than either one alone.

Choice B reason: The client will have to do some things differently because it is not the same medication, but a combination of two medications. The client will have to monitor their blood pressure, weight, fluid intake, and electrolyte levels more closely, as the addition of hydrochlorothiazide may increase the risk of dehydration, hypotension, and hypokalemia. The client will also have to avoid alcohol, salt, and potassium supplements, as they may interact with the medication and affect its efficacy or safety.

Choice C reason: The client will still have to diet to lose weight, as the medication does not cause weight loss, but may cause weight gain due to fluid retention. The client will have to follow a healthy diet that is low in sodium, fat, and cholesterol, as these may worsen hypertension and increase the risk of cardiovascular complications. The client will also have to exercise regularly, as this may help lower blood pressure and improve overall health.

Choice D reason: The client may experience fewer side effects with the new medication, as the combination of metoprolol and hydrochlorothiazide may lower the dose and frequency of each medication, and reduce the adverse effects of each one. For example, metoprolol may cause fatigue, dizziness, or bradycardia, while hydrochlorothiazide may cause dry mouth, headache, or gout. The combination of these two medications may balance out these effects and improve the client's tolerance and compliance.

Choice A reason: Vitamin K is the antidote for warfarin, not heparin. Vitamin K reverses the effects of warfarin by increasing the synthesis of clotting factors in the liver.

Choice B reason: Glucagon is the antidote for insulin, not heparin. Glucagon increases the blood glucose level by stimulating the breakdown of glycogen in the liver.

Choice C reason: Protamine is the antidote for heparin, not vitamin K or glucagon. Protamine neutralizes the effects of heparin by binding to it and forming a stable complex.

Choice D reason: Iron is not an antidote for any anticoagulant. Iron is a mineral that is essential for the production of hemoglobin and red blood cells.